S. Leonard Syme, the father of social epidemiology, dies at 92
Professor emeritus was beloved by the public health community as a trailblazer and mentor
- 6 min. read ▪ Published
S. Leonard Syme, who pushed the study of the psychosocial determinants of disease from the fringes to a central tenet of the field of public health, passed away of silent aspiration pneumonia on January 26, 2025, in Cabo San Lucas, Mexico. He was 92, having been born on July 4, 1932.
“Len was a true giant, the father of social epidemiology, and one of the most beloved teachers and mentors Berkeley Public Health has ever had,” said Michael C. Lu, dean of the UC Berkeley School of Public Health. “Few individuals have transformed public health as profoundly as Len. He pioneered the study of social determinants of health, which has fundamentally transformed medicine and public health and continues to shape research, practice, and public policy today in our nation and around the world.”
As a professor of epidemiology and community health—and prior to that, working for the National Institutes of Health and other federal agencies—he demonstrated the impact that such factors as poverty, stress, social class, and social isolation have on health. His research examined these psychosocial stressors on people around the world: bus drivers in San Francisco, civil servants in London, and Japanese men at home and abroad.
Syme served for more than 20 years as co-principal investigator at Berkeley Public Health’s Health Research for Action, where his team developed the model for grassroots, community based-interventions to prevent disease and promote health. This model has proven a highly effective, highly impactful vehicle to deliver medical information to underserved populations.
“Len was deeply committed to not only pioneering work in figuring out the underlying determinants of health. but also to putting theory into action with deep community involvement in finding solutions, which he did through the school’s Health Research for Action center with highly successful projects over 30 years,” said UC Berkeley Professor Linda Neuhauser.
Along the way, Syme was elected to the National Academy of Sciences and won many coveted awards for his research and teaching, among them the Wade Hampton Frost Leadership Award—one of the most prestigious awards in the field of epidemiology—from the American Public Health Association, for developing the study of social epidemiology. He also received the Berkeley Citation for distinguished service to the university and was given the Panunzio Prize as Outstanding Emeritus Professor in the statewide university system.
Syme’s drive to examine the psychosocial factors that compromise one’s ability to stay healthy—rather than following the traditional medical model to study the etiology of individual diseases—has become such a mainstay of public health thinking that it’s hard to remember that it was, during the 1960s and much of the 1970s, heresy.
“It was the fringe of the fringe,” said Sir Michael Marmot, director of the Institute of Health Equity at University College London, who came to Berkeley to study with Syme in the mid-1970s. “Epidemiology was the fringe part of medicine, and social epidemiology was the fringe part of epidemiology. Len made respectable the idea that social and psychosocial influences on diseases—cardiovascular disease in particular—could be important. It was with scientific rigor, which made it respectable.”
A tough boyhood in Canada to a PhD from Yale
It was an unusual journey for a boy who spent an uneasy childhood in Winnipeg, Canada, then a small, dreary city in the Canadian prairie. In his 2011 autobiography, Memoir of a Useless Boy, Syme described surviving tough threats from inside and outside his home, which provided challenges but also gave him empathy for people facing obstacles and a conviction about the protective powers of strong social ties and, above all, hope.
Syme was the first in his family to attend college, starting at a local school and then transferring to the University of Manitoba in 1949. It was a small school, but nearly the entire faculty were Oxford or Cambridge–trained teachers, working in Canada until the post-war job market opened up back home. He received his bachelors and masters degree from UCLA in 1955 and then landed at Yale, where he earned a PhD in what was then called the sociology of medicine.
Syme’s early research at NIH, examining the psychosocial causes of heart disease, was scoffed at by the established medical community. When he presented his theory on the influence of social factors on health to an American Heart Association meeting, Syme was chastised.
“One man took me aside and said, ‘Don’t ever do that again,”’ he recalled in an interview in 2023. “He told me to stick with the things we already know about: high serum cholesterol, cigarette smoking, high blood pressure.”
He didn’t listen.
As the decades went by, and Syme completed more ground-breaking studies, the Public Health establishment slowly began to embrace his perspectives, began to adopt his new approach, and eventually even began to celebrate his contributions. It was a long road, but changed the direction of public health forever.
In a message to UC Berkeley School of Public Health, Syme’s daughter, Karen Englund, wrote that the beloved researcher had enjoyed the holidays in Mexico surrounded by family, directly before he died.
“His days were full of good food, football, stories, warmth, and laughter,” Englund wrote. “He loved waking up everyday to a different sunrise and then ending each day with a gorgeous sunset over the ocean.”
“He wanted me to share that he felt at peace with his life,” she added. “He told me, ‘It’s a good feeling to have reached 92 with no regrets!’”
Syme was grateful, Englund wrote, that he was able to accomplish what he set out to do in his life.
Syme is survived by three children: Karen Englund (husband Steve Englund), of Cabo San Lucas, Mexico, David Syme of Orinda, and Janet Syme Piller (husband Greg Piller) of Herndon, VA; and four grandchildren Chris Piller (wife Mairead Horton) of Chicago, Nolan Englund (partner Jordan Ellison) of Los Angeles, Melanie Piller (wife Catherine Weathered) of Portland, OR, and Jenna Englund of Cabo San Lucas, Mexico. His wife, Marilyn, predeceased him in December 2006.