US Public Health Service

The US Public Health Service (PHS) is one of seven Uniformed Services of the United States and has been around for over 200 years.  The origins of the PHS may be traced to the passage of an Act in 1798 signed by President John Adams that provided for the care and relief of sick and injured merchant seamen.  The earliest Marine Hospitals created to care for the seamen were located along the East Coast, at the harbors of the major port cities, with Boston being the site of the first such facility, followed later by others including in the Baltimore vicinity at Curtis Bay.  Later they were also established during the 1830s and 1840s along inland waterways, the Great Lakes, and the Gulf of Mexico. By the 1850s the Marine Hospitals were established along the Pacific Coasts as the country expanded westward.  Funding for the Marine Hospital’s was provided by a mandatory tax of about 1% of the wages of all maritime sailors. The PHS commissioned officer corps was formally established by congressional legislation in 1889, and signed by 22nd/24th President Grover Cleveland.  At first open only to physicians, over the course of the 20th Century, the PHS expanded to include veterinarians, dentists, physician assistants, sanitary engineers, pharmacists, nurses, environmental health officers, scientists, physical therapists, and other types of health professionals. The PHS was called upon to assist the military in the Spanish-American War of 1898.  All of the PHS Marine Hospitals were made available for the care of the sick and wounded of the Army and Navy. A PHS medical officer was on duty aboard the Revenue Cutter McCullough with the fleet of Commodore Dewy at the battle of Manila Bay.

 

During World War II, the President was given legislative authority for militarizing the PHS. Congress on November 11, 1943 authorized military benefits for the commissioned officers of the PHS and also gave the President the authority to declare the PHS to be a military service in times of war.  The Public Health Service Act of July 1, 1944, which repealed the 1943 Act, contained the same provision for militarization of the PHS.  On June 21, 1945, President Truman issued Executive order No. 9575 which declared "the commissioned corps of the Public Health Service to be a military service and a branch of the land and naval forces of the United States during the period of the present war, World War II. " The Public Health Service Act of July 1, 1944 was later amended to state that the President might declare the PHS to be a military service not only in time of threatened or actual war, but also in "an emergency involving the national defense proclaimed by the President." In the absence of a declared war in Korea, the PHS reverted back to a Uniformed Service although many PHS officers deployed. The PHS also contributed support to military operations such as in Vietnam and the Persian Gulf.  For example, the PHS organized surgical teams in Vietnam, consisting of both active duty officers and civilian personnel.  PHS was also involved in efforts to control malaria and other infectious diseases in Vietnam.  On July 6, 1988, the Department of Health and Human Services and the Department of Defense signed for the first time a Memorandum of Agreement which established a contingency planning relationship between the departments "for the mobilization and employment of US Public Health Service (PHS) Commissioned Corps Officers in DoD health care activities." The PHS has partnered, very successfully, with the Defense Health Agency of the Department of Defense to augment behavioral health and physical therapy resources for returning Soldiers, Sailors, Airmen, and Marines. 

 

Although a small branch of service with 6746 commissioned officers, the PHS deployed nearly 900 officers providing a continuous presence from 2001 to 2014 for ongoing operations in both Afghanistan and Iraq. PHS officers also deployed to backfill medical needs at Landsthul Regional Medical Center in Germany and Tripler Army Medical Center in Hawaii to provide care to wounded warriors.  PHS officers are currently assigned to the Pentagon, NORAD, TRICARE, Secret Service, Department of Homeland Security, and Army and Air Force medical treatment facilities (MTFs) all across the nation providing care to wounded warriors with traumatic brain injuries. PHS officers also provide direct health care services to service members of the US Coast Guard and the commissioned officers of NOAA.

 

PHS officers are involved in health care delivery to underserved and vulnerable populations, disease control and prevention, biomedical research, food and drug regulation, mental health and drug abuse services, and response efforts for natural and man-made disasters as an essential component of the largest public health program in the world. The PHS were once again called upon in 2014 when President Barack Obama pledged the nation’s resources in the fight against the Ebola virus in West Africa.  A team of specialized PHS officers deployed to Monrovia, Liberia, to manage and staff a 25-bed hospital (MMU) constructed by the Department of Defense to treat health care workers stricken with the virus.  More than 300 PHS officers deployed to Monrovia for the MMU mission, while an additional 300 PHS officers deployed to West Africa in support of CDC missions.  

 

In the recent past, PHS officers were deployed to respond to multiple public health crises. Some notable recent deployments involving the PHS:

 

In addition to disaster response, the PHS has partnered with the US Navy on their health diplomacy missions. PHS officers have been part of the Navy's Pacific Partnership (in the Pacific basin) and Continuing Promise (in the Caribbean/west Atlantic) since 2007. Such missions are often carried out on either the USNS Mercy (T-AH-19) or USNS Comfort (T-AH-20), though other ships, such as the USS Bataan (LHD-5) have also been used.

 

Today, the PHS has and continues to serve this Nation in time of peace and war.  Although a small Uniformed Service of 6746 commissioned officers, the PHS stands ready to meet the global and domestic health challenges of the 21st century as the only Uniformed Service in the world that focuses exclusively on the public’s health.