William H. Stewart
Encyclopedia
William H. Stewart was an American pediatrician
and epidemiologist
. He was appointed tenth Surgeon General of the United States
from 1965 to 1969.
. He began college at the University of Minnesota
and completed his undergraduate degree at Louisiana State University
(LSU) (1942), after his father moved the family to Baton Rouge
during World War II
to chair the pediatrics
department at LSU. Stewart earned his medical degree through an accelerated program at the LSU Health Sciences Center in New Orleans, under the auspices of the U.S. Army's Specialized Training Program. After graduating in 1945, he received a commission as a first lieutenant
, kept an inactive status during his 9-month internship at Philadelphia General Hospital, and then served as a Medical Officer at Brooke General Hospital in San Antonio, Texas
(1946–1947). After a brief stint at the Minneapolis Veterans Administration
hospital at Fort Snelling, Stewart returned home to Baton Rouge for a 2-year pediatrics residency
at Charity Hospital
(1948–1950). His plans to enter private practice were cut short by the outbreak of the Korean War
and his remaining military obligation.
's Epidemic Intelligence Service
(EIS) at the Communicable Disease Center (CDC). In February 1951, Stewart accepted a Commission in PHS's Inactive Reserve as a Senior Assistant Surgeon. Four months later, he was dispatched as the sole physician epidemiologist to CDC’s Thomasville, Georgia
Field Station. As an EIS Fellow he worked under Dr. James Watt
(soon to be named Director of the new National Heart Institute) (NIH), studying how fly eradication dampened outbreaks of childhood diarrhea
l diseases and about DDT
's efficacy in combating typhus
. After EIS, Stewart followed his mentor to the National Heart Institute and became a trainee at the Grants and Training Branch of the National Heart Institute (November 1953). When PHS opened a Heart Disease Control Program under its Bureau of State Services (BSS), Stewart was named chief (October 1954), returning to NIH in July 1956 to lead its Technical Services Branch.
In April 1957 then-Surgeon General LeRoy Edgar Burney
recruited junior officer Stewart to join his staff. Stewart managed a number of projects related to planning, administrative reorganization, and health professions education and led the Office's applied research unit—Public Health Methods—from July 1958 through 1961. With some form of national health insurance
widely anticipated to be imminent, Stewart became an inhouse expert for PHS on issues related to health services delivery and third-party reimbursement. In November 1961 he returned to BSS to head a new Division of Community Health Services devoted to these issues, then from January 1963 through August 1965 worked closely with Medicare
architect Wilbur Cohen (the Department of Health, Education, and Welfare (DHEW) Assistant Secretary for Legislation), as an Assistant to Dr. Boisfeuillet Jones, the Special Assistant for Health and Medical Affairs (subsequently renamed the Assistant Secretary for Health). Stewart’s nomination to be Surgeon General on September 24, 1965 came as a complete surprise. Only weeks earlier, then-Surgeon General Luther Leonidas Terry
had appointed him to succeed James Watt as Director of NHI.
and to cut back because of the war in Vietnam
and a slowing of the phenomenal growth of NIH. His response was to weave PHS into the Johnson
Administration’s creative approaches to federalism, using the highly successful Hill-Burton hospital construction program as a starting point for efforts to improve access to services through government planning. Soon after Stewart became Surgeon General, for example, PHS took on the high-profile and critical task of certifying the nation’s hospitals for compliance with Title 6 of the Civil Rights Act of 1964
, prior to the July 1966 implementation of Medicare reimbursement for health services. Public concern that NIH research become the basis for improved care and greater access to care moved DHEW to convene the DeBakey Commission, whose 1964 Report Stewart used as the basis for PHS’s Regional Medical Program (the Heart Disease, Cancer, and Stroke Amendments of 1965). States relations programs, including categorical grants-in-aid to state health departments, were revamped along the lines of urban planning, as the Comprehensive Health Planning Act (also known as the Partnership For Health Act of 1966 and its 1967 Amendments) bypassed state health departments to award grants directly to local government and community not-for-profits, coordinated through state (so-called "section 314a") and nongovernmental ("section 314b") planning agencies.
