Natan ‘Nikolai’ Abramovich Vigdorchik (1874–1954): social activism and public health in early 20th-century Russia

摘要

Virtually unknown in the West, the physician Nikolai Vigdorchik is recognized in Russian-Soviet history for his role in introducing social security into Russia. He rose from Jewish working-class origins to a career that combined activism in labour rights and public health with extensive and path-breaking publications in social security, occupational safety and public health. He contributed more than 30 years of leadership to Soviet research and educational institutions devoted to occupational safety and health. Vigdorchik's 1935 publication on lead and hypertension is illustrative of his contribution to modern epidemiological methods, describing a statistical bias in the study of hospitalized patients. It predates by 11 years Joseph Berkson's paper, after whom the bias is named. Vigdorchik's life illustrates a modern-day conundrum: social activism comes with political cost – by virtue of its evidence-based orientation, public health science is safer but both are necessary to move a culture towards health and stability. nnA cornerstone of effective public health activities, the discipline of epidemiology as ‘a systematized body of principles by which to design and evaluate’ population-based observational studies dates ostensibly from the end of World War II.1 A significant contribution to this beginning occurred in 1946 when Joseph Berkson published a paper describing a bias in statistical studies of hospitalized patients.2 Originally, he presented the problem at an American Statistical Association meeting in 1938. The 1946 paper does not provide any references but gives hospital data without population data. Not until the late 1970s did population-based evidence appear, demonstrating that this bias exists in reality.3 It is named Berkson's Bias