PHS was established on July 16, 1798, by an Act of Congress as a prepaid hospital program for merchant seamen. Since then, PHS has grown from a handful of contract physicians to more than 50,000 health care professionals and a 6,000-member all-officer Commissioned Corps. Together, they account for more than 90 percent of the Department of Health and Human Services’ full-time personnel. PHS expenditures have grown from $75,000 in 1798 to about $25 billion during fiscal year 1998.

• During its 200-year history, PHS has provided vital services such as quarantines to control the spread of disease, medical inspection of immigrants, education of health professionals, and basic and clinical research to improve and protect the Nation’s health. Since the Civil War, PHS has been particularly active in promoting progress in public health and medicine. Highlights include:
• Nobel Prize-winning research on the leading causes of death, including cardiovascular disease, injuries, cancer, and HIV/AIDS. Public education campaigns have been conducted based on research results, such as the campaign to achieve a smoke-free society.
• Pioneering regulation to ensure the safety of the Nation’s food supply, as well as the safety and efficacy of pharmaceuticals and medical de-vices. In addition, PHS participates in the new Food Safety Initiative and the Partnership for Food Safety Education.
• Cutting-edge surveillance of communicable diseases such as Hanta virus infections, influenza, and tropical parasitic diseases and successful campaigns against small-pox, polio, and malaria. In addition, immunization rates continue to increase among children, with rates for some vaccines exceeding the Healthy People 2000 objective.
• Grants for health professions education, hospital construction, and medical services to improve the Nation’s health care system.
• Sanitation programs to bring clean water and sewage disposal to tens of thousands at home and abroad.
• Delivery of health care to people in need, including programs to expand treatment for mental illness and substance abuse.

PHS often has had to undertake difficult and unpleasant tasks. In the years during World War I, for example, PHS staff members helped prepare rat poison to combat an outbreak of bubonic plague. Another problem during the 19th and early 20th centuries was typhoid fever. PHS assisted in providing inoculations. The fight against the spread of communicable disease has always been one of PHS’s major goals. In the 1950s, mobile immunization clinics were used to reach populations who had difficulty getting immunized.

PHS’s success can be seen in many areas. Age-adjusted death rates are down for leading causes of death such as heart disease, stroke, pneumonia/influenza, diabetes, and liver disease. Almost half of these gains can be attributed to public health measures.

PHS’s role in promoting health and preventing disease will be even more critical in the future as the number of underserved people grows and expenditures for health care remain constrained.

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