The United
States Public Health Service (PHS) celebrated its
bicentennial year in 1998. Its mission is to promote
the health of the nation, understand and prevent
disease, assure safe and effective drugs and devices,
deliver health care services, and supply health
expertise in time of national emergencies. Whether
serving as either Civil
Servants or Commissioned
Officers, dietitians and public health nutritionists
play an integral part in the mission of this distinguished
service.
During the late nineteenth century, records indicate
that proper nutrition and nourishment of hospitalized
patients were regulated under the direction of a
hospital steward. By 1902, preparation and food
service responsibilities were charged to pharmacists,
the only professional personnel other than the medical
officers attached to the hospitals. The importance
of nutrition and dietetics in the provision of health
care quickly became recognized as a required component
of hospital care. |
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The service of dietitians and nutritionists in the
PHS dates back to the year 1919. During that year, the
first dietetic section was organized in the PHS Division
of Hospitals which operated a medical care program for
American seamen. These hospitals were primarily located
in port cities with in-patient capacities ranging from
about 100 to 1,000 beds.
Ms Hallie Corsette, the first dietitian employed by
the PHS, was accorded the title Superintendent of Dietitians.
She supervised this newly created dietetic section of
the Division of Hospitals. The dietitians were placed
under the organizational structure of the medical officer
in charge of a facility. Ms. Corsette spent the majority
of her time planning dietary departments and recruiting
dietitians for the hospitals. By the close of 1919,
there were approximately 85 dietitians in the Division
of Hospitals; that number doubled over the next two
years. During those early years, a dietitian's duties
were focused chiefly on the purchase, preparation and
delivery of food.
In 1919, the PHS was charged with the responsibility
of furnishing medical and hospital care to sick and
disabled veterans of World War I. In 1922 the Veterans
Bureau was established to provide on-going medical care
to war veterans. As a result, the responsibility for
supervising many of the Public Health Service Hospitals
was transferred to the Veterans Bureau, later known
as the Veterans
Administration. Over 145 PHS dietitians were transferred
to those facilities to care for disabled war veterans.
The remaining PHS dietitians were placed under the general
direction of the Office of Nursing, Division of Hospitals.
Although the dietetic section was abolished as a result
of the transfers, dietitians continued with their primary
duties of food service administration and took on the
additional role of providing patient nutrition education.
During the Second World War, PHS dietitians worked as
part of the Civil Defense Mobilization Program. They
were responsible for developing recommendations for
foods, food storage, equipment and service that could
be used if communities suffered bombing attacks.
The functions and responsibilities of the PHS expanded
rapidly during the late 1930s and the early 1940s. Likewise,
the role of dietitians within the PHS continued to expand
beyond the hospital setting as dietitians were hired
by state and local health departments. The creation
of the Children's Bureau in 1912 provided states with
grant-in-aid for Maternal and Child Health, Crippled
Children's Services (Title V) and Child Welfare (Title
IV). Subsequently, in 1936 Ms Marjorie M. Heseltine
was employed as the first nutrition consultant in the
Children's Bureau. Five years later, the Bureau hired
a second consultant, Ms Helen Stacey.
In 1942 the PHS established mobile field units to conduct
nutrition appraisals in selected states. A medical officer
was also assigned to work as a nutrition consultant
for public health officials. Nutrition clinics were
developed in a few state and local health departments.
Today, both the Maternal
and Child Health Bureau and the Centers
for Disease Control and Prevention still continue
to play a vital role in providing nutrition leadership
and expertise to the state and local health departments.
As the work of the PHS expanded and the science of public
health developed, the need for collaboration between
related professionals in the public health field became
evident. With the passage of the Public Health Service
Act in 1944, a series of laws were passed which significantly
affected the nation's medical research, training efforts
and increased health services in the United States.
The expansion of the PHS required people with additional
specialized skills that could be rapidly deployed in
response to public health emergencies. The Regular Commissioned
Corps was expanded to include dietitians, nurses, veterinarians,
scientists, physical therapists, and sanitarians, and
other health professionals.
The authority to commission dietitians as PHS officers
was granted on July 1, 1944. At that time, the dietetic
section of the Division of Hospitals was reestablished.
Ms Marjorie Wood, the first commissioned dietitian and
the PHS Commissioned Corps' first Chief Dietitian, headed
the unit. The section was renamed the Dietetic Branch,
Office of Professional Services, and was charged with
the responsibility of developing, establishing and maintaining
dietetic standards in PHS hospitals; a major emphasis
was placed on therapeutic nutrition and teaching programs.
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