Tony McMichael was an outstanding epidemiologist whose research progressed from classic studies of individual risk factors, especially among industrial workers, through to the global determinants of health and disease, and in particular man-made climate change.
Born in Adelaide, South Australia, to David Clunie McMichael, an architect, and Catherine Marion McMichael née Padman, a homemaker, Tony studied at St Peter’s College, an Anglican boys’ school. He qualified in medicine at the University of Adelaide, but even as a medical student he looked beyond Australia to understand the diversity of health in settings very different from those in which he had grown up. The stark inequalities in this world were made clear to him during his stay in a leper colony in India. Shortly afterwards he spent time in Papua New Guinea, where he met Judith Healy, whom he would marry in 1967. Following in the tradition of Rudolf Virchow, he understood the political determinants of health and he took a year out to become president of the National Union of Students. 1968 was an exceptional time to be a student leader and the personal connections that he made then proved valuable throughout his life.
Tony worked briefly in general practice before enrolling as the first PhD student in epidemiology at Monash University in Melbourne. There he became acquainted with the work of René Dubos, a microbiologist turned ecologist and thought leader, leading to a period of postdoctoral research at the University of North Carolina at Chapel Hill. While there, he undertook seminal research on occupational health, demonstrating the importance of the ‘healthy worker effect’, whereby those exposed to occupational hazards often had better health outcomes than the general population, because their initial better health either encouraged them to select certain occupations or made them more attractive to employers.
Following his return to Australia, his career progressed and he was appointed to the foundation chair of occupational and environmental health at the University of Adelaide in 1986. He consolidated his reputation as an outstanding epidemiologist, undertaking seminal work on a wide range of topics. Notable among his contributions was the first study to confirm that exposure to lead, common in water pipes, damage to children’s neurological development. He demonstrated his ability to think outside the box when it came to obtaining data, collecting not just the usual blood samples but also the baby teeth of children living near a lead smelter, taking on the unusual role for an epidemiologist of the tooth fairy. By obtaining a much more precise estimate of the cumulative exposure of children, he was able to show that it was not just the proximity to the smelter that was important, but also the concentration of lead in house dust and soil. Another major contribution was one of the first studies to show a link between passive smoking and disease, paving the way for the smoking bans that are now taken for granted in many countries.
These contributions alone would be sufficient to place him among the world’s leading epidemiologists. However, it is probably his later work for which he will be best remembered. He coined the term ‘planetary overload’, arguing that the Earth was no longer able to sustain an expanding population that seemed determined to consume its natural resources and degrade its environment. The challenge for epidemiologists was to provide the empirical evidence of the harm being caused by humanity to its home on Earth. Tony developed innovative models of the global ecosystem, established new methods to study it and identified ever more diverse sources of data. In this way, he was able to show links between climate change and changes such as increased heat stress in older people and in the distribution of insect vectors of disease.
In the early 1990 he moved to the United Kingdom to become professor of epidemiology at the London School of Hygiene and Tropical Medicine, becoming chair of the committee assessing health risks for the United Nations’ Intergovernmental Panel on Climate Change. He was very proud to be included among the many recipients when that organisation was awarded the 2007 Nobel Peace Prize.
In 2001 he returned to Australia, to take over as head of the National Centre for Epidemiology and Population Health, where he greatly expanded understanding of the complex relationship between climate and infectious disease. This work was extremely influential with the World Health Organization, leading to the creation of a research programme on climatic, environmental, agricultural and nutritional influences on infectious diseases, which he then chaired. This played to his strengths; he was a true polymath and, on occasion, was known to distribute not name cards but wide-ranging and eclectic topics for conversation at the dinner parties he and Judith hosted.
Throughout his life, Tony was a tireless advocate for social justice and healthy public policy. Shortly before his untimely death he was the lead author of an open letter to the Australian Prime Minister calling for action on climate change and health at the forthcoming G20 meeting. Given the strength of opposition to such action from the climate change deniers, he was amused to be accused of being both a fascist and a socialist, albeit by different people.
Tony McMichael’s work was recognised in many ways, including the award of the Order of Australia, the John Goldsmith award for outstanding contributions to environmental epidemiology, and election to the UK Academy of Medical Sciences and the US National Academy of Sciences. In his spare time he was a talented pianist. He died of septicaemia associated with renal failure, a condition for which he had earlier received a successful transplant from Judith. He is survived by Judith, an eminent health policy researcher at the Australian National University, and by his two daughters, Celia and Anna.
Martin McKee
[The Lancet 2014 384 (9953) 1498 www.download.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61913-9/fulltext – accessed 18 June 2015; The Guardian 13 October 2014 www.theguardian.com/society/2014/oct/13/tony-mcmichael – accessed 18 June 2015; BMJ 2014 349 6673 www.bmj.com/content/349/bmj.g6397 – accessed 18 June 2015; Med J Aust 2014 201(9) 552 www.mja.com.au/journal/2014/201/9/anthony-j-mcmichael-ao-mb-bs-phd – accessed 18 June 2015; London School of Hygiene and Tropical Medicine Alumni blog Obituary: Professor Tony McMichael http://blogs.lshtm.ac.uk/alumni/2014/10/03/obituary-professor-tony-mcmichael/ – accessed 18 June 2015; Australian Academy of Science Obituary: Tony McMichael www.science.org.au/publications/newsletter-dec14/obituary-tony-mcmichael]