History(cont.)

A nursing shortage during the war led to the passage of the Nurse Training Act of 1943, which created a PHS-administered program called the Cadet Nurse Corps.  The program provided participants with a tuition scholarship and a small monthly stipend while attending a qualified nursing school.  In return for this support, the Cadets had to agree to work after graduation in essential nursing services for the duration of the war.  To symbolize their commitment to the war effort, the Cadets wore specially-designed uniforms.  Over 124,000 nurses (including some 3,000 African Americans) were trained in this program from its origin in 1943 to its termination in 1948.  The Cadet Nurse Corps marked the beginning of PHS involvement on a large scale in funding the education of health professionals.

The PHS expanded significantly during World War II, doubling its personnel between 1940 and 1945 to reach a level of 16,000 employees.  The war also increased the involvement of the PHS in international affairs, leading to the creation of an Office of International Health Relations.  Two legislative acts during this period also had an impact on the PHS.  A 1943 law reorganized the Service, consolidating its programs into four subdivisions: the Office of the Surgeon General, the National Institute (later Institutes) of Health, and two new entities, the Bureau of Medical Services and the Bureau of State Services.  The 1944 Public Health Service Act codified on an integrated basis all of the authorities of the Service and strengthened the administrative authority of the Surgeon General.  The act also allowed the PHS to develop a major postwar program of grants for medical research through the National Institutes of Health.

Another legacy of World War II PHS grew out of a wartime program to control malaria in areas around military camps and maneuver areas in the United States.  The PHS-administered Malaria Control in War Areas program, based in Atlanta, expanded its responsibilities over the course of the war to include the control of other communicable diseases such as typhoid fever, dengue, and typhus.  By the end of the war, the program had demonstrated its value in the control of infectious disease so successfully that it was converted in 1946 to the Communicable Disease Center (CDC).  The mission of the CDC expanded over the succeeding decades to include areas such as nutrition, chronic disease and occupational and environmental health.  To reflect this broader scope, its name was changed in 1970 to the Center for Disease Control.  It received its current designation, Centers for Disease Control and Prevention (but retaining the acronym CDC) in 1992.

Two major legislative acts passed just after the war, in 1946, had a significant impact on the PHS.  The National Mental Health Act greatly increased the involvement of PHS, which administered the programs established by the law, in the area of mental health.  The law supported research on mental illness, provided fellowships and grants for training mental health professionals, and made available to states grants to assist in the establishment of clinics and treatment centers and to fund demonstration projects.  It also called for the establishment of a National Institute for Mental Health, which was created as a part of the PHS in 1949.  The other 1946 law that had an influence on the activities of the PHS was the Hospital Survey and Construction Act, more commonly referred to as the Hill-Burton Act.  It authorized the PHS to make grants to the states for surveying their hospitals and public health centers, for planning construction of additional facilities, and to assist with construction costs.

In 1953, the Federal Security Agency was elevated to cabinet status as the Department of Health, Education, and Welfare (DHEW), but this change in status had little direct impact on the PHS at the time.  However, the Service did assume several new tasks in the 1950s.  For example, it became fully responsible for the health of American Indians and Alaska Natives in 1955, when all Indian health programs of the Bureau of Indian Affairs were transferred to the PHS.  A new Division of Indian Health (which later became the Indian Health Service) was established to administer these programs.  In 1956, the Armed Forces Medical Library became the National Library of Medicine, which was made a part of the PHS.

The PHS continued to expand in the 1960s.  Two agencies that were also housed in DHEW were incorporated into the PHS in this decade.  St. Elizabeths Hospital, which had begun in 1855 as the Government Hospital for the Insane, was brought into PHS in 1967 (although much of its physical plant and programs were transferred to the District of Columbia in 1987).  The Food and Drug Administration, whose predecessor organization dates back to 1906, was made a part of the PHS in 1968, thus involving the Service much more heavily in the area of regulation.

The famous Surgeon General’s report on Smoking and Health, issued in 1964, undoubtedly made many Americans much more aware not only of the dangers of smoking, but also of the PHS and the Surgeon General.  Although not the first statement from a PHS Surgeon General concerning the health effects of smoking, it was an extensive and well-documented report which clearly stated some of the health risks of tobacco.  It eventually led to the introduction of the now-familiar Surgeon General’s warnings on cigarette packages.

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