- Michael McGinnis
James Michael McGinnis (12 July 1944 – ) is a physician, public servant, and long-time contributor to national and international health policy leadership, serving through four Administrations (Carter, Reagan, Bush, Clinton) as a key focal point for policy coordination and initiatives in disease prevention and health promotion. Currently, he is Senior Scholar at the Institute of Medicine, as well as Executive Director of its Roundtable on Value & Science-Driven Health Care.
Born in Columbia, Missouri in 1944, McGinnis moved to California in 1949 when his father was sent by the A.B. Chance Company (later Emerson Electric) to help open a west coast office. He attended public schools for K-12 in San Mateo, but from ages 9 to 17, his summers were spent back in Missouri, working on his maternal grandfather’s corn, wheat and soy bean farm in central Missouri. Active in student government from an early age, he continued those interests as a pre-med undergraduate at the University of California at Berkeley, serving as the president of his graduating class.
Education and professional training
During his undergraduate years at U.C. Berkeley, he created the Cal in the Capital internship program, which sends Berkeley students to Washington D.C. every summer to work in Congress, federal agencies, think tanks, and voluntary organizations. This competitive program still thrives 40 years later, sending over sixty students to D.C. every summer. McGinnis graduated from Berkeley in 1966 with a B.A. in Political Science then attended UCLA, receiving both an M.A. in political science and an M.D. in 1971. He later went on to study public policy at the Kennedy School at Harvard University, receiving an M.P.P. in 1977. He was student speaker for all three of his university graduating classes: Berkeley, UCLA Medical, and the Kennedy School at Harvard. After an internship in internal medicine at the Boston City Hospital, McGinnis completed a residency in preventive medicine while serving in the U.S. Public Health Service as an international medical officer.
McGinnis began medical school with an interest in international health, which led to his focus on the international relations track of the Master’s work in political science he completed along with his M.D. As part of this work, he spent time in residence at the World Health Organization offices in Lausanne and Geneva, conducting research on the diplomatic dynamics at the formation of the organization and the role it played in marshaling the engagement of program support from sometimes rival countries. When the time came for McGinnis to serve his military obligation, he joined the U.S. Public Health Service in 1972 as an International Medical Officer, serving as Coordinator for U.S.-Eastern European health programs. In 1974, he volunteered for service in the World Health Organization’s smallpox eradication program in India. Working initially as a field epidemiologist tracking and containing reported cases, McGinnis then assumed responsibility as WHO’s State Coordinator for the eradication program in Uttar Pradesh, India’s largest state, serving there through the completion of the eradication effort and implementing the surveillance system that was adopted for the maintenance phase of the program.
Returning to the United States after the end of smallpox, McGinnis shifted his focus for the next two decades on domestic health policy (see below), but in 1995 to 1996, again at the request of the World Health Organization, he became chair of the World Bank/European Commission Sectoral Task Force on Health and Human Services in Bosnia. This was one of several task forces established to manage the support for postwar reconstruction of health facilities and health services in the war-torn region. Under McGinnis’ leadership the Task Force developed the first bilateral agreement outside of the Dayton Accords—aimed at forging consensus on reconstruction priorities by the health ministries of both the Republica Srpska and Bosnia & Herzegovina.
Healthy People and other U.S. Health Policy Contributions
In 1977, McGinnis was a Fellow at Harvard Medical School’s Center for Community Health and Medical Care when he accepted an offer from the newly appointed Secretary of Health Education and Welfare Joseph Califano to return to Washington to work in the Carter Administration. He was appointed Deputy Assistant Secretary for Health in the U.S. Department of Health, Education and Welfare (now Department of Health and Human Services), and served through four Administrations—those of Presidents Jimmy Carter, Ronald Reagan, George H. W. Bush, and William J. Clinton—in that post, as well as Assistant Surgeon General and Director of the U.S. Office of Disease Prevention. During this period, McGinnis chaired the Secretary’s Task Force on Smoking and Health, led the development of Healthy People, the nation's prevention agenda, and the creation of the U.S. Preventive Services Task Force, a body formed in 1984 to develop a systematic and comprehensive assessment of the evidence on the effectiveness of clinical preventive services, and served to pioneer the broader advance of evidence-based medicine.
