Pasteur’s Quadrant and Population Health.

In 1997, Donald Stokes published his book Pasteur’s Quadrant: Basic Science and Technological Innovation. In the book, Stokes tried to find a way to reconcile the goals of science with the imperatives under which government operates, aiming to forge a new compact between science and government. His elegant, and much cited, synthesis for this centered around Pasteur’s quadrant, shown in the figure below.

Stokes anchored the potential contributions of science to a two-by-two grid and used scientists he deemed paradigmatic to illustrate his general points. Therefore, Louis Pasteur, whose work was at the core of advancing our understanding of infectious disease but was also directly applicable to the evolution of vaccination, resides in “Pasteur’s quadrant” at the intersection of advancing basic science knowledge and knowledge that is use-inspired, or “useful.” Nils Bohr, the Danish physicist whose work helped advance our understanding of quantum theory and atomic structure, resides in the top left corner, where work aspires to advance knowledge with little attention to its immediate application. Thomas Edison, meantime, the American inventor whose contributions include the practical electric light bulb, occupies the bottom right quadrant, where work with immediate relevance dwells, applying knowledge to practical use that aims to improve the world.

Stokes’ paradigm was itself an update of an earlier, more linear conception of the link between scientific knowledge and its applications proposed by Vannevar Bush in his report Science, The Endless Frontier, published some 50 years earlier. Although over the past two decades, several scholars have suggested updates to Stokes’ schema, his paradigm remains helpful and a useful guide for science to grapple with a perennial tension between its goals—advancing knowledge and providing ideas that can help propel the world forward.

I have long thought that this paradigm has particular utility for structured academic thought. But of particular interest to us is this: how does thinking about this paradigm help us understand the production of knowledge, and its potential utility, in public health?

在

Fi

Second, placing ourselves in Pasteur’s quadrant as we do, our work is, in some ways, a bold expression of confidence in the direct utility of what we do at the time we are doing it. We recognize Pasteur’s work as useful insofar as it laid the foundations of much of our understanding of vaccinology. His work, when it was being done, was far less clearly useful or linked to the health of populations. The path of discovery is windy and not infrequently tortuous, and it is perhaps a hubristic step too far to say that we know what line of inquiry will definitely lead to utility and relevance to the work of population health improvement. However, the causes of population health change over time, and embarking on work that one knows will be useful going forward is a tall order.

Th

In summary, the initial appeal of Stokes’ paradigm is somewhat complicated when one dives deeper into the real mechanics of the generation of knowledge in public health, and the utility of that same knowledge towards improving the health of the public. I have come to think that rather than dwelling in Pasteur’s quadrant only, our work rightly crosses into Bohr and Edison territory, and that we would do well to accept and nurture such cross-quadrant incursion. That may be less clarifying than a scientific taxonomist might like, but perhaps speaks to the intellectual breadth of the academic public health enterprise.

I hope everyone has a terrific week. Until next week.

Warm regards,

Warm regards,

Sandro

Sandro Galea, MD, DrPH
Dean and Professor, Boston University School of Public Health
Twitter: @sandrogalea

Previous Dean’s Notes are archived at: /sph/category/news/deans-notes/