Cycles of administrative upheaval accompanied these dramatic changes at PHS. The first of two major reorganizations reflected nearly a decade’s worth of planning, articulated in terms of operations research and functionally oriented management theory (known as program planning and budgeting). In contrast, the second was a dramatic reshuffling of the organizational deck by Acting Secretary of DHEW and Medicare program architect Wilbur Cohen. When Stewart became Surgeon General, he inherited an agency over which he, a career officer in PHS’s Commissioned Corps, exerted line authority. PHS enjoyed strong relationships with state health departments, the American Medical Association
, and budgetary largesse for the National Institutes of Health
. As a result of the two reorganizations, his successor would report as a senior advisor to the Assistant Secretary for Health and Scientific Affairs, a political appointee, and would not even be appointed until well into President Nixon’s first term.
Stewart’s influence was more visible during the first reorganization than the second. Reorganization Plan No. 3, enacted April 25, 1966 and effective the following January (1967) gave explicit attention to the issues of access to services and environmental health. The CDC served as a model, with its decentralized administration, relative independence from Washington, and strong public constituencies. PHS activities were arranged into five Bureau-level units: Health Manpower (education programs); Health Services (concerning access, Medicare, and Medicaid); Disease Prevention and Environmental Control (environmental health); the National Institute of Mental Health
(research and clinics); and the National Institutes of Health (basic and clinical research).
PHS’s new organizational chart was quickly outmoded. When the second reorganization took place the following spring (1968) the Assistant Secretary for Health and Scientific Affairs for DHEW, Dr. Philip Lee, replaced the Surgeon General as head of PHS. The five Bureaus were consolidated into three: the National Institutes of Health; a new Health Services and Mental Health Administration (HSMHA); and a new Consumer Protection and Environmental Health Service (CPEHS), which contained programs from the short-lived Bureau of Disease Prevention & Environmental Control and the Food and Drug Administration
, formerly an independent agency that had reported directly to the Secretary of DHEW.
From the optimistic days of the Civil Rights Act of 1964, the War on Poverty
, and Medicare, PHS entered into an era characterized by more complicated bureaucratic
maneuvering, increased public involvement, and renewed efforts to control Federal health expenditures. Midway through President Richard Nixon’s first year in office, Stewart submitted his resignation (August 1, 1969). He returned to Louisiana State University (LSU)'s Medical Center at New Orleans, first as Chancellor (1969–74), then as a Professor of Pediatrics and head of the department (1973–77), concurrent with an appointment as Secretary of Louisiana’s State Department of Health and Human Resources (1974–77). Since that time, Stewart has served as Head of the Department of Preventive Medicine and Public Health at LSU.
of complications from kidney failure.
Pediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...
and epidemiologist
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...
. He was appointed tenth Surgeon General of the United States
Surgeon General of the United States
The Surgeon General of the United States is the operational head of the Public Health Service Commissioned Corps and thus the leading spokesperson on matters of public health in the federal government...
from 1965 to 1969.
Early years
Stewart was born in Minneapolis, MinnesotaMinneapolis, Minnesota
Minneapolis , nicknamed "City of Lakes" and the "Mill City," is the county seat of Hennepin County, the largest city in the U.S. state of Minnesota, and the 48th largest in the United States...
. He began college at the University of Minnesota
University of Minnesota
The University of Minnesota, Twin Cities is a public research university located in Minneapolis and St. Paul, Minnesota, United States. It is the oldest and largest part of the University of Minnesota system and has the fourth-largest main campus student body in the United States, with 52,557...
and completed his undergraduate degree at Louisiana State University
Louisiana State University
Louisiana State University and Agricultural and Mechanical College, most often referred to as Louisiana State University, or LSU, is a public coeducational university located in Baton Rouge, Louisiana. The University was founded in 1853 in what is now known as Pineville, Louisiana, under the name...
(LSU) (1942), after his father moved the family to Baton Rouge
Baton Rouge, Louisiana
Baton Rouge is the capital of the U.S. state of Louisiana. It is located in East Baton Rouge Parish and is the second-largest city in the state.Baton Rouge is a major industrial, petrochemical, medical, and research center of the American South...
during World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...
to chair the pediatrics
Pediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...
department at LSU. Stewart earned his medical degree through an accelerated program at the LSU Health Sciences Center in New Orleans, under the auspices of the U.S. Army's Specialized Training Program. After graduating in 1945, he received a commission as a first lieutenant
First Lieutenant
First lieutenant is a military rank and, in some forces, an appointment.The rank of lieutenant has different meanings in different military formations , but the majority of cases it is common for it to be sub-divided into a senior and junior rank...
, kept an inactive status during his 9-month internship at Philadelphia General Hospital, and then served as a Medical Officer at Brooke General Hospital in San Antonio, Texas
San Antonio, Texas
San Antonio is the seventh-largest city in the United States of America and the second-largest city within the state of Texas, with a population of 1.33 million. Located in the American Southwest and the south–central part of Texas, the city serves as the seat of Bexar County. In 2011,...
(1946–1947). After a brief stint at the Minneapolis Veterans Administration
United States Department of Veterans Affairs
The United States Department of Veterans Affairs is a government-run military veteran benefit system with Cabinet-level status. It is the United States government’s second largest department, after the United States Department of Defense...
hospital at Fort Snelling, Stewart returned home to Baton Rouge for a 2-year pediatrics residency
Residency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
at Charity Hospital
Charity Hospital
Charity Hospital was one of two teaching hospitals which were part of the Medical Center of Louisiana at New Orleans . Three weeks after the events of Hurricane Katrina, then Governor Kathleen Blanco said that Charity Hospital would not reopen, even though the military had scrubbed the building to...
(1948–1950). His plans to enter private practice were cut short by the outbreak of the Korean War
Korean War
The Korean War was a conventional war between South Korea, supported by the United Nations, and North Korea, supported by the People's Republic of China , with military material aid from the Soviet Union...
and his remaining military obligation.
Career
Stewart's introduction to the Public Health Service (PHS) came when the Air Force agreed to transfer him into the first class of renowned epidemiologist Alexander LangmuirAlexander Langmuir
Alexander Duncan Langmuir was an American epidemiologist. He is renowned for creating the Epidemic Intelligence Service.-Biography:...
's Epidemic Intelligence Service
Epidemic Intelligence Service
The Epidemic Intelligence Service is a program of the United States' Centers for Disease Control and Prevention . Established in 1951, due to biological warfare concerns arising from the Korean War, it has become a hands-on two-year postgraduate training program in epidemiology, with a focus on...
(EIS) at the Communicable Disease Center (CDC). In February 1951, Stewart accepted a Commission in PHS's Inactive Reserve as a Senior Assistant Surgeon. Four months later, he was dispatched as the sole physician epidemiologist to CDC’s Thomasville, Georgia
Thomasville, Georgia
Thomasville is the county seat of Thomas County, Georgia, United States. The city is the second largest in Southwest Georgia after Albany.The city deems itself the City of Roses and holds an annual Rose Festival. The town features plantations open to the public, a historic downtown, a large...
Field Station. As an EIS Fellow he worked under Dr. James Watt
James Watt
James Watt, FRS, FRSE was a Scottish inventor and mechanical engineer whose improvements to the Newcomen steam engine were fundamental to the changes brought by the Industrial Revolution in both his native Great Britain and the rest of the world.While working as an instrument maker at the...
