Thomas Parran, Jr. - Biography - Surgeon General

Surgeon General

Parran became active in New Deal politics in New York and entered national politics as well. In 1934 his former supervisor-now President of the United States-Roosevelt appointed Parran to the Committee on Economic Security, which drafted the Social Security Act of 1935; Title 6 authorized millions for public health departments and for biomedical research. And following the close of Surgeon General Hugh S. Cumming's term, President Roosevelt appointed Parran as Surgeon General of the United States; he was sworn in on 6 April 1936.

Parran's syphilis control campaign was in full swing by the fall of 1936. Title 6 funds supported efforts to identify and treat syphilis, the National Venereal Disease Control Act of 1938 made funds available for rapid treatment centers that employed the new sulfa drugs and, later, penicillin. During 1937 his book about syphilis, Shadow on the Land, was published and very well received. However, his work against syphilis is tainted by the Tuskegee Syphilis Study (1932 - 1972) and the Guatemala syphilis experiments (1946 - 1948) which were conducted by the PHS's Division of Venereal Diseases, partially during his tenure as Surgeon General.

During World War II, reports from Europe indicated that the public health situation was dire, and that prompt action was needed, and a highly qualified medical officer was required to direct the Public Health Division of the Civil Affairs Branch (G-5) of the newly-formed headquarters. Because all of the senior Army medical officers with competence in this field were already holding highly important positions, the Army turned to Dr. Parran for help, and he released his deputy, Dr. Warren Fales Draper, to the military headquarters. Draper became a member of General Dwight Eisenhower's staff as the Chief of the Public Health Branch and the top public health adviser for Supreme Headquarters, American Expeditionary Forces with the rank of brigadier general.

In addition to syphilis control, Surgeon General Parran left his mark on the scope and structure of public health, both at home and abroad. World War II brought quick expansion and new opportunities for expanded duties. In response Parran and his deputies rewrote the statutes underlying PHS operations-the Public Health Service Acts of 1943 and 1944-establishing a four-bureau structure that would remain in place through 1967, and deftly arranged for the transfer of wartime research contracts from the Office of Scientific Research and Development, creating an extramural grants program for NIH. Parran also served as a mentor to a generation of Public Health Service Commissioned Corps physicians, to whom he gave the leeway to create new institutions and programs in the areas of clinical research into cancer and other conditions, mental health, tuberculosis control, prevention of malaria and other communicable diseases, construction of nonprofit hospitals, and international health. Parran's leadership role in international health affairs dated back to the 1930s with the Rockefeller Foundation and the Pan American Health Organization. Parran chaired the International Health Conference where the World Health Organization (WHO) draft constitution was adopted (1946) and led subsequent U.S. delegations.

Parran was an early and committed advocate of national health insurance, shielding PHS from direct conflict with those who opposed insurance by tempering his public advocacy with a focus on creating a regionally organized health services infrastructure to precede Federal dollars for care. The Hospital Survey and Construction Act of 1946 (Hill-Burton) was a signal step in this direction. Nevertheless, Parran was attacked by American Medical Association editorialist Morris Fishbein for supporting President Truman's proposed national insurance program. Truman's decision not to reappoint Parran in the spring of 1948 may have been an outcome of public disputes over this issue. Parran declined the position of Director of the World Health Organization to attempt to maintain the independence of the Public Health Service from the newly created bureaucracy, the Department of Health Education and Welfare. He lost that fight, and his job, only to move on again to further advances in the health education field.