Dean Ken Warner: Real World Player

Dean Ken Warner: Real World Player

Ken Warner, who took the reins of the University of Michigan School of Public Health on July 1, is not your typical ivory-tower academic.

One of the world’s most distinguished tobacco policy researchers, he is himself an ex-smoker who sympathizes with those who haven’t been able to quit. A key figure in the successes of the tobacco-control movement, he freely admits that he basically stumbled into the field and, for that matter, into public health itself.

Warner was working on his PhD in economics at Yale when his 21-year-old sister, and only sibling, lost her four-year battle with a rare form of cancer.

“Out of a sense of impotence, I decided to write a dissertation related to cancer,” he says. He ended up analyzing the diffusion of leukemia chemotherapies “with the notion that I was looking at a technical change process in a quasi-market setting. That’s how I justified it as an economics dissertation.”

In 1972, with his dissertation still two years from completion, Warner interviewed at Michigan for a joint appointment in economics and public policy.

His job talk—his first attempt to describe the ongoing work—was “an unmitigated disaster, probably the worst talk I ever gave,” Warner recalls. “It was clear to me, when the chair walked me out of the room, that I was not going to get an offer in economics.”

But luck was on his side. The director of the university’s Institute of Public Policy Studies, now the Ford School of Public Policy, was a close colleague of Warner’s dissertation adviser, who had spoken highly of him. “The director of the institute asked if he could look for another half-time appointment for me, essentially a tenure home, since he didn’t then have the ability to make full-time appointments,” Warner says. “There was an opening in the School of Public Health for a health economist. I came back for another interview and was offered the job.”

Although he didn’t realize it at the time, it was the job of his dreams.

“I knew nothing about public health,” he admits, “but I took it because it was the University of Michigan and I wanted to be here. I assumed that this was a way station, that I would spend a couple of years here finishing my dissertation, then move over to the economics department.”

By the time Warner finished his dissertation two years later, he says, “I had fallen in love with the field and this school. I had glimpsed what has become the defining feature to me of why it’s such a privilege to be a faculty member in this school: you have all the freedom and pleasure of being a university professor, yet what you’re working on matters.”

Warner soon became friends with another young economist in the Institute of Public Policy Studies, Paul Courant. “I’m one of the few people in the world who used to bum cigarettes from Ken Warner,” says Courant, who served as provost of the University of Michigan from 2002–05 and was one of those who urged the reluctant Warner to become a candidate for dean last spring. “We were just kids together then, learning how to be college professors.”

Last year, Warner chaired the search committee to find a successor to SPH Dean Noreen Clark, in part because he didn’t wish to be a candidate himself. “I wanted to carry out the search and get a good dean from the candidates we had,” he says. “But when that didn’t work out, and they approached me, I thought, ‘I love this school. This place has given me a fantastic career and life. If I could be helpful in this capacity, then what the heck, I ought to do it.’” He emphasizes that without the “truly fabulous” team of associate deans and department chairs who work with him, the job would have had far less appeal.

Becoming involved in tobacco policy was also unexpected: Warner was spending the 1975–76 academic year at the National Bureau of Economic Research at Stanford, studying changes in the utilization of surgical procedures before and after Medicare and Medicaid, when he saw a couple of seemingly contradictory newspaper articles about the effectiveness of the anti-smoking campaign since the 1964 Surgeon General’s Report. While both relied on data, one article suggested the campaign was proving successful. The other, noting that cigarette consumption had not declined substantially since 1964, implied that it was a dismal failure.

“Something was wrong, something wasn’t making sense,” says Warner, who was interested in part because he had recently quit smoking. “Then I heard a seminar on changes in motor-vehicle accident rates associated with new automotive safety measures, and I had one of those ‘aha’ moments—the thinking that underlay that study suggested a way I could address the question of what had really happened with smoking.”

The proper way to evaluate the effectiveness of efforts to reduce smoking, he concluded, was not to compare cigarette smoking in 1975 with cigarette smoking in 1964. The right question to ask was what cigarette consumption would have been in 1975 had it not been for the anti-smoking campaign.

“I performed a regression analysis that projected cigarette consumption as it would have been in 1975 in the absence of the campaign, given the trends beforehand, and concluded that smoking would have risen through the 1970s and would have been about 25 percent higher than it actually was in 1975,” he says. “That finding implied that the public health campaign had made a big difference.”

Making a difference has been the common denominator in all his work, and tobacco control was the arena where his goals and expertise converged. And it is, indeed, an arena.

“It brings absolutely all the elements together,” Warner says. “It’s a fascinating mixture of economics, politics, sociology, psychology, physical science, marketing, ethics—it’s got it all. The thing that’s kept me coming back is the diversity of intellectual challenges embedded in grappling with this seemingly simple device—the cigarette. That and the real-world importance of doing so.”

In addition to his research, Warner wrestles with those challenges in multiple ways. Like testifying before the U.S. Senate and House of Representatives, serving as the World Bank’s representative to the negotiations that led to the World Health Organization’s historic international treaty on tobacco control, and being a founding member of the board of directors of the American Legacy Foundation, the organization responsible for the “truth®” anti-smoking campaign aimed at kids.

Dr. Judith Mackay, senior policy advisor on tobacco at WHO and director of the Asian Consultancy on Tobacco Control, called Warner’s input during the treaty negotiations “vital. The principal concern of member states, especially developing countries, was economic. Dr. Warner’s towering and authoritative presence put their minds at rest.”

But before all that, there was the time back in 1981 when then-Senator Jesse Helms, from the tobacco state of North Carolina, tried to get Warner’s federal research funding cut off.

Helms wrote a four-page letter to then-new Secretary of Health and Human Services Richard Schweiker, asking him to “take a look” at a study funded by the National Center for Health Services Research that Warner was directing.

Describing it as “fairly typical of how HHS has been wasting money to formulate questionable public policy,” Helms fumed that the study “turns the congressional policy of informing people on its head, and is designed to develop techniques to implement a policy of behavior control.” He cited “the apparent inability of its director, Professor Kenneth E. Warner, to entertain any suggestion that the question of smoking and disease is still a question. His attitude is that the case is closed, a verdict of guilty has been rendered, and the only unresolved issue is the method of punishment.”

Warner—who keeps a framed copy of Helms’s letter in his office—found out what was going on when he called his project officer to ask for an extension of the grant as well as some supplemental funding. “He laughed out loud and said, ‘Do you know what’s happened?’” Warner recalls. “Then he told me about this letter. Apparently it was the first time they ever received something like this at the National Center.”

Warner got both the extension and the supplement, but he also got the HHS assistant secretary of health as an editor —a move deemed necessary because the final report was being sent to Helms. “There were at least a couple of dozen blue pencil marks on every page of my final report,” he says. “For example, whenever I would say ‘smoking is addictive,’ he made it ‘smoking is alleged to be addictive.’ I was sufficiently young and intimidated at the time to go along with what he wanted. I would never do that now. It’s one of the few things in my career that I really regret.”

Public health, Warner says, “is an inherently political field. If we have often been saved by our science, we have equally often been let down by the people who determine what science is permitted to flourish, and what is suppressed. By itself, science rarely solves an important public health problem. But excellent science, supported by excellent politics, can and does make a difference. We need to educate our students to work effectively in both arenas.”

Given the serendipitous events that have shaped his own life and career, Warner is well aware that setting a substantive agenda for his term as dean is, at best, an iffy proposition. His predecessor’s experience makes the point. “When Noreen Clark assumed the deanship ten years ago,” he says, “who would have thought that terrorism would have had such a defining role in the public health of the first decade of the 21st century?”

Having said that, one theme does stand out. “I want to see us do something more visible and substantial in the area of global public health,” Warner says. “We have many faculty who are engaged in global public health work, but I don’t think the school has received the recognition it deserves for the contribution it’s making. I want to figure out how to make it clear that we’re making that contribution and also how to make that contribution more substantial. The wealthiest countries have really let down the rest of the world,” he adds. “Achieving health gains—major health gains—in poor nations is quite inexpensive, but we haven’t committed the financial resources, and we certainly haven’t committed the political and organizational resources, to solve those problems. I would love to see our school help provide the intellectual guidance in determining how to diminish this avoidable burden.”

Another of Warner’s goals is to harness resources in the school to assist both the public and decision-makers in understanding the relative importance of different risks to health and in allocating societal resources accordingly. He points to his own field as an example of the public’s capacity to distort risks. Two decades ago, a national survey found that people thought it was more important to install smoke detectors in their homes than to quit smoking, even though cigarette-smoking kills nearly hundred times as many people as fires. What’s more, Warner notes, “cigarette-ignited fires are the leading cause of burn deaths!”