(soon to be named Director of the new National Heart Institute) (NIH), studying how fly eradication dampened outbreaks of childhood diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
l diseases and about DDT
DDT
DDT is one of the most well-known synthetic insecticides. It is a chemical with a long, unique, and controversial history....
's efficacy in combating typhus
Typhus
Epidemic typhus is a form of typhus so named because the disease often causes epidemics following wars and natural disasters...
. After EIS, Stewart followed his mentor to the National Heart Institute and became a trainee at the Grants and Training Branch of the National Heart Institute (November 1953). When PHS opened a Heart Disease Control Program under its Bureau of State Services (BSS), Stewart was named chief (October 1954), returning to NIH in July 1956 to lead its Technical Services Branch.
In April 1957 then-Surgeon General LeRoy Edgar Burney
Leroy Edgar Burney
Leroy Edgar Burney was an American physician and public health official. He was appointed the eighth Surgeon General of the United States from 1956 to 1961.-Early years:...
recruited junior officer Stewart to join his staff. Stewart managed a number of projects related to planning, administrative reorganization, and health professions education and led the Office's applied research unit—Public Health Methods—from July 1958 through 1961. With some form of national health insurance
National health insurance
National health insurance is health insurance that insures a national population for the costs of health care and usually is instituted as a program of healthcare reform. It is enforced by law. It may be administered by the public sector, the private sector, or a combination of both...
widely anticipated to be imminent, Stewart became an inhouse expert for PHS on issues related to health services delivery and third-party reimbursement. In November 1961 he returned to BSS to head a new Division of Community Health Services devoted to these issues, then from January 1963 through August 1965 worked closely with Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
architect Wilbur Cohen (the Department of Health, Education, and Welfare (DHEW) Assistant Secretary for Legislation), as an Assistant to Dr. Boisfeuillet Jones, the Special Assistant for Health and Medical Affairs (subsequently renamed the Assistant Secretary for Health). Stewart’s nomination to be Surgeon General on September 24, 1965 came as a complete surprise. Only weeks earlier, then-Surgeon General Luther Leonidas Terry
Luther Leonidas Terry
Luther Terry was an American physician and public health official. He was appointed the ninth Surgeon General of the United States from 1961 to 1965, and is best known for his warnings against the dangers of and the impact of tobacco use on health.-Early years:Luther Leonidas Terry was born in Red...
had appointed him to succeed James Watt as Director of NHI.
Surgeon General
Stewart found himself at the helm of PHS under pressure both to expand his agency because of Medicare and MedicaidMedicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
and to cut back because of the war in Vietnam
Vietnam War
The Vietnam War was a Cold War-era military conflict that occurred in Vietnam, Laos, and Cambodia from 1 November 1955 to the fall of Saigon on 30 April 1975. This war followed the First Indochina War and was fought between North Vietnam, supported by its communist allies, and the government of...
and a slowing of the phenomenal growth of NIH. His response was to weave PHS into the Johnson
Lyndon B. Johnson
Lyndon Baines Johnson , often referred to as LBJ, was the 36th President of the United States after his service as the 37th Vice President of the United States...
Administration’s creative approaches to federalism, using the highly successful Hill-Burton hospital construction program as a starting point for efforts to improve access to services through government planning. Soon after Stewart became Surgeon General, for example, PHS took on the high-profile and critical task of certifying the nation’s hospitals for compliance with Title 6 of the Civil Rights Act of 1964
Civil Rights Act of 1964
The Civil Rights Act of 1964 was a landmark piece of legislation in the United States that outlawed major forms of discrimination against African Americans and women, including racial segregation...
, prior to the July 1966 implementation of Medicare reimbursement for health services. Public concern that NIH research become the basis for improved care and greater access to care moved DHEW to convene the DeBakey Commission, whose 1964 Report Stewart used as the basis for PHS’s Regional Medical Program (the Heart Disease, Cancer, and Stroke Amendments of 1965). States relations programs, including categorical grants-in-aid to state health departments, were revamped along the lines of urban planning, as the Comprehensive Health Planning Act (also known as the Partnership For Health Act of 1966 and its 1967 Amendments) bypassed state health departments to award grants directly to local government and community not-for-profits, coordinated through state (so-called "section 314a") and nongovernmental ("section 314b") planning agencies.
