E. Richard (Rick) Brown, a nationally recognized public health leader who advocated for health care reform and pioneered the collection and broad dissemination of health survey data to influence policy, died Friday, April 20. Rick was 70 at the time of his death, and passed away shortly after moderating a session at the Keeneland Conference Center in Kentucky on the critical role of state and local health surveys. Throughout his life, Rick looked for ways to build bridges between the most underserved Americans and the people who were supposed to help them – lawmakers, academics, and advocates. For Rick, helping people was always a deeply personal mission.
As a past president of the American Public Health Association, a member of dozens of health advisory committees and boards, and through his work for two U.S. Presidents – Clinton and Obama – and several U.S. Senators — Bob Kerrey, Bill Bradley, Paul Wellstone, and Al Franken — Rick forged a reputation for his intense determination to make health care services more accessible and more affordable to all Americans. He was a tireless advocate for the uninsured, and promoted the development of health data surveys to both dispel persistent myths about the uninsured and document the devastating consequences of the chronic lack of health insurance for millions of Americans.
Rick’s career was based in academia, and he achieved significant success within the academic community. He received his bachelor’s, master’s, and doctoral degrees at UC Berkeley, and was a professor in the Departments of Health Services and Community Health Sciences in the UCLA Fielding School of Public Health for the past 33 years. He was the founding director of the UCLA Center for Health Policy Research, which he established in 1994 to translate academic research into practical evidence that policy audiences and community health organization could use in their work. Central to this vision was the concept of credible and comprehensive data that could make a non-partisan case for policies and programs that could improve the health and well-being of all Californians and the nation.
The California Health Interview Survey
One of Rick’s major accomplishments through the Center was the development of the California Health Interview Survey (CHIS), which since its inception has been the nation’s largest state health survey and a critical source of information for California and national lawmakers regarding individual and household health status in California. It has served as a model for health surveys for other states.
In 2001, the Center produced the first CHIS data from interviews with more than 55,000 California households, creating in the process a wealth of health data on the nation’s most populous – and diverse – state. Subsequent iterations of the survey followed every two years from 2003 to 2011. CHIS has become an essential source for policymakers, advocates, researchers, media and others interested in understanding the health of Californians, and that of previously under-studied ethnic, racial, disabled, and sexual minority groups.
CHIS data and Center research have been at the heart of some of the state’s and the nation’s most pressing health policy debates. CHIS findings were used extensively by then-governor Arnold Schwarzenegger and both parties in the legislature during California’s first attempt to institute comprehensive health care reform in 2007 and 2008. CHIS-based research also focused national attention on the problem of recession-driven loss of insurance by many in 2010, and helped propel the passage of the federal Affordable Care Act (ACA) that year. Since then, California lawmakers have used CHIS to prepare for the implementation of the ACA in 2014.
CHIS data and Center research have been the cornerstone of dozens of California laws and initiatives, including legislation to increase participation in the federal food stamp program; develop new public-private expansion programs for children ineligible for private insurance, Medi-Cal or Healthy Families; collect data on sexual minorities; impose a fast-food restaurant moratorium on impoverished areas of Los Angeles; and remove soda and other sugar-sweetened beverages from schools and government vending machines.
Dr. Robert K. Ross, CEO and president of The California Endowment, which has supported CHIS data collection and many of the seminal studies based on CHIS, summarized Rick’s impact in these words:
There are few areas of public health in California that Rick has not, in some way, touched, influenced or informed. He understood that good quality information was the engine that powered all the things he cared most passionately about, from expanding health insurance coverage to feeding and caring for the state’s poorest and most marginalized residents.
As evidence of his impact, both the Los City Council and the California State Assembly have adjourned sessions in his honor in the days since his sudden passing.
The Roots Of A Passion For Health Policy
Rick’s passion for health policy was rooted in harsh personal experience, as I only recently learned. He was born to Eastern European immigrant parents in a working class community in Plainfield, N.J., and moved to Southern California at an early age. His father was a union and social justice organizer on the east and west coasts. Times were often hard for the family. At one point, they all lived in a tent behind their friends’ restaurant. His parents separated when he was 12, and he and his brother were raised by their single mother, Sylvia, who worked as a book-keeper. When his brother smashed his bike into a tree and needed medical care, Rick got his first taste of what it was like to be poor and without basic health coverage. “My mother always remembered the stigma she felt when the eligibility workers at the county hospital grilled her about her income and were very demeaning to her because she couldn’t pay the medical bills,” he would remember later. That first-hand experience of being a medical “charity case” inspired him to not only study public health but to link it to ways to improve health coverage for all.
Rick’s career always reflected his roots as a community activist, dating from his university experiences at Berkeley. As an activist, Rick co-authored California’s first single-payer health care legislation in 1990, and co-wrote several other health care reform bills in the 1990s and 2000s, which helped shape the policy and political dialogue on health care reform during those decades. Teased by his family that he was “a serious man,” Rick had a broad smile and deep-throated laugh that was infectious. His generosity of spirit made him beloved by many.
On a personal note, I met Rick 23 years ago when I joined the faculty at UCLA, and worked with him for the last 18 years as Associate Director of the Center for Health Policy Research. The Rick Brown I knew evolved over the past two decades to become more of a pragmatist without losing his idealism. On many occasions, he laughingly described himself as a “recovering single-payer advocate” to audiences who wondered why he was supportive of health reform efforts that fell short of replacing our complex system of health care financing with a single-payer system. But Rick recognized that politics is the art of the possible, and he always believed that all efforts to improve access to health care –whether through expansion of public programs, subsidized private insurance, or employer mandates – were important steps toward the ultimate goal of universal access to health care in the U.S.
To honor Rick, the Center has created a memorial website: www.rememberingrick.com; please visit and leave your remembrance of a man who touched so many lives in the fields of public health, health policy, and health services research.