New Campaigns: Fighting High Blood Pressure and Glaucoma, 1973-1988
Gorman continued to be an advocate for better mental health services, but (perhaps feeling frustrated by the slow progress of reform and the resistance from Presidents Nixon and Ford) found his attention drawn to other dangerous health problems. One of these was high blood pressure. Studies in the late 1960s and early 1970s had shown that lowering high blood pressure (hypertension) could often prevent the usual outcomes of stroke, heart failure, and kidney failure. [See the Edward Freis site on Profiles in Science for details about this research.] Impressed by these studies, Gorman and Mary Lasker in 1972 asked Elliot Richardson, Secretary of Health, Education, & Welfare, to consider launching--with cooperation from state, local, and private groups--an educational and preventive campaign against hypertension (which then affected about 35 million Americans). Since the 1950s many new drugs had become available to treat this disease, but many people didn't even know they had it. Though he could not provide more than modest funding, Richardson enlisted the help of Theodore Cooper, director of the National Heart Institute, to get the education campaign started. Meanwhile, Lasker and Gorman developed a parallel citizens' organization which could not only work closely with federal and state governments, but could enlist the help of employers, schools, professional groups and others in the private sector. According to Gorman, this group, Citizens for the Treatment of High Blood Pressure (CTHBP), was "the first massive prevention campaign against a chronic disease."
The group's first (and most difficult) task was to gain passage of the 1976 bill authorizing federal grants to state health departments for hypertension programs. They had few allies in this battle--all of the major health organizations opposed the plan as impractical, including the Association of State and Territorial Health Officers. The legislation resulted in the appropriation of more than $120,000,000 to all 50 states to establish state hypertension programs. In turn, state legislators appropriated more than $50,000,000 to support the initiative. In the early years of the National High Blood Pressure Program there was a diversity of programs with no central mechanism to define national objectives. The CTHBP proposed a strong central Coordinating Committee which would be advisory to the National Heart Institute. This committee included representatives of the American Heart Association, the National Kidney Foundation, the American Medical Association, the American Nurses Association, and others. The resulting National High Blood Pressure Education Program was a highly successful preventive health campaign. Through the various media, and through events such as National High Blood Pressure Month, the education program promoted the simple message that people should have their blood pressure checked regularly, and if it was above acceptable limits, they should be treated with medication and diet, and keep up such treatment for the rest of their lives. By 1987, hypertension screening and treatment had achieved a secure place in public health programs, and Gorman was able to close the CTHBP offices in January of 1988, considering its job done.
Partly through the CTHBP, Mary Lasker had become deeply interested in developing a similar organization to address the problem of glaucoma. Like hypertension, glaucoma was a "silent" disease that took an enormous toll--it was the leading cause of blindness in the U.S. By the early 1980s several groups, including the National Eye Institute, the National Society to Prevent Blindness, and the American Academy of Ophthalmology, had started screening and education programs targeting glaucoma, but these efforts were often uncoordinated, fragmented and only marginally successful. A 1980 report had found that the estimated number of undiagnosed glaucoma cases had not changed significantly, and was likely to increase as the population aged. Merck, Sharp, and Dohme (the pharmaceutical company which manufactures several widely used glaucoma drugs) had held several conferences on glaucoma control, and agreed to provide a grant of $100,000 to establish the National Initiative for Glaucoma Control in 1983. This citizens group would "serve as the catalyst for a broad-based glaucoma detection and control program, eventually supported by the federal government, the private sector, medical academia, the health care community, and volunteer community-based organizations." An advisory council was formed, including members of all groups and organizations concerned with glaucoma, to formulate goals and strategies, and oversee the activities of the organization. NIGC's primary activity was lobbying for federal and state project grant legislation, to support screening and education programs carried out by other associated groups.
Gorman served as Executive Director of NIGC until 1988, when the organization was disbanded. When he retired from his executive director duties, Gorman told his colleagues that he wanted to work on a new book. He died the following year, on April 1, 1989.
Writing in 1962, one observer of health care policymaking, Dr. Louis Lasagna, described Gorman as "the country's greatest modern missionary for mental health," and added: "He has an expert knowledge of the ins and outs of Congressional maneuverings. He is forceful, and has a newsman's flair for the catchy phrase and the dramatic scene. . . . He is an inveterate name dropper, and uses the names of influential scientists and politicians with telling effect. He is impatient of delays and cavalier in his contempt for those who disagree with him. But despite these facts, Mike Gorman is probably most responsible for an almost sevenfold increase in federal appropriations for mental health in [the last] eight years." Lasagna's concluding statement was prescient: "He will unquestionably remain one of the most influential professional laymen in America, and those who underestimate his talents are in for even more surprises in the future."