Cycles of administrative upheaval accompanied these dramatic changes at PHS. The first of two major reorganizations reflected nearly a decade’s worth of planning, articulated in terms of operations research and functionally oriented management theory (known as program planning and budgeting). In contrast, the second was a dramatic reshuffling of the organizational deck by Acting Secretary of DHEW and Medicare program architect Wilbur Cohen. When Stewart became Surgeon General, he inherited an agency over which he, a career officer in PHS’s Commissioned Corps, exerted line authority. PHS enjoyed strong relationships with state health departments, the American Medical Association
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...
, and budgetary largesse for the National Institutes of Health
National Institutes of Health
The National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...
. As a result of the two reorganizations, his successor would report as a senior advisor to the Assistant Secretary for Health and Scientific Affairs, a political appointee, and would not even be appointed until well into President Nixon’s first term.
Stewart’s influence was more visible during the first reorganization than the second. Reorganization Plan No. 3, enacted April 25, 1966 and effective the following January (1967) gave explicit attention to the issues of access to services and environmental health. The CDC served as a model, with its decentralized administration, relative independence from Washington, and strong public constituencies. PHS activities were arranged into five Bureau-level units: Health Manpower (education programs); Health Services (concerning access, Medicare, and Medicaid); Disease Prevention and Environmental Control (environmental health); the National Institute of Mental Health
National Institute of Mental Health
The National Institute of Mental Health is one of 27 institutes and centers that make up the National Institutes of Health...
(research and clinics); and the National Institutes of Health (basic and clinical research).
PHS’s new organizational chart was quickly outmoded. When the second reorganization took place the following spring (1968) the Assistant Secretary for Health and Scientific Affairs for DHEW, Dr. Philip Lee, replaced the Surgeon General as head of PHS. The five Bureaus were consolidated into three: the National Institutes of Health; a new Health Services and Mental Health Administration (HSMHA); and a new Consumer Protection and Environmental Health Service (CPEHS), which contained programs from the short-lived Bureau of Disease Prevention & Environmental Control and the Food and Drug Administration
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
, formerly an independent agency that had reported directly to the Secretary of DHEW.
From the optimistic days of the Civil Rights Act of 1964, the War on Poverty
War on Poverty
The War on Poverty is the unofficial name for legislation first introduced by United States President Lyndon B. Johnson during his State of the Union address on January 8, 1964. This legislation was proposed by Johnson in response to a national poverty rate of around nineteen percent...
, and Medicare, PHS entered into an era characterized by more complicated bureaucratic
Bureaucracy
A bureaucracy is an organization of non-elected officials of a governmental or organization who implement the rules, laws, and functions of their institution, and are occasionally characterized by officialism and red tape.-Weberian bureaucracy:...
maneuvering, increased public involvement, and renewed efforts to control Federal health expenditures. Midway through President Richard Nixon’s first year in office, Stewart submitted his resignation (August 1, 1969). He returned to Louisiana State University (LSU)'s Medical Center at New Orleans, first as Chancellor (1969–74), then as a Professor of Pediatrics and head of the department (1973–77), concurrent with an appointment as Secretary of Louisiana’s State Department of Health and Human Resources (1974–77). Since that time, Stewart has served as Head of the Department of Preventive Medicine and Public Health at LSU.
Personal life
Stewart died at age 86 in Metairie, LouisianaMetairie, Louisiana
Metairie is a census-designated place in Jefferson Parish, Louisiana, United States and is a major part of the New Orleans Metropolitan Area. Metairie is the largest community in Jefferson Parish. It is an unincorporated area that would be larger than most of the state's cities if it were...
of complications from kidney failure.