CHAPTER 1
PART 1
PRESIDENT NIXON'S COMMITTEEON HEALTH EDUCATION
On February 18, 1971, President Richard M. Nixon presented his"Health Message to Congress."
In the last twelve months alone, America's medicalbill went up 11 percent, from $63 to $70 billion. Inthe last ten years, it has climbed 170 percent, from the$26 billion level in 1960. Then we were spending 5.3percent of our gross national product on health; todaywe devote 7 percent of our gross national producton health expenditures ... We spend vast sums totreat illnesses and accidents that could be avoidedfor a fraction of those expenditures. We focus ourattention on making people well rather than keepingpeople well, and—as a result—both our health andour pocketbooks are poorer. A new national healthstrategy should assign a much higher priority to thework of prevention.
The president highlighted measures to be taken "against the long-rangecauses of illnesses and accidents." One of these measures washealth education.
In the final analysis, each individual bears the majorresponsibility for his own health. Unfortunately, toomany of us fail to meet that responsibility. Too manyAmericans eat too much, drink too much, work toohard, and exercise too little. Too many are carelessdrivers.
These are personal questions, to be sure, but theyare also public questions. For the whole society hasa stake in the health of the individual. Ultimately,everyone shares in the cost of his illnesses or accidents.Through tax payments and through insurancepremiums, the careful subsidize the careless, thenonsmokers subside those who smoke, the physicallyfit subsidize the ignorant and vulnerable.
It is in the interest of our entire country, therefore,to educate and encourage each of our citizens todevelop sensible health practices. Yet we have givenremarkably little attention to the health education ofour people. Most of our current efforts in this areaare fragmented and haphazard—a public serviceadvertisement one week, a newspaper article another,a short lecture now and then from the doctor. There isno national instrument, no central force to stimulateand coordinate a comprehensive health educationprogram.
I have therefore been working to create such aninstrument. It will be called the National HealthEducation Foundation. It will be a private, nonprofitgroup that will receive no federal money. Itsmembership will include representatives of business,labor, the medical profession, the insurance industry,health and welfare organizations, and variousgovernmental units. Leaders from these fields havealready agreed to proceed with such an organizationand are well on the way toward reaching an initialgoal of $1 million in pledges for its budget. Thisindependent project will be complemented by otherfederal efforts to promote health education.
At the same time President Nixon presented his message toCongress, the American Association for Health, Physical Education,and Recreation (AAHPER), School Health Division (an affiliateof the National Education Association, the largest professionalorganization in the world) was reevaluating its role in national health-educationaffairs. On April 6, 1971, the division council took actionto explore the feasibility of a federation of national health-educationorganizations. The concept of the feasibility study was subsequentlyapproved through consensus of the AAHPER board of directors.My professional colleagues requested that I assume the leadershiprole in conducting the feasibility study. After careful consideration,I accepted the challenge.
THE NEENAH 8
With the assistance of my peers, criteria were established for selectingnational organizations to participate in the study and raise fundsto underwrite the costs for a national conference. Eight nationalorganizations with active health-education programs and healtheducatormemberships accepted the invitation to participate in thestudy:
• Health Education Section, American College HealthAssociation
• School Health Division, American Association for Health,Physical Education, and Recreation
• Public Health Education Section, American Public HealthAssociation
• School Health Section, American Public Health Association
• American School Health Association
• Conference of State and Territorial Directors of Public HealthEducation
• Society of State Directors of Health, Physical Education, andRecreation
• Society of Public Health Educators, Inc.
The first mini conference, hosted by Kimberly-Clark Corporation,was held in Neenah, Wisconsin, on May 9–11, 1971. The conferencewas devoted to exploring the feasibility of a federation, identifyingand prioritizing common interests and concerns, considering pointsof view toward forming a federation, describing the structure of acoalition, and planning for a follow-up conference.
The conference was referred to as the "Neenah 8," which wasinterlaced with President Nixon's Health Message to Congress. Theconference was in line with changing patterns in consumer healtheducation and a logical part of the evolution of the health-educationprofession. In the past fifty years, health education has achievedacademic and professional status in more than one hundred highereducation institutions throughout the United States. The followingexcerpt is from the conference proceedings:
Public and school health educators now believe thatthe profession must achieve greater autonomy for self-directionthrough some type of an amalgamation ofeffort. We must cooperatively plan comprehensivehealth education programs, eliminating bothfragmentation and duplication ... This can be achievedonly when we unify our efforts and speak out as onevoice.
The Neenah 8 was established to combine our efforts to espousethe cause of organized health education, since others could take ourplace. Advertising and marketing are usually the primary goals ofhealth commercials. The promotion of prescription drugs on nationaltelevision and the Internet lacks true educational value at a timewhen most people lack the basic school health education to interpretsuch information. Yet the interest in health and medicine has grownrapidly, as evidenced by the vast number of current daytime andprimetime television shows, from Dr. Oz, and The Doctors to ER andGrey's Anatomy. Also, the growing need and desire for consumerhealth information and education today is evidenced by the rapidexpansion of health topics on cable television and the Internet,which are vital options for future delivery of health information andeducation, a critical part of health-care reform.
President Nixon's Health Message to Congress, the first Neenahconference, and the creation of the nation's first presidential Committeeon Health Education represented major events—for the first time inhistory—to take comprehensive health education to the people. Thiswas exciting. Unfortunately, President Nixon's underlying motiveswere hidden behind the mask of well-written recommendations in hismessage to Congress and the members of the Committee on HealthEducation.
APPOINTMENT TO THE PRESIDENT'S COMMITTEE
During 1970–1972, I was serving as the vice president for school healthof AAHPER. At this time, Laura Mae Brown, president of AAHPER,had been asked by Secretary Elliot Richardson to recommend,on behalf of the association, the names of individuals who mighteffectively serve as members of President Nixon's Committee onHealth Education.
While attending the AAHPER National Convention in Detroitin April 1972, Brown stopped me in the hall and said, "Joy, I sent aletter to President Nixon recommending you represent school healthon his health-education committee. You are likely to receive theappointment, and I know you will do an outstanding job."
Laura Mae Brown deeply moved me with her statement, sinceshe and I were often on opposite sides on certain professional issuesdiscussed within the association. She was special.
During the next six months, I did not receive any officialinformation about the President's Committee on Health Education,although it was a hot topic of conversation at the Neenah 8 meetingin Wisconsin in May 1971.
In the fall, I attended the Annual American Public HealthAssociation meeting in Minneapolis, during which PresidentNixon's newly created Committee on Health Education warranteda special session. At the time, there were only fourteen memberson the committee. No person specifically represented school healtheducation. Also, no women, representatives from rural America, orSpanish-speaking Americans were on the current roster. I quicklylearned that there was much dissatisfaction within the ranks.
Once it had been confirmed that the President's Committee onHealth Education had no representation from professionals in thefield of health education, I was motivated to take on the task of gettingmyself on the committee or someone else qualified and willing totake on the challenge.
As acting coordinator of the new tenuously coalesced group ofnational health-education organizations, I felt compelled to bringneeded representation from health education to the unbalancedpresidential committee. I was going directly from Minneapolis toWashington, DC, on professional business. Since I am not a strangerat our nation's capital, perhaps I could find someone who might helpme promote representation on the committee.
While in Washington, I met with Carl A. Troester Jr., the executivesecretary of AAHPER. I said, "Our people believe we have a real crisis.There are no school health educators on President Nixon's Committeeon Health Education, which was just unveiled in Minneapolis. Doyou have any suggestions on how we still might get representationon the committee?"
He said, "Joy, AAHPER officