- Julius B. Richmond
Julius Benjamin Richmond, (
September 26 ,1916 –July 27 ,2008 ) served as theUnited States Surgeon General and theUnited States Assistant Secretary for Health during the Carter Administration, from 1977 to 1981. He held the rank of Vice Admiral in theUnited States Public Health Service Commissioned Corps while serving in those positions. He was also noted for his role in creating theHead Start program for disadvantaged children, serving as its first national director.Early life
Richmond was born in
Chicago toRussia n-Jew ish immigrant parents. ["Richmond was born in 1916 into a Jewish-Russian immigrant family...." Passage quoted from [http://www.springerlink.com/content/q250267711267v28 "The physician and social renewal: Julius B. Richmond as role model",] in the "Journal of Medical Humanities ," Volume 12, No. 1, March 1991, Pages 25-34] He was educated during theGreat Depression , earning his B.S. at theUniversity of Illinois at Urbana-Champaign , followed by an M.S. in physiology and his M.D. from theUniversity of Illinois College of Medicine in 1939. After completing an 18-month rotating internship at Cook County Hospital in Chicago, Richmond entered twopediatrics residencies, the first at Chicago’s Municipal Contagious Disease Hospital (1941–1942) and the second at Cook. The United States’ entry intoWorld War II interrupted Richmond’s postgraduate training, as he volunteered and was inducted into the Army Air Corps in February 1942. Through 1946 Richmond worked as a flight surgeon with the Air Force’s Flying Training Command.Academic career
After demobilization, Richmond completed his residency and began what would be a distinguished
academic career in which public service was an integral part of scholarlyresearch . He began as a professor in Pediatrics at his alma mater (1946–53) and a Markle Foundation scholar in medical science (1948–53), and was active both in nonprofit children’s welfare organizations and Chicago’s Institute for Psychoanalysis. During 1953 he moved to the State University of New York at Syracuse College of Medicine (now known as the Upstate Medical Center). The Supreme Court’s decision in Brown v. Board of Education (1954) inspired Richmond and his colleague,Betty Caldwell , to turn their interdisciplinary research, integrating elements ofpsychiatry intopediatrics , toward policy ends as they documented how poverty threatened the psychosocial development of young children. They focused on cognitive abilities developed during a child’s first years, where functional deficits linked topoverty , for example, those caused bymalnutrition , could make learning more difficult and as a result, put the children of the poor at risk of failing both at school and later on, in attempts to advance economically.Richmond’s work at Syracuse caught the eye of
Sargent Shriver , head of theKennedy Foundation . After PresidentLyndon B. Johnson tapped Shriver to head a new independent agency, theOffice of Economic Opportunity (OEO) (1964), Shriver convinced Richmond to take a leave of absence and join him. At OEO Richmond would use a demonstration grants mechanism to create two important new public health programs that incorporated OEO’s mandate to aid local groups directly, rather than channeling resources through state health departments, the traditional partners of theDepartment of Health, Education, and Welfare 's Public Health Service. During 1965, Richmond implemented ProjectHead Start , an enrichment program for disadvantaged pre-school age children that was greeted eagerly by community groups. Building on health-related proposals submitted in response to Head Start, in 1966 Richmond sponsored a series of Neighborhood Health Centers that united economic development and local oversight of, and participation in, health services delivery.In 1967, Richmond left OEO to return to Syracuse, to serve as Dean of the medical faculty. During 1971 he moved to
Harvard Medical School , where he held professorships in two departments, Child Psychiatry and Human Development (1971–73) and Preventive & Social Medicine (1971–79), directed the Judge Baker Guidance Center in Boston (1971–77), a nonprofit mental health organization that works with Boston’s juvenile courts, and also served as Chief of Psychiatry at theChildren's Hospital Boston .As Surgeon General
Nearly a decade later after Richmond stepped down from OEO, former OEO official
Joseph Califano , now PresidentJimmy Carter ’s Secretary of DHEW, asked him to return to Federal service as Assistant Secretary for Health (July 1977). Richmond accepted, on condition that his position as Assistant Secretary, with its line authority over PHS, be combined with that of Surgeon General, widely recognized as a spokesperson for public health. Califano obliged with a December 1977 inhouse reorganization that boosted and streamlined PHS’s management capabilities through its Office of the Assistant Secretary for Health (OASH).Richmond brought a commitment to access and equity that reflected his earlier work implementing President Johnson’s