Healthy People is the most widely known of McGinnis’ contributions. Developed when he was serving in 1978-1979 as Chair of the Secretary’s Task Force on Disease Prevention and Health Promotion for HEW Secretary Joseph Califano and Surgeon General Julius Richmond, it began as an effort to develop a Surgeon General’s report to serve as a U.S. answer to the report A New Perspective on the Health of Canadians, released in 1974 by Canadian Minister of Health Marc Lalonde. McGinnis felt the U.S. report could do more than merely marshal the scientific evidence supporting the importance of a stronger focus on prevention. Drawing from the successful India smallpox eradication experience using quantified targets to drive focus, orient monitoring, and shift resources, he embedded measurable decade-long goals for reducing death rates by 1990 for Americans at each of the major life stages: reducing infant mortality by 35% by 1990, children by 20%, adolescents and young adults by 20%, and adults by 25%. For older adults, the goal was to reduce the average number of sick days by 20% over the decade. He also began at that time, a parallel effort involving each of the agencies of the U.S. Public Health Service (National Institutes of Health, Centers for Disease Control, Food and Drug Administration, Indian Health Service, Health Resources and Services Administration, and Alcohol, Drug Abuse, and Mental Health Administration), in cooperative work with non-governmental experts from around the country to develop measurable 1990 objectives in 15 priority areas grouped as health promotion, health protection, and clinical preventive services. These objectives targeted improvements on issues such as tobacco use, child passenger restraints, environmental quality, and high blood pressure control, deemed necessary to achieve the national goals. The life stage goals were released in 1979 in Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention and the objectives were released in 1980 in Promoting Health/Preventing Disease: Objectives for the Nation. Work then began through a national Healthy People Consortium to engage states, major cities, and voluntary national organizations in efforts to adopt and tailor the national Healthy People objectives to their own needs and priorities. When the 1990 results came in, they were on or close to the goal in each case: a 35% reduction in infant mortality, a 25% reduction in child deaths, a 12% reduction for adolescents and young adult deaths, a 25% lower adult death rate, and 17% fewer days of disability for older adults. The process has continued with national goals and objectives being reviewed and revised in Healthy People 2000, Healthy People 2010, and Healthy People 2020. A number of other countries have since developed similar efforts, and related work in the U.S. has also turned to development of a high priority set of national Leading Health Indicators, the pilot work group for which was chaired by McGinnis as part of the Healthy People 2010 process.
Other programs and policies launched at his initiative include: the first HHS/USDA Dietary Guidelines for Americans, now in its seventh edition; the first Surgeon General's Report on Nutrition and Health (1988); and the work of the Public Health Functions Steering Committee to develop the 10 Essential Services of Public Health. The latter initiative was an outgrowth of the town hall meetings he co-hosted with the health commissioners in each of the 50 state capitals during 1994 for public discussions on the importance of public health as a component of health reform. McGinnis also initiated: the National Coordinating Committee on Worksite Health Promotion (1979–1987) to catalyze employer commitment to healthier workforces; the National Coordinating Committee on School Health (co-chaired by HHS, the Department of Education and USDA); and the Panel on Cost Effectiveness in Health and Medicine that in 1995 developed guidelines for the conduct of economic analyses of the returns to health investments. The contributions for which McGinnis is perhaps best personally known are the JAMA paper, "Actual Causes of Death" co-authored with William Foege, which focused attention on the root causes of the nation’s leading killers and cripplers and underscored the preventability of many of the nation’s leading health threats, and the Health Affairs paper “The Case for More Active Policy Attention to Health Promotion” co-authored with Pamela Russo and James Knickman.
From 1999 to 2005, McGinnis served as Senior Vice President and founding Director of the Health Group, and as Counselor to the President at the Robert Wood Johnson Foundation (RWJF). At RWJF, his charge was to build the Foundation’s contribution to the development of national leadership and capacity for a stronger focus on population health—in effect to help build the field of population health. Hallmarks of this work include the launch of the RWJF Active Living family of programs, the Health & Society Scholars Program, and the Young Epidemiology Scholars Program. The Active Living Programs represented a major national initiative focused on design, engineering, and policy strategies to build physical activity back into peoples’ living and working environments. The RWJF Health & Society Scholars Program was created to train a generation of extraordinary interdisciplinary scientific and policy experts to lead understanding and action at the interfaces of the domains determining health prospects—genetics, social circumstances, physical environments, behavioral choices, and medical care. To encourage interest in public health early the training of the nation’s best and brightest students, McGinnis launched the RWJF Young Epidemiology Scholars Program which is a competitive regional and national program to engage high school students in innovative project work in epidemiology—the basic science of public health.
Voluntary service and recognitions
McGinnis has served on various national committees and boards, including the National Academies IOM Committee on Children's Food Marketing (chair), the NIH State-of-the-Science Conference on Multivitamins in Chronic Disease Prevention (chair), and the Health Professionals Roundtable on Preventive Services (chair), the National Governors Association Commission on Childhood Obesity (co-chair), the Board of Directors of the Nemours Foundation, and the Partnership for Prevention (chair, policy committee). He previously served on the NAS Board on Agriculture, Health and the Environment; the NAS Food and Nutrition Board; the Institute of Medicine’s Roundtable on Health and the Environment; the HHS Nutrition Policy Board (chair); the HHS Working Group on Leading Health Indicators (chair); the HHS Task Force on Health Risk Assessment (chair); the National Coordinating Committee on Clinical Preventive Services (chair); and the Armed Forces Epidemiological Board. McGinnis is an elected member of the Institute of Medicine of the National Academies, Fellow of the American College of Epidemiology and Fellow of the American College of Preventive Medicine. McGinnis recognitions for his contributions to society include the Wilbur Cohen Award, the Porter Prize, the National Health Leader of the Year Award, and the Distinguished Service Medal of the U.S. Public Health Service.
- Institute of Medicine Roundtable on Evidence Based Medicine
- Learning What Works Best
- Papers published (PubMed)
- Department of Health and Human Services
- National Institutes of Health
- RWJF Young Epidemiology Scholars Program
- The National Academies
- U.S. Preventative Task Force
- Food Marketing to Children and Youth: Threat or Opportunity?
- Powerpoint: Food Marketing to Children and Youth: Threat or Opportunity?
- Promoting Health Preventing Disease; Objectives for the Nation
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