History(cont.)

When the war ended, the PHS was given the responsibility of caring for all returning veterans, leading to large increases in staff and in the number of hospitals operated by the Service.  This situation was short-lived, however, as Congress created an independent Veterans Bureau in 1921, and in the following year the responsibility and resources for the treatment of veterans was transferred from the PHS to the new Bureau.

In the period between the two world wars, the PHS expanded the population to which it provided health care beyond the traditional categories of merchant seamen and the Coast Guard.  The PHS assumed responsibility for the care of individuals suffering from leprosy when it converted the state leprosy facility in Carville, Louisiana into a national leprosy hospital.  Under the PHS, the hospital at Carville carried out pioneering research on the nature and treatment of leprosy

In 1928 the Service detailed a Commissioned Officer to serve as Director of Health for the Bureau of Indian Affairs of the Department of the Interior and also assigned a number of other Officers to the Bureau to provide medical assistance in the field.  This cooperative arrangement continued until the PHS eventually took over the responsibility for the health of American Indians and Alaska Natives from the Bureau almost forty years later.  Another category of beneficiaries was added to the roster of those served by the PHS in 1930, when the law creating the Federal Bureau of Prisons included provisions for the assignment of PHS Officers to supervise and provide medical and psychiatric services in Federal prisons.

Although the PHS had always dealt with issues of mental health to some extent in the marine hospitals, and had become more involved with mental health in connection with the medical screening of immigrants, it did not establish a formal organizational unit in this area until 1929.  Initially the Division of Mental Hygiene focused largely on questions of substance abuse, as is suggested by the fact that it was actually called the Division of Narcotics for the first year of its existence.  The 1929 law that created the Division also authorized the creation of two PHS hospitals for the treatment of narcotics addicts, and these facilities were opened in Lexington, Kentucky and Fort Worth, Texas in the 1930s.

The PHS became more involved in the broader health concerns of the nation under the New Deal.  The Social Security Act of 1935 provided the PHS with funds and the authority to build a system of state and local health departments, something it had already been doing on an informal basis.  Under the legislation, the PHS was also able to provide grants to states to stimulate the development of health services, train public health workers, and undertake research on health problems.  Although these programs were funded and aided by the Federal Government, they were run at the state and local level, joining the various governments in a public health partnership.

When Thomas Parran was appointed Surgeon General in 1936, he embraced these new authorities.  He was more of an activist than his predecessor.  One of the areas of particular concern to Parran was VD.  As Surgeon General, he helped to focus attention on VD as a public health problem, rather than emphasizing moral issues.  His articles in popular magazines and his 1937 book Shadow on the Land helped to break down the taboo against discussion of VD in the media.  His efforts were also instrumental in the passage of the National Venereal Disease Control Act of 1938, which provided Federal funds to the states through the PHS for VD control programs, as well as supporting research into the prevention and treatment of these diseases.

As a result of a government reorganization in 1939, the PHS was taken out of the Treasury Department and given a new administrative home.  President Franklin D. Roosevelt aligned the PHS with a number of other social service agencies, such as the Social Security Board, in a newly created Federal Security Agency.  The reorganization, however, had little effect on the basic functions and operations of the Service.

With the entry of the country into World War II in 1941, some PHS Officers were detailed to the military services.  The PHS also provided personnel to the United Nations Relief and Rehabilitation Administration to staff medical care and disease prevention programs in refugee camps in Europe and the Middle East.  The Coast Guard was militarized in 1941, and 663 PHS Officers, eight of whom were killed in the line of duty, served with the Guard during the war.

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