Anna Huber

LI 383 Government Docs

Emporia State University

Medicine and the United States Government

Historical Context• 1798 Passage of an act for the relief

of sick and disabled seamen. Established a federal network of hospitals for the care of merchant seamen.

• 1871 Appointment of the first Supervising Surgeon (later called Surgeon General) for the Marine Hospital Service.

• 1891 Passage of immigration legislation, assigning to the Marine Hospital Service the responsibility for medical examination of arriving immigrants.

• 1902 Conversion of Marine Hospital Service into the Public Health and Marine Hospital Service, recognizing its activities in the field of public health. In 1912 the name was shortened to the Public Health Service.

Department Health, Education, and Welfare

• The Cabinet-level Department of Health, Education and Welfare (1953) was created by President Eisenhower.

• The Department of Education Organization Act (1979) created a separate Department of Education.

• HEW became the Department of Health and Human Services (HHS) in 1980.

US Department of Health and Human Services• Lead by the Office of the Secretary• Heads over 300 programs• Responsible for 25% of all government

spending• “ [T]he United States government's

principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.”

Divisions of US Department of Health and Human Services

• National Institutes of Health (NIH)

• Food and Drug Administration (FDA)

• Centers for Disease Control and Prevention (CDC)

• Indian Health Services (IHS)

• Human Resources and Services Administration (HRSA)

• Substance Abuse and Mental Health Services Administration (SAMHSA)

• Agency for Healthcare Research and Quality (AHRQ)

• Centers for Medicare and Medicaid Services (CMS)

• Administration for Children and Families (ACF)

• Administration on Aging (AoA)

• Agency for Toxic Substances and Disease Registry (ATSDR)

The Laboratory of Hygiene

• Originated in 1887 as a one room laboratory at the Marine Hospital Service in Staten Island, New York.

• Became the National Institutes of Health in 1930

National Institutes of Health

• Now located in Bethesda, Maryland with over 18,000 employees

• 27 Institutes and Centers

• Focus “on current and emerging health needs and promising areas of science”

Mission Statement

• “Science in pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability.”

Budget

• 28 Million annually• 80% through

competitive research grants

• 10% supports internal research

• Office of Extramural Research allocates grant monies

• NIH Roadmap

Divisions of the National Institutes of Health

• National Cancer Institute (1937)• National Eye Institute (1968)• National Heart, Blood and Lung Institute (1948)• National Human Genome Research Institute (1989)• National Institute on Aging (1974)• National Institute on Alcohol Abuse and Alcoholism

(1970)• National Institute on Allergy and Infectious

Diseases (1948)• National Institute of Arthritis and Musculoskeletal

and Skin Disease (1986)• National Institute of Biomedical Imaging and

Bioengineering (2000)• Eunice Kennedy Shriver National Institute of Child

Health and Human Development (1962)• National Institute on Deafness and Other

Communication Disorders (1988) • National Institute of Dental and Craniofacial

Research (1948) • National Institute of Diabetes and Digestive and

Kidney Diseases (1948)• National Institute of Biomedical Imaging and

Bioengineering (2000)• Eunice Kennedy Shriver National Institute of Child

Health and Human Development (1962)

• National Institute on Deafness and Other Communication Disorders (1988)

• National Institute of Dental and Craniofacial Research (1948)

• National Institute of Diabetes and Digestive and Kidney Diseases (1948)

• National Institute on Drug Abuse (1973)• National Institute of Environmental Health Sciences

(1969) • National Institute of General Medical Sciences

(1962)• National Institute of Mental Health 1949• National Institute of Neurological Disorders and

Stroke 1950 • National Institute of Nursing Research 1986• National Library of Medicine 1956• Center for Information Technology 1964• Center for Scientific Review 1946• John E. Fogarty International Center for Advanced

Study in the Health Sciences 1968• National Center for Complementary and Alternative

Medicine 1999• National Center for Minority Health and Health

Disparities 1993• National Center for research resources 1962• NIH Clinical Center 1953

National Library of Medicine

• Worlds largest medical library• Scope covers all areas of biomedicine and

healthcare• 9 Million + items in the collection including

historic archives• “Explores the uses of computer and

communication technologies to improve the organization and use of biomedical information”

John Shaw Billings (1838-1913)

"What would induce a man to spend years of labor in getting together and printing tens of thousands of titles of articles concerning the treatment of fevers, consumption, wounds, and abscesses. Among the chief motives, no doubt, is the desire to be of public service, a feeling very strong in all Americans, except perhaps politicians."

History of NLM

• Billings organized the Library of the Surgeon Generals Office (1865-95)

• Collection grew from 1,800 volumes in 1836 to 50,000 in 1874

• Index Medicus started as handwritten cards, became printed lists (1879-2004)

• Terms began to be simultaneously electronically indexed in 1964 and retrieved through MEDLARS system

Databanks and Databases

• MEDLARS ran on a Honeywell mainframe by GE

• 1971 Began online searching • 1992 MEDLARS continued to be active until

Medline searching became available on the internet.

• 1997 Access to Medline became free (Gore). • 1997 Medline became accessible through the

free PubMed interface, part of the Entrez family of databases.

NCBI Databases and Electronic Resources

National Network of Libraries of Medicine

• Supports research and other libraries through the National Network of Libraries of Medicine

• Docline

• Lonesome Doc

• NLM Classification

• MeSH

National Repository

“The Director of the National Institutes of Health shall require that all investigators funded by the NIH submit or have submitted for them to the National Library of Medicine’s PubMed Central an electronic version of their final, peer-reviewed manuscripts upon acceptance for publication, to be made publicly available no later than 12 months after the official date of publication: Provided, That the NIH shall implement the public access policy in a manner consistent with copyright law.”

Public Access Policy, Division G, Title II, Section 218 of PL 110-161