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A Pioneer in Public Health, Elizabeth Barrett-Connor Dies at 84

Her Rancho Bernardo Study, now in its 47th year, both broadened and deepened understanding at the intersection of medicine, research and human health.

Epidemiologist, researcher and public health pioneer, Elizabeth Barrett-Connor, MD, transformed public understanding of the wellbeing of middle-aged men and women. The Distinguished Professor in the Department of Family Medicine and Public Health at University of California San Diego School of Medicine died Sunday after a long illness. She was 84.

A self-described “pathological optimist,” Barrett-Connor was as deeply loved as she was fiercely regarded. Her immense portfolio of internationally acclaimed research offered a continuous challenge to traditional methods for examining global populations, and together set a new precedent for the study of human health in groups.

For example, it was Barrett-Connor who, long before it became conventional wisdom, advocated examining the whole person – their minds, bodies, even their social ties – and evaluating these factors with the same scrutiny as disease itself. Because of the questions she insisted on asking, the global conversation about what creates good health and happiness is today deeper, richer and more intricately understood.

Elizabeth Louise Barrett was born April 8, 1935 in Evanston, Ill, the only child of Florence (nee Hershey) and Willard Barrett. Willard Barrett, who earned a PhD in chemistry from Cornell and worked for ammunitions companies during World War II, later moved the family to Lee, Mass., where they settled. Barrett-Cohen’s childhood was rich with family visits, travel and long days spent outdoors, often listening to classical music or riding horses.

After graduation from Northfield Preparatory School, Barrett-Connor earned a degree in zoology from Mount Holyoke College. She intended to go on to nursing school but while boarding the train to take her to her nursing entrance exams, she encountered a friend who suggested nursing school was a poor choice given how terrible Barrett-Connor was at taking orders from others.

That off-the-cuff comment gave Barrett-Connor enough courage to scuttle her plans and instead become a doctor. She earned her medical degree from Cornell University in 1960.

Barrett-Connor completed both internship and residency in internal medicine at the University of Texas Southwestern Medical School in 1963, followed by a year studying infectious disease at the University of Miami. At a dinner one evening, she was introduced to James Connor, a Miami professor and specialist in pediatric infectious disease.

“I met her, and this long honeymoon began,” James Connor said. “We had a meeting of the minds.”

James Connor asked her to marry him some months later, standing on a bridge at Mount Holyoke. It would be a long engagement. Barrett-Connor was soon accepted for a National Institutes of Health postdoctoral fellowship at the London School of Hygiene and Tropical Medicine.

She wrote James Connor every day. In 1965, she received her diploma in Clinical Medicine of the Tropics; then was married at the Church of Scotland in London.

After the wedding, James Connor was offered the job as head of the Division of Pediatric Infectious Disease at the newly-formed UC San Diego School of Medicine.

He accepted the position on the condition that the university offer a job to his wife, who was offered an assistant professorship in community medicine. It was a departure from her training, but she jumped in nevertheless.

Slight and light-haired with an easy smile, Barrett-Connor was a fixture and force on campus for nearly half a century. Her inquiries focused on the intersections of medicine, research and human health. Never willing to be constrained by department, discipline or genre, she earned an international reputation as a thinker willing to explore not just pertinent topics like hormones, obesity and cancer, but how and when they each overlapped and interplayed in the complicated web of life.

“Dr. Barrett-Connor was truly inspiring,” said Dr. Cheryl Anderson, interim chair of Family Medicine and Public Health at UC San Diego and a close friend of the Connor family. “Her contribution to the field of women's health and to cardiovascular epidemiology were profoundly impactful and will be taken forward. Her remarkable accomplishments included meaningfully changing our understanding of heart disease in women.”

Just two years after arriving in San Diego, Barrett-Connor launched what would be the defining project of her career: The Rancho Bernardo Study. Initially conceived to investigate the population prevalence of hyperlipidemia (high cholesterol) and its connection to heart disease, the study dramatically expanded under Barrett-Connor’s leadership. She identified a cohort of middle-aged men and women within the community, and began tracking additional factors, including lifestyle, well-being and risk of cardiovascular disease.

Among the many notable achievements of the study was the first evidence that women have more clustered risk factors than men, that fasting glucose is a heart disease risk factor, that in terms of osteoporosis and bone health, low dietary calcium predicts future hip fractures, and that osteoporosis is an overlooked health issue in men as well as women.

Four decades later, the study is on-going, producing invaluable longitudinal data related to population health and gender disparity across a slew of diseases. It has altered the field of epidemiology and informed nearly all modern methods for the investigation of the biology of human groups.

“She was always seeking knowledge. There was always another question. And there was always another answer,” said her daughter, Caroline Connor, a nurse practitioner in obstetrics and gynecology at UC San Diego Health.

As mother and wife, Barrett-Connor was a study in balance. Despite a heavy clinical load and extensive research commitments, she strived to cook dinner for her three children every night. Weekends and summer holidays saw the Connor family piling into their station wagon and heading to Lake Tahoe or Baja, CA, where they camped, fished and reveled in the great outdoors.

In both her home and professional life, Barrett-Connor epitomized the role of working mother at a time when the ideals of “leaning in” and “having it all” were only beginning to enter society’s consciousness.

“We were enablers to each other,” said James Connor, Emeritus Professor in Pediatrics at UC San Diego. “Every time she had a chance, she would enable me. And every time I had a chance, I would enable her.”

Among Barrett-Connor’s numerous awards and honors: the 2018 Fred Conrad Koch Lifetime Achievement Award for her contributions in endocrine physiology and the role of hormones in disease pathogenesis in cardiovascular disease, diabetes, osteoporosis and breast cancer; the 2013 Women in Epidemiology, Epidemiology and Prevention Mentoring Award; the 2012 Endocrine Society Mentoring Award; the 2009 Osteoporosis Foundation Living Legacy Award; and the 1998 NIH Award for Outstanding Work in Gender Differences in Osteoporosis. Her reach in training the next generation of scientists extended internationally. For just over a decade she served as a faculty member for both the US Ten Day Seminar and the International Ten Day Seminar on the Epidemiology and Prevention of Cardiovascular Diseases.

She was a member of the Institute of Medicine (IOM), Master of the American College of Physicians (ACP) and author of more than 900 publications.

Barrett-Connor is survived by her husband James, her 3 children Jonathan, Caroline and Steven, and her two step children, Dave and Susan and eight grandchildren. In lieu of flowers, the family requests donations to the Rancho Bernardo Foundation.

David A. Brenner Vice Chancellor for Health Sciences Steven R. Garfin Interim Dean, School of Medicine