White, Kerr L.

Kerr L. White is arguably the founder of the discipline of health services research in the United States. Throughout his long and distinguished career as a researcher, university professor, and government and foundation administrator, he developed the conceptual framework of health services research, established and shaped government health services research programs, and funded the emerging discipline of health services research.

White was born in Winnipeg in 1917, and he grew up in Ottawa, Canada. His father was a foreign correspondent for the London Times and the Economist, and his mother operated a lending library that emphasized various medical topics. He majored in economics and political science at McGill University, followed by graduate study in economics at Yale University. During World War II, he interrupted his graduate studies to serve in the Royal Canadian Army. After the war, he undertook medical training at McGill University, graduating in 1949. White completed his residency in internal medicine at Dartmouth College's Hitchcock Clinic and Hospital and a fellowship at McGill's Royal Victoria Hospital in the departments of medicine and psychiatry. He then joined the Department of Internal Medicine at the University of North Carolina–Chapel Hill as an assistant professor of medicine and preventive medicine. In 1962, White was appointed chair of the Department of Epidemiology and Community Medicine at the University of Vermont. In 1965, he moved to Johns Hopkins University to establish the Division of Hospitals and Medical Care, which later became the Department of Health Care Organization. In 1978, he became the deputy director for health sciences at the Rockefeller Foundation. White retired in 1984, remaining active in the health research community as a thought leader and as a mentor.

White's professional legacy can be divided into three domains: (1) scholarship, which defined the field of health services research; (2) training and mentoring leaders in this new field; and (3) the development of programs and other initiatives that have a sustained impact on the research on healthcare quality and the delivery of quality medical care.

While he was a 2nd-year medical student in 1947, White published his first article, which predicted many of the methodological and substantive domains of health services research and their relation to what would eventually be known as evidence-based medicine. At the University of North Carolina, White formulated the key ideas, which he expounded in 1961 in a seminal New England Journal of Medicine article that he coauthored, “The Ecology of Medical Care.” White stressed, in addition to the appropriate use of methodological tools to conduct health care research, that society has an obligation to allocate healthcare resources as efficiently and effectively as possible to improve the quality of medical outcomes, benefiting both patients and providers. Moreover, he stressed that healthcare research was concerned with medicine as a social institution. White has authored or coauthored some 250 publications, including 11 books.

White proved instrumental in institutionalizing health services research, both through his editorial influence in journals such as Medical Care and Health Services Research and ensuring funding for the International Journal of Health Services, and through his vision in developing the organizational framework for the National Center for Health Services Research (NCHSR), which eventually became a federal agency and in 1999 was reauthorized as the Agency for Healthcare Research and Quality (AHRQ).

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