William H. Stewart
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William H. Stewart (May 19, 1921 – April 23, 2008) was an American
pediatrician Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the ...
and
epidemiologist Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and risk factor, determinants of health and disease conditions in a defined population. It is a cornerstone of public health, and shapes policy decision ...
. He was appointed tenth
Surgeon General of the United States The surgeon general of the United States is the operational head of the United States Public Health Service Commissioned Corps (PHSCC) and thus the leading spokesperson on matters of public health in the federal government of the United States. Th ...
from 1965 to 1969.


Biography


Early life and education

Stewart was born in
Minneapolis, Minnesota Minneapolis () is the largest city in Minnesota, United States, and the county seat of Hennepin County. The city is abundant in water, with thirteen lakes, wetlands, the Mississippi River, creeks and waterfalls. Minneapolis has its origins ...
. He began college at the
University of Minnesota The University of Minnesota, formally the University of Minnesota, Twin Cities, (UMN Twin Cities, the U of M, or Minnesota) is a public university, public Land-grant university, land-grant research university in the Minneapolis–Saint Paul, Tw ...
and completed his undergraduate degree at
Louisiana State University Louisiana State University (officially Louisiana State University and Agricultural and Mechanical College, commonly referred to as LSU) is a public land-grant research university in Baton Rouge, Louisiana. The university was founded in 1860 nea ...
(LSU) (1942), after his father moved the family to
Baton Rouge Baton Rouge ( ; ) is a city in and the capital of the U.S. state of Louisiana Louisiana , group=pronunciation (French: ''La Louisiane'') is a state in the Deep South and South Central regions of the United States. It is the 20th-sma ...
during
World War II World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the vast majority of the world's countries—including all of the great powers—forming two opposin ...
to chair the
pediatrics Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until th ...
department at LSU. Stewart earned his medical degree through an accelerated program at the LSU Health Sciences Center in
New Orleans New Orleans ( , ,New Orleans
Merriam-Webster.
; french: La Nouvelle-Orléans , es, Nuev ...
, under the auspices of the
U.S. Army The United States Army (USA) is the land service branch of the United States Armed Forces. It is one of the eight U.S. uniformed services, and is designated as the Army of the United States in the U.S. Constitution.Article II, section 2, cl ...
's Specialized Training Program. After graduating in 1945, he received a commission as a
first lieutenant First lieutenant is a commissioned officer military rank in many armed forces; in some forces, it is an appointment. The rank of lieutenant has different meanings in different military formations, but in most forces it is sub-divided into a s ...
, kept an inactive status during his 9-month
internship An internship is a period of work experience offered by an organization for a limited period of time. Once confined to medical graduates, internship is used practice for a wide range of placements in businesses, non-profit organizations and gover ...
at
Philadelphia General Hospital The Blockley Almshouse, later known as Philadelphia General Hospital, was a charity hospital and poorhouse located in West Philadelphia. It originally opened in 1732/33 in a different part of the city as the Philadelphia Almshouse (not to be conf ...
, and then served as a Medical Officer at Brooke General Hospital in
San Antonio, Texas ("Cradle of Freedom") , image_map = , mapsize = 220px , map_caption = Interactive map of San Antonio , subdivision_type = Country , subdivision_name = United States , subdivision_type1= State , subdivision_name1 = Texas , subdivision_t ...
(1946–1947). After a brief stint at the Minneapolis
Veterans Administration The United States Department of Veterans Affairs (VA) is a Cabinet-level executive branch department of the federal government charged with providing life-long healthcare services to eligible military veterans at the 170 VA medical centers and ...
hospital at
Fort Snelling Fort Snelling is a former military fortification and National Historic Landmark in the U.S. state of Minnesota on the bluffs overlooking the confluence of the Minnesota and Mississippi Rivers. The military site was initially named Fort Saint Anth ...
, Stewart returned home to Baton Rouge for a 2-year pediatrics
residency Residency may refer to: * Domicile (law), the act of establishing or maintaining a residence in a given place ** Permanent residency, indefinite residence within a country despite not having citizenship * Residency (medicine), a stage of postgrad ...
at
Charity Hospital Charity may refer to: Giving * Charitable organization or charity, a non-profit organization whose primary objectives are philanthropy and social well-being of persons * Charity (practice), the practice of being benevolent, giving and sharing * Ch ...
(1948–1950). His plans to enter private practice were cut short by the outbreak of the
Korean War , date = {{Ubl, 25 June 1950 – 27 July 1953 (''de facto'')({{Age in years, months, weeks and days, month1=6, day1=25, year1=1950, month2=7, day2=27, year2=1953), 25 June 1950 – present (''de jure'')({{Age in years, months, weeks a ...
and his remaining military obligation.


