MCH/Public Health Milestones Part VIII: 1965-1969

1. MCH/Public HealthMilestonesPart VIII: 1965-1969 Department of Maternal and Child Health University of Alabama at Birmingham

2. Greg R. Alexander, MPH, ScDCathy Chadwick, MPH Donna J. Petersen, MHS, ScDMaryAnn Pass, MD, MPH Martha Slay, MPHNicole Shumpert, BS Department of Maternal and Child Health The MCH Leadership Skills Training Institute University of Alabama at Birmingham Department of Maternal and Child Health University of Alabama at Birmingham

3. Acknowledgement Supported by funding from the Maternal and Child Health Bureau Department of Maternal and Child Health University of Alabama at Birmingham

4. 1965 Medicaid and Medicare enacted Title V Amended Children and Youth Project Neighborhood and Migrant Health Centers Child Nutrition Act Highway Safety Act Reorganization of HEW Title V authorizes infant care, family planning, and dental EPSDT School Lunch and Child Nutrition Act expanded Children’s Bureau transferred to Office of Child Development Rubella vaccine licensed 1969 Department of Maternal and Child Health University of Alabama at Birmingham

5. The 1960’s and 70’s • Tremendous expansion of federally funded programs for the poor and for children • Growth in public sector programs at the state and local levels, many providing direct services • Growth in disillusionment with government Department of Maternal and Child Health University of Alabama at Birmingham

6. Department of Maternal and Child Health University of Alabama at Birmingham

7. War on Poverty • In his first State of the Union address, on January 8, 1964, President Johnson announced that his administration "today, here and now, declares unconditional war on poverty in America, and I urge this Congress and all Americans to join with me in that effort.“ • His program called for a systematic effort in "chronically distressed areas" of the country, a youth employment ("job corps") plan, expansion of the food stamp and unemployment relief systems, and special aid to schools, libraries, hospitals, and nursing homes. Department of Maternal and Child Health University of Alabama at Birmingham

8. War on Poverty:President Johnson and Mrs. Johnson in Kentucky Department of Maternal and Child Health University of Alabama at Birmingham

9. 1965: Title XVIII and XIX of the Social Security Act • Medicare (Title XVIII) established to provide health insurance coverage to persons over age 65 • Medicaid (Title XIX) established to provide health insurance coverage to low income women and children (also, aged, blind and disabled) Department of Maternal and Child Health University of Alabama at Birmingham

10. Department of Maternal and Child Health University of Alabama at Birmingham

11. 1965: Title V Amended, P.L. 89-97 • The 1965 amendments (P.L. Law 89-97) amended Title V of the Social Security Act by providing comprehensive health care for children and youth, the so-called “C&Y Projects”. Department of Maternal and Child Health University of Alabama at Birmingham

12. Department of Maternal and Child Health University of Alabama at Birmingham

13. C & Y Projects • There was a growing realization that comprehensive care was needed for children and youth, particularly in low-income areas. • Legislation passed in 1965 (P.L 89-97), provided this care through Children and Youth (C & Y) projects. • A primary directive was to make these services accessible, available and appropriate to the identified low-income neighborhoods • The intent was to provide comprehensive health care to children and youth including health supervision, screening, medical care, nutrition, and social services. Department of Maternal and Child Health University of Alabama at Birmingham

14. Department of Maternal and Child Health University of Alabama at Birmingham

15. Comprehensive Neighborhood Health Centers • Comprehensive Neighborhood Health Centers were created as part of the Partnership for Health Act and under the Office of Economic Opportunity. • The intent of these centers was to provide family-focused community health care. • In 1971, the program was transferred to the Public Health Service and was renamed the Community Health Centers Program Department of Maternal and Child Health University of Alabama at Birmingham

16. Department of Maternal and Child Health University of Alabama at Birmingham

17. Migrant Health Program • The Migrant Health Program was established in 1965 to provide prenatal and infant care services to migrants, seasonal farm workers and their families Department of Maternal and Child Health University of Alabama at Birmingham

18. Migrant Health Department of Maternal and Child Health University of Alabama at Birmingham

19. 1966: Child Nutrition Act • The intent of the Child Nutrition Act of 1966 was to ensure that children were provided with adequate food in order to promote better development and learning Department of Maternal and Child Health University of Alabama at Birmingham

20. Department of Maternal and Child Health University of Alabama at Birmingham

21. 1966: Highway Safety Act and the National Traffic and Motor Vehicle Safety Act • Authorized the federal government to set and regulate standards for motor vehicles and highways • Vehicles were built with new safety features, including head rests, energy-absorbing steering wheels, shatter-resistant windshields, and safety belts • By 1970, motor-vehicle-related death rates were decreasing Department of Maternal and Child Health University of Alabama at Birmingham

22. Department of Maternal and Child Health University of Alabama at Birmingham

23. 1967: Department of HEW Reorganized • A reorganization of the Department of Health, Education and Welfare (HEW) was instituted by administrative order. • The health and welfare components of the Children’s Bureau were separated, with some of the responsibilities of the Children’s Bureau distributed among other agencies Department of Maternal and Child Health University of Alabama at Birmingham

