United States Public Health Service
|United States Public Health Service|
Seal of the United States Public Health Service
Flag of the United States Public Health Service
|Jurisdiction||Federal government of the United States|
|Agency executive||Dr. Howard K. Koh, Assistant Secretary for Health|
|Parent agency||Department of Health and Human Services|
United States Public Health Service Commissioned Corps
The Public Health Service Act of 1944 structured the United States Public Health Service (PHS) as the primary division of the Department of Health, Education and Welfare (HEW), which later became the United States Department of Health and Human Services. The PHS comprises all Agency Divisions of Health and Human Services and the Commissioned Corps. The Assistant Secretary for Health (ASH) oversees the PHS and the United States Public Health Service Commissioned Corps.
Agencies within the Public Health Service
- Agency for Healthcare Research and Quality (AHRQ)
- Agency for Toxic Substances and Disease Registry (ATSDR)
- Centers for Disease Control and Prevention (CDC)
- Food and Drug Administration (FDA)
- Health Resources and Services Administration (HRSA)
- Indian Health Service (IHS)
- National Institutes of Health (NIH)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
United States Public Health Service Commissioned Corps
The United States Public Health Service Commissioned Corps employs more than 6,000 public health professionals for the purpose of delivering public health promotion and disease prevention programs and advancing public health science. Members of the Commissioned Corps often serve on the frontlines in the fight against disease and poor health conditions.
As one of the United States seven uniformed services, the PHS Commissioned Corps fills public health leadership and service roles within federal government agencies and programs. The PHS Commissioned Corps includes officers drawn from many professions, including environmental and occupational health, medicine, nursing, dentistry, pharmacy, psychology, social work, hospital administration, health record administration, nutrition, engineering, science, veterinary, health information technology, and other health-related occupations.
Officers of the Corps wear uniforms similar to those of the United States Navy with special PHSCC insignia, and the Corps uses the same commissioned officer ranks as the United States Navy, Coast Guard and NOAA Corps from ensign to admiral, uniformed services pay grades O-1 through O-10 respectively.
The mission of the U.S. Public Health Service Commissioned Corps is to protect, promote, and advance the health and safety of the United States. According to the PHSCC, this mission is achieved through rapid and effective response to public health needs, leadership and excellence in public health practices, and advancement of public health science.
The origins of the Public Health Service can be traced to the passage, by the 5th Congress, of An Act for the Relief of Sick and Disabled Seamen in 1798. The earliest marine hospitals created to care for the seamen were located along the East Coast, with Boston being the site of the first such facility; later they were also established along inland waterways, the Great Lakes, and the Gulf of Mexico and Pacific Coasts. Funding for the hospitals was provided by a mandatory tax of about 1% of the wages of all maritime sailors.
A reorganization in 1870 converted the loose network of locally controlled hospitals into a centrally controlled Marine Hospital Service, with its headquarters in Washington, D.C. The position of Supervising Surgeon (later Surgeon General) was created to administer the Service, and John Maynard Woodworth was appointed as the first incumbent in 1871. He moved quickly to reform the system and adopted a military model for his medical staff, instituting examinations for applicants and putting his physicians in uniforms. Woodworth created a cadre of mobile, career service physicians who could be assigned as needed to the various marine hospitals. The commissioned officer corps (now known as the Commissioned Corps of the U.S. Public Health Service or the Public Health Service Commissioned Corps) was established by legislation in 1889. At first open only to physicians, over the course of the twentieth century, the Corps expanded to include veterinarians, dentists, physician assistants, sanitary engineers, pharmacists, nurses, environmental health officers, scientists, and other health professionals.
The scope of activities of the Marine Hospital Service also began to expand well beyond the care of merchant seamen in the closing decades of the nineteenth century, beginning with the control of infectious disease. Quarantine was originally a state function rather than federal, but the National Quarantine Act of 1878 vested quarantine authority to the Marine Hospital Service and the National Board of Health. The National Board was not reauthorized by Congress in 1883 and its powers reverted to the Marine Hospital Service. Over the next half a century, the Marine Hospital Service increasingly took over quarantine functions from state authorities.
As immigration increased dramatically in the late nineteenth century, the Federal Government also took over the processing of immigrants from the states, beginning in 1891. The Marine Hospital Service was assigned the responsibility for the medical inspection of arriving immigrants at sites such as Ellis Island in New York. Commissioned officers played a major role in fulfilling the Service's commitment to prevent disease from entering the country.
Because of the broadening responsibilities of the Service, its name was changed in 1902 to the Public Health and Marine Hospital Service, and again in 1912 to just the Public Health Service. The Service continued to expand its public health activities as the nation entered the twentieth century, with the Commissioned Corps leading the way. As the century progressed, PHS commissioned officers served their country by controlling the spread of contagious diseases such as smallpox and yellow fever, conducting important biomedical research, regulating the food and drug supply, providing health care to underserved groups, supplying medical assistance in the aftermath of disasters, and in numerous other ways.
Today the mission of the Commissioned Corps of the PHS is "Protecting, promoting, and advancing the health and safety of the Nation."
Tuskegee Study of Untreated Syphilis in the Black Male
In 1932, the Public Health Service, working with the Tuskegee Institute, began a study to record the natural history of syphilis in hopes of justifying treatment programs for blacks. It was called the "Tuskegee Study of Untreated Syphilis in the Negro Male".
The study initially involved 600 black men – 399 with syphilis, 201 who did not have the disease. The study was conducted without the benefit of patients' informed consent. Researchers told the men they were being treated for "bad blood," a local term referring to several ailments, including syphilis, anemia, and fatigue. In truth, they did not receive the proper treatment needed to cure their illness. In exchange for taking part in the study, the men received free medical exams, free meals, and burial insurance. Although originally projected to last 6 months, the study actually went on for 40 years. It has been called "arguably the most infamous biomedical research study in U.S. history."
Syphilis Studies in Guatemala
A USPHS physician who took part in the Tuskegee program, John Charles Cutler, was in charge of the U.S. government's syphilis experiments in Guatemala, in which Guatemalan prisoners, soldiers, orphaned children, and others were deliberately infected with syphilis and other sexually-transmitted diseases from 1946-1948 in order to study the disease, in a project funded by a grant from the National Institutes of Health.
Emergency response since 1999
Commissioned Corps emergency response teams are managed by the Office of the Surgeon General. They are trained and equipped to respond to public health crises and national emergencies, such as natural disasters, disease outbreaks, or terrorist attacks. The teams are multidisciplinary and are capable of responding to domestic and international humanitarian missions. Officers have responded to many such emergencies in the past, including:
- 1999 - Hospital center at Fort Dix, NJ, for Kosovo Refugees
- 2001 - September 11 attacks
- 2001 - 2001 anthrax attacks
- 2004 - 2004 Indian Ocean earthquake and tsunami
- 2005 - Hurricane Katrina
- 2005 - Hurricane Rita
- 2006 - 2006 Hawaii earthquake
- 2007 - Medicine Contamination in Panama
- 2008 - Hurricane Gustav
- 2008 - Hurricane Ike
- 2009 - 2009 Samoa earthquake
- 2010 - 2010 Haiti earthquake
- 2010 - Deepwater Horizon oil spill
- 2011 - 2011 Japan Tsunami and Earthquake
- 2012 - Hurricane Sandy - NY/NJ
Notes and references
- Organizational Chart of Health & Human Services, 2007
- US Department of Health and Human Services. Office of the Assistant Secretary for Health (ASH)
- Gostin, Lawrence O. (2008). "Box 8: The Federal Presence in Public Health". Public Health Law: Power, Duty, Restraint, Revised and Expanded (2nd ed.). University of California Press. p. 156. ISBN 0520253760. Retrieved 2012-11-08.
- Ungar, Rick (January 17, 2011). "Congress Passes Socialized Medicine and Mandates Health Insurance -In 1798". Forbes.com. Retrieved 2012-11-08.
- Smillie, W. G. The National Board of Health, 1879-1883 American Journal of Public Health and The Nation's Health (1943) 33(8):925-930.
- Katz RV, Kegeles SS, Kressin NR, et al. (November 2006). "The Tuskegee Legacy Project: willingness of minorities to participate in biomedical research". J Health Care Poor Underserved 17 (4): 698–715. doi:10.1353/hpu.2006.0126. PMC 1780164. PMID 17242525.
- US Department of Health and Human Services. Emergency Response at Commissioned Corps
- Blue, Rupert (September 1917). "Conserving The Nation's Man Power: How The Government Is Sanitating The Civil Zones Around Cantonment Areas. A Nation-Wide Campaign For Health". National Geographic Magazine. XXXII (3): 255–278.
- Hendrick, Burton J. (April 1916). "The Mastery Of Pellagra: How The Doctors Of The United States Public Health Service Have Found A Way Of Curing And Preventing It". The World's Work: A History of Our Time XXXI: 633–639. Retrieved 2009-08-04.
- Leupp, Constance D. (August 1914). "Removing The Blinding curse Of The Mountains: How Dr. McMullen, Of The Public Health Service Is Organizing The War Against Trachoma In The Appalachians". The World's Work: A History of Our Time XLIV (2): 426–430. Retrieved 2009-08-04.
- Annual Report Of The Surgeon General Of The Public Health. Washington: Government Printing Office.
|Wikimedia Commons has media related to United States Public Health Service.|
- U.S. Public Health Service
- Office of the Surgeon General
- Office of the Public Health Service Historian
- PHS history and WWII women's uniforms in color – WWII US women's service organizations (WAC, WAVES, ANC, NNC, USMCWR, PHS, SPARS, ARC and WASP)