Those who know him best say Warner has the right stuff to tackle these goals.

“I think he will represent the school remarkably well,” says his friend and frequent collaborator Peter Jacobson, professor of health management and policy. “In my view, one of the failures of schools of public health is to be more involved in the public debate over why public health is important. I think he has the stature, the skills and the knowledge to be an extraordinarily effective spokes-person for public health and for the University of Michigan.”

“The first time I heard Ken speak, I was a student at the University of North Carolina,” remembers Edith Parker, associate professor of health behavior and health education at SPH and the new associate dean for academic affairs. “He talked about tobacco as a public health problem. I thought then that he was either a brave man or a foolish one to come down to tobacco land and speak against smoking. Since then I’ve come to realize that’s the kind of guy he is. He’s got the courage to say what people donnecessarily want to hear, but he does it with such humor and wit and intellect that they accept it even if they don’t welcome it. All of these qualities will serve him well as dean.”

“Ken is always on,” says Courant.

“He works hard at anything he’s doing, and that kind of liveliness and engagement is infectious. But the fundamental quality for this kind of work, where you’re leading by persuasion, is that you have very good taste, the ability to recognize the difference between really good work and just okay work, and to ask the right questions of the right people. Ken’s interests and knowledge are very broad, and he’s capable of learning in new areas very quickly and accurately. I think that will serve him very well. People trust his judgment, and with good reason.”

Courant is also Warner’s colleague in one of his other passions, an Ann Arbor poker game that’s been going on for more than 30 years now.

“I’ve been playing poker in organized games since I was in ighth grade,” says Warner, “so I sort of look down my nose at the masses who have newly discovered the game. In some ways,” he laughs, “it was more fun when poker was considered kind of tawdry. Now it’s respectable.”

He also engages in three other extracurricular activities—golf, “whenever I can”; biking, when weather permits; and working out, “whenever I must,” which he defines as “at least every other day.” He describes golf as his first real addiction since giving up smoking 30 years ago. “Only this one,” he says, “I get to feed all too infrequently.”

Both golf and working out are activities he enjoys with his wife of 28 years, Patricia Warner, MPH ’77. One Saturday a month, the two also volunteer at a local church breakfast program for the homeless.

Warner is effusive in his praise, both personal and professional, for Pat, associate hospital director, UM Hospitals and Health Centers, and chief administrative officer of C.S. Mott Children’s Hospital. “She’s always had the high-powered job,” her husband says. “I have the deepest respect for her skills as a manager and leader.”

Medicine and health are clearly this family’s affair. The Warners’ older son, Peter Murchie, has worked for the U.S. Environmental Protection Agency since earning master’s degrees from both SPH and the UM School of Natural Resources and Environment. Murchie’s wife, Stephanie Farquhar, who received her PhD from SPH in 2000, is an assistant professor in the Portland State University School of Community Health. Younger son Andy Warner, who is engaged to schoolteacher Shannon Anderson, is a first-year student at the University of Washington School of Medicine.

Given that he helped inspire his own kids, it’s no wonder Ken Warner has been a popular teacher at SPH. “His enthusiasm for research, his understanding of the subject matter, his devotion to his students, and his commitment to the department and the university impressed me so much that I found myself working harder and longer than I had ever imagined,” remembers Berhanu Alemayehu, DrPH ’01, who did his doctorate with Warner.

Like any good mentor, Warner wants those who go into his profession to have the same freedom he did, the kind that allows for serendipity.

“I believe my value to public health has been far greater due to the fortunate accident of falling into what was, thirty years ago, a highly unorthodox area of endeavor for a health economist,” he says. “Nobody was doing tobacco policy research, nobody was funding it, but I found it a sufficiently compelling issue that I got into it. Lo and behold, now there’s a field. And it’s one that makes a difference. That convinced me that I would want a similar opportunity—a similar academic freedom—for future generations of scholars and students to luck into something new and different of their own.”

He adds, “I want all of our students, all of our faculty, to experience the kind of passion that working in public health has afforded me. A good school should create opportunities for that to happen."

If he plays his cards right, it will.

Article written by Jeff Mortimer; photography by Peter Smith.

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From the moment he discovered public health by chance 33 years ago, Ken Warner knew he'd found his calling -- because in public health, says the school's new dean, “what you're working on matters.”