24. Department of Maternal and Child Health University of Alabama at Birmingham

25. 1967: Title V Authorizes Infant Care, Family Planning and Dental Care • The Title V authorization of 1967 created three new medical project grants: • infant care (neonatal intensive care) • family planning • dental care Department of Maternal and Child Health University of Alabama at Birmingham

26. Department of Maternal and Child Health University of Alabama at Birmingham

27. Title XIX Amendments EPSDT • The Medicaid statute (Title XIX) was amended in 1967 to create the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program for needy children. • The purpose of EPSDT was to identify and diagnose health problems of indigent children though the provision of periodic physical and developmental examinations. • The program also provided funds for the treatment of illnesses and other health conditions Department of Maternal and Child Health University of Alabama at Birmingham

28. Child receiving oral polio vaccine Department of Maternal and Child Health University of Alabama at Birmingham

29. 1968: School Lunch and Child Nutrition Act Expanded • In 1968, Congress expanded the School Lunch and Child Nutrition Act. • A program was created to provide food for school-age children during the summer. • Additionally, a year-round program was initiated to provide food to low-income children, as well as children in day-care centers and Head Start programs. Department of Maternal and Child Health University of Alabama at Birmingham

30. Department of Maternal and Child Health University of Alabama at Birmingham

31. 1969: White House Conference on Food, Nutrition, and Health • In 1969, President Nixon convened a White House Conference on Food, Nutrition, and Health. • After this Conference, the Secretary of Agriculture established the Food and Nutrition Service in order to administer the federal food assistance programs. Department of Maternal and Child Health University of Alabama at Birmingham

32. President Richard M. Nixon Department of Maternal and Child Health University of Alabama at Birmingham

33. Children’s Bureau Transferred to Office of Child Development • The Children’s Bureau was disbanded in 1969. • Duties that had remained with the Children’s Bureau after the HEW reorganization, were transferred to the newly created Office of Child Development. • When this occurred, the health programs of the Children’s Bureau were transferred to the U.S. Public Health Services, in an agency now known as the Maternal and Child Health Bureau. Department of Maternal and Child Health University of Alabama at Birmingham

34. Department of Maternal and Child Health University of Alabama at Birmingham

35. Rubella Vaccine Licensed • The rubella vaccine was licensed in June, 1969. Department of Maternal and Child Health University of Alabama at Birmingham

36. Child with Rubella Department of Maternal and Child Health University of Alabama at Birmingham

37. Maternal and Child Health/Public Health Milestones: 1965-1969 Photo Acknowledgements Slide 6: During the 1960s, hundred of thousands of people took part in several different protest movements, including the civil rights movement, the anti-Vietnam War movement, the women's rights movement, the gay rights movement, and the environmental movement. These activists were attempting to change American society through demonstrations, marches, sit-ins, and teach-ins. Jason Laure/Woodfin Camp and Associates, Inc. www.encarta.com Slide 8: On April 24, 1964, Lyndon and Lady Bird Johnson visited Inez, KY, and the property of Tommy Fletcher, a father of eight whose living conditions epitomized the squalor that characterized Appalachia for decades. On Fletcher’s porch, Johnson declared the War on Poverty. (AP photo) www.post-gazette.com Slide 10: Physician and nurse examining elderly patient in home. 1963. CDC/Charles Farmer. www.cdc.gov Slide 12: Courtesy of WHO and National Library of Medicine. www.nlm.nih.gov Slide 14: Courtesy of National Library of Medicine. www.nlm.nih.gov Slide 16: Courtesy of National Library of Medicine. www.nlm.nih.gov Department of Maternal and Child Health University of Alabama at Birmingham

38. Maternal and Child Health/Public Health Milestones: 1965-1969 Photo Acknowledgements Slide 18: Public Health Service photo. Slide 20: Courtesy of National Library of Medicine. www.nlm.nih.gov Slide 24: Nursery school. Courtesy of the National Library of Medicine. www.nlm.nih.gov Slide 26: Building a Better Life [Family Planning]. Courtesy of the National Library of Medicine. www.nlm.nih.gov Slide 28: www.cdc.gov . Health workers administering oral polio vaccine to child. 1963. CDC. Slide 30: Courtesy of the National Library of Medicine. www.nlm.nih.gov Slide 32: Richard M. Nixon. www.encarta.com . Richard M. Nixon, the twice-elected 37th president of the United States, was the only chief executive to resign from office. Shortly after becoming General Dwight D. Eisenhower's vice-presidential running mate in 1952, Nixon was suspected of misusing a fund. He is heard here giving his famous "Checkers" speech concerning this incident. Slide 34: Mother and child in consultation with a physician. Courtesy of National Library of Medicine. www.nlm.nih.gov Slide 36: Rash of rubella on child’s back. 1978. CDC PHS Book: Mullan, F. Plagues and Politics: The Story of the U.S. Public Health Service. New York: Basic Books. 1989. Department of Maternal and Child Health University of Alabama at Birmingham

39. CREDITS • This work builds upon the earlier efforts of Dr. Allan C. Oglesby, Cindy Camberg, EdD, and Cathy Chadwick of the Maternal and Child Health Institute to Increase Leadership Skills Project, San Diego State University, and draws upon their Manual of the History and Philosophy of Maternal and Child Health as a foundation for this multi-volume series. Department of Maternal and Child Health University of Alabama at Birmingham