From Yellow Fever To Aids, Fighting For Public Health The Job Of The Service, Now 200 Years Old, Is Never Done.

Posted: July 16, 1998

It took less than 100 days. Ten percent of Philadelphia's population died in the yellow fever epidemic that devastated this city in 1793.

Memories of that disaster spurred Congress to create the Public Health Service 200 years ago: July 16, 1798. The small corps of physicians - the first group of federal employees who had to meet testing requirements to be hired - was charged with caring for merchant marines.

We've relegated yellow fever to the history books, but the Public Health Service continues to be a not-so-silent partner in our challenge to the hazards that put our lives at risk every day.

Across the street from Independence Hall, not far from the final resting place of many victims of that long-ago epidemic, the PHS wages its battle from the regional office of the U.S. Department of Health and Human Services.

The agenda is always unfinished. Cure one disease, and another pops up. Preserving public and private health is a solemn public charge and a mission with high stakes. The work is seldom spectacular. No neon lights. No dramatic posturing. Just a roll-up-your-sleeves kind of dedication to better health care and safety for 260 million people.

And our achievements have been significant. Since 1965, the maternal mortality rate in the United States has been cut in half. Adjusting for age, mortality rates are down for leading causes of death such as heart disease, pneumonia, influenza, diabetes and liver disease. Almost half the gains can be attributed to public-health efforts.

We began this century with a life expectancy of 47 years for men, 49 for women. We've stretched that set of numbers by almost 30 years. And we intend to stretch them even more.

The taxpayer dollar gets excellent value out of the Public Health Service, in terms of treatment and its more effective and less costly counterpart, prevention.

Ask the millions alive today because of simple things we now take for granted, such as immunizations. Ask the thousands healthy because of an aggressive campaign to encourage organ donation. Ask the professionals seeking solutions in our nation's laboratories, confident that their mission will be backed up by the resources required.

Meanwhile, HHS extends preventive health coverage and care to increasing numbers of people in need. The Children's Health Insurance Program is seeking out the uninsured, and programs to provide immunizations for senior citizens are flourishing.

We are at the threshold of making Sudden Infant Death Syndrome a rarity, and the battle against AIDS, including prevention programs, has come far.

President Clinton created the 21st Century Fund to support work at the National Institutes of Health. The Centers for Disease Control and Prevention (CDC) has programs to discourage teen smoking, encourage health lifestyles, and prevent HIV infection. The CDC continues its work with state health departments to protect citizens from outbreaks of disease.

America at its finest is a delivery system for dreams. Part of that promise ought to be the delivery of a healthy, safe life free of danger and disease. We need to back that promise with our national conscience and a national commitment.

Lynn H. Yeakel is regional director of the Department of Health and Human Services for the Mid-Atlantic Region.

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