Great Society . In national health affairs, however, the latter half of the 1970s was a period of retrenchment and effort to curb health-related expenditures. Economic downturns challenged the country’s willingness to support a continued expansion of health care programs and after 1974] , the removal of wage and price controls on health care providers meant dramatic cost increases for the Medicare andMedicaid programs. Many believed that controls were a necessary prerequisite to any form ofnational health insurance , and the type of controls became a point of contention, for example, with the Congress opposing the Carter Administration’s decision to focus onhospital expenditures.Despite the times, Richmond’s neighborhood health centers remained, championed by Congress and reinforced by an assortment of PHS programs to improve access to care. Transferred to PHS jurisdiction in the early 1970s, neighborhood health centers were renamed
community health center s, authorized under 1975 legislation, scaled down and revamped to focus on rural (1975) and urban (1977) areas, spread thin to include new constituencies like residents ofAppalachia andmigrant worker s and those served by PHS’s National Health Service Corps. During Richmond’s tenure, Congress would pass theHealth Services and Centers Act of 1978 (PL95-626), which reauthorized a broad array of public health services, community and migrant health centers, grants for primary care projects, and grants-in-aid to support public health programs and authorized $2.9 billion in expenditures. The health of children also remained a top priority. The Communicable Disease Center (CDC) carried out a successfulimmunization campaign that focused onmeasles and other childhood diseases that disproportionately affected the poor, meeting an initial goal of immunizing at least 90 percent of eligible children by October 1979. In addition, there were efforts to establish a Child Health Assurance Program to improve prevention by broadening eligibility for the existing Medicaid Early and Periodic Screening, Diagnosis and Treatment Program.At PHS Richmond remains best known for his leadership in devising and implementing quantitative goals for public health, first published in 1979 as "Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention". "Healthy People" moved PHS beyond its limited capabilities to lessen disparities in health services provision, to spur change by getting information out to journalists, health departments, and others about gains already made in reduced mortality from noninfectious causes. Richmond and Secretary Califano drew on the precedent of former Surgeon General
Luther Terry 's1964 Report on Smoking and Health to build professional and public consensus toward making prevention key to PHS’s efforts.A new
Office of Disease Prevention and Health Promotion (1979) under Assistant Surgeon GeneralMichael McGinnis prepared the formal publication, setting forth ambitious health goals to be achieved by 1990, and the Institute of Medicine drafted an accompanying volume, "Promoting Health/Preventing Disease: Objectives For The Nation" (1980), which included a series of specific targets within set categories for each age-group. One of the major goals of this effort was to educate people on how they could take more personal responsibility for their health through wise lifestyle choices. Richmond’s Healthy People campaign was a remarkable success, especially in light of the political firestorm in Congress and by the tobacco industry when Secretary Califano became an outspoken critic ofcigarette smoking as a major contributor to preventable disease.Later life
After the
Reagan Administration assumed power in the spring of 1981, Richmond stepped down from his dual post and returned to academe.At Harvard he would serve as a Professor of Health Policy (1981–1988) and as the John D. MacArthur Professor of Management and Director of the
Division of Health Policy Research and Education (1987 onward) and as well chair the steering committee of theNational Academy of Science ’s Forum on the Future of Children and Families (NAS). Since 1988 he had beenEmeritus at Harvard.Richmond died of cancer at age 91, at his home in
Chestnut Hill , near Boston, onJuly 27 ,2008 . [http://www.boston.com/news/local/articles/2008/07/30/physician_who_led_launch_of_head_start_dies?mode=PF "Physician who led launch of Head Start dies",] by Bryan Marquard, "Boston Globe ,"July 30 ,2008 ]References
;Sources
* [http://www.latimes.com/news/printedition/california/la-me-richmond30-2008jul30,0,5321250.story Julius Richmond's obituary at the Los Angeles Times]"This article was originally based on
public domain [http://www.surgeongeneral.gov/library/history/biorichmond.htm text] written by the U.S. government."
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