Public Health Service (PHS), United States

█ BELINDA ROWLAND

The United States Public Health Service is a federal government agency that promotes the health of the people of the United States and the world. It is a principle component of the Department of Health and Human Services (HHS) and is composed of eight agencies. Among other duties, the Public Health Service is charged with, through its agencies, preparing for and leading the nation's medical response to a threat or disaster, whether naturally occurring or an act of terrorism.

The PHS originated in 1798 through the passage of an act that provided for the care of injured and sick merchant seamen. Politicians of the time assumed that healthy seamen would protect the security and economic well being of the country. A marine hospital fund was created to provide medical services to merchant marines. Monies for this fund came, in part, from an American seaman tax of 20 cents each month. This became the first program for medical insurance in the United States. Marine hospitals were established along coasts and inland waterways. By 1981, all of the marine hospitals and clinics had closed.

In 1870, the independently controlled network of hospitals was organized into the Marine Hospital Service. The Service was administered by the Supervising Surgeon General, a title that was later changed to Surgeon General. At this time, the Service developed a military organization and approach. The medical officers were called surgeons and had to pass entrance exams and wear uniforms. In 1889, legislation to formalize the uniformed service aspect of the Service created the Commissioned Corps. As a result, medical officers were given military titles and pay.

By the late 1800s, the activities of the Marine Hospital Service extended beyond the care of seamen. In the effort to control infectious disease, the Service was given the power to quarantine and was responsible for the medical examinations of immigrants. As a result of its expanding responsibilities, in 1902 the name of the service was changed to the Public Health and Marine Hospital Service. The name "Public Health Service" was adopted in 1912.

The PHS celebrated its 200th anniversary in 1998. At that time, it employed about 5,700 Commissioned Corps officers and 51,000 civilians. In 1993, the budget of the PHS was 17 billion dollars. The PHS is administered by the Assistant Secretary for Health and the Surgeon General. It is composed of the Office of Public Health and Science, 10 Regional Health Administrators, and eight agencies. The eight agencies within the PHS are:

Centers for Disease Control and Prevention (CDC). The mission of the CDC is to promote health through the prevention and control of disease, injury, and disability. The CDC functions on both national and international levels.
Agency for Toxic Substances and Disease Registry (ATSDR). The ATSDR mission is to prevent the exposure to and adverse effects of toxic substances in the environment.
National Institutes of Health (NIH). The NIH is a medical research center that conducts and funds medical research with the goal of achieving better health for the people of the United States and the world. It is composed of 27 Institutes and Centers and is one of the world's leading medical research centers.
Food and Drug Administration (FDA). The FDA assures the safety and effectiveness of drugs, medical devices, and biological products as well as the safety of cosmetics and foods.
Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA strives to reduce the illness, disability, death, and costs resulting from mental illness and substance abuse.
Health Resources and Services Administration (HRSA). The HRSA directs national health programs which assure that the American people have equal access to healthcare.
Agency for Healthcare Research and Quality (AHRQ). The AHRQ funds research intended to improve the quality and outcome of healthcare, examine medical errors, address patient safety, and expand access to effective healthcare. It provides information to persons so that they can make better healthcare decisions.
Indian Health Services (IHS). The IHS is the healthcare provider and advocate for Alaska Natives and American Indians.

█ FURTHER READING:

BOOKS:

Kondratas, R. Images from the History of the Public Health Service. N.p., U.S. Department of Health and Human Services, Public Health Service, 1994.

Kurian, G. T., ed. A Historical Guide to the U.S. Government. New York: Oxford University Press, 1998.

Mullan, F. Plagues and Politics: The Story of the United States Public Health Service. New York: Basic Book, Inc., 1989.

ELECTRONIC:

Kondrates, R. "Images from the History of the Public Health Service." April 27, 1998. http://www.nlm.nih.gov/exhibition/phs_history/contents.htm (December 14, 2002).

Office of the Public Health Service Historian, 18–23 Parklawn Building, 5600 Fishers Lane, Rockville, Maryland, 20857. (301) 443–5363. January 15, 2002. http://lhncbc.nlm.nih.gov/apdb/phsHistory. (December 14, 2002).