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To Improve Human Health: A History of the Institute of Medicine
project in typically grandiose terms. It would ''appraise the extent to which the health problems of the disadvantaged are a consequence of economics, race, failure of the delivery system and a failure of the other related systems in society." Although the results were much more limited, the study did yield useful methodology for using certain conditions, such as anemia and middle-ear infections, as statistical "tracers" that could be employed to compare the effectiveness of different health delivery systems. The project also mined data sets such as a record of live births and infant deaths in New York City in 1968 to show that differences in infant deaths between whites and blacks could be somewhat reduced through "easily obtained personal and medical information.''49
The health contrast studies resembled the sort of work that a faculty member might do in a school of public health. In sponsoring them, the Institute of Medicine put its imprimatur on a research project that was largely conducted by outsiders. The Institute did not use the studies to make authoritative statements on health policy questions, in part because IOM Council members such as Harvard statistician Fred Mosteller urged the IOM to be cautious about pushing its conclusions beyond the reach of the data.50
Health Effects of Abortion
In contrast to the entitlement and health contrast studies, the abortion study showed how the IOM could contribute to health policy debates, even on a controversial topic. This project stemmed from the famous January 1973 Supreme Court decision in the case of Roe v. Wade that states could not ban abortions during the first trimester of pregnancy. In the fall, David Hamburg and David Mechanic, both of whom were IOM Council members, suggested that the IOM might want to examine the health impact of legalizing abortion. The idea captured the imagination of the IOM Council and won the approval of the Program Committee, the Council, and NAS authorities.
In February 1974, John Hogness invited Dr. Mildred M. Bateman, director of the West Virginia Department of Mental Health, to chair the steering committee created for the abortion study. Ten others joined her, including seven IOM members. All came with imposing titles: the head of the Obstetrics and Gynecology Department at Meharry Medical College, the chief of the Epidemiology Department at Harvard's School of Public Health, the dean of the Medical School at Case Western Reserve University, the president of the Social Sciences Research Council.51 The committee's pedigree testified to the