Early career

Stewart's introduction to the
Public Health Service In public relations and communication science, publics are groups of individual people, and the public (a.k.a. the general public) is the totality of such groupings. This is a different concept to the sociological concept of the ''Öffentlichkei ...
(PHS) came when the Air Force agreed to transfer him into the first class of renowned epidemiologist
Alexander Langmuir Alexander Duncan Langmuir (12 September 1910 – 22 November 1993) was an American epidemiologist. He is renowned for creating the Epidemic Intelligence Service. Biography Alexander D. Langmuir was born in Santa Monica, California. He received h ...
's
Epidemic Intelligence Service The Epidemic Intelligence Service (EIS) is a program of the U.S. Centers for Disease Control and Prevention (CDC). The modern EIS is a two-year, hands-on post-doctoral training program in epidemiology, with a focus on field work. History Creation ...
(EIS) at the
Communicable Disease Center The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
(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 is the county seat of Thomas County, Georgia, United States. The population was 18,413 at the 2010 United States Census, making it the second largest city in southwest Georgia after Albany, Georgia, Albany. The city deems itself the "C ...
Field Station. As an EIS Fellow he worked under Dr.
James Watt James Watt (; 30 January 1736 (19 January 1736 OS) – 25 August 1819) was a Scottish inventor, mechanical engineer, and chemist who improved on Thomas Newcomen's 1712 Newcomen steam engine with his Watt steam engine in 1776, which was fun ...
(soon to be named Director of the new
National Heart Institute The National Heart, Lung, and Blood Institute (NHLBI) is the third largest Institute of the National Institutes of Health, located in Bethesda, Maryland, United States. It is tasked with allocating about $3.6 billion in FY 2020 in tax revenue to ...
) (NIH), studying how
fly Flies are insects of the Order (biology), order Diptera, the name being derived from the Ancient Greek, Greek δι- ''di-'' "two", and πτερόν ''pteron'' "wing". Insects of this order use only a single pair of wings to fly, the hindwing ...
eradication dampened outbreaks of childhood
diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin wi ...
l diseases and about
DDT Dichlorodiphenyltrichloroethane, commonly known as DDT, is a colorless, tasteless, and almost odorless crystalline chemical compound, an organochloride. Originally developed as an insecticide, it became infamous for its environmental impacts. ...
's efficacy in combating
typhus Typhus, also known as typhus fever, is a group of infectious diseases that include epidemic typhus, scrub typhus, and murine typhus. Common symptoms include fever, headache, and a rash. Typically these begin one to two weeks after exposure. ...
. 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 The Bureau of State Services (BSS) was one of three principal operating agencies of the United States Public Health Service (PHS) from 1943 until 1966. The bureau contained the PHS divisions that administered cooperative services to U.S. states ...
(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 (December 31, 1906 – July 31, 1998) was an American physician and public health official. He was appointed the eighth Surgeon General of the United States from 1956 to 1961. Biography Early years Burney was born in Burney, I ...
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 (NHI), sometimes called statutory health insurance (SHI), is a system of health insurance that insures a national population against the costs of health care. It may be administered by the public sector, the private sector ...
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 Wilbur Joseph Cohen (June 10, 1913 – May 17, 1987) was an American social scientist and civil servant. He was one of the key architects in the creation and expansion of the American welfare state and was involved in the creation of both the Ne ...
(the
Department of Health, Education, and Welfare The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto is ...
(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 (September 15, 1911March 29, 1985) 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 dan ...
had appointed him to succeed James Watt as Director of NIH.


Surgeon General

Stewart found himself at the helm of PHS under pressure both to expand his agency because of Medicare and
Medicaid Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and pers ...
and to cut back because of the
war in Vietnam The Vietnam War (also known by other names) was a conflict in Vietnam, Laos, and Cambodia from 1 November 1955 to the fall of Saigon on 30 April 1975. It was the second of the Indochina Wars and was officially fought between North Vietnam a ...
and a slowing of the phenomenal growth of NIH. His response was to weave PHS into the
Johnson Johnson is a surname of Anglo-Norman origin meaning "Son of John". It is the second most common in the United States and 154th most common in the world. As a common family name in Scotland, Johnson is occasionally a variation of ''Johnston'', a ...
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 The Civil Rights Act of 1964 () is a landmark civil rights and United States labor law, labor law in the United States that outlaws discrimination based on Race (human categorization), race, Person of color, color, religion, sex, and nationa ...
, 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 The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's state ...
, and budgetary largesse for the
National Institutes of Health The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
. 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 The National Institute of Mental Health (NIMH) is one of 27 institutes and centers that make up the National Institutes of Health (NIH). The NIH, in turn, is an agency of the United States Department of Health and Human Services and is the prima ...
(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 Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
(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 The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
, 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 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 p ...
, and Medicare, PHS entered into an era characterized by more complicated
bureaucratic The term bureaucracy () refers to a body of non-elected governing officials as well as to an administrative policy-making group. Historically, a bureaucracy was a government administration managed by departments staffed with non-elected offi ...
maneuvering, increased public involvement, and renewed efforts to control Federal health expenditures.


Later career

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, Louisiana Metairie ( ) is a census-designated place (CDP) in Jefferson Parish, Louisiana, United States, and is part of the New Orleans metropolitan area. With a population of 143,507 in 2020, Metairie is the largest community in Jefferson Parish and was (a ...
of complications from kidney failure.


References

* * {{DEFAULTSORT:Stewart, William H. 1921 births 2008 deaths University of Minnesota alumni Surgeons General of the United States American pediatricians United States Army officers Louisiana State University faculty Louisiana State University alumni People from Minneapolis Deaths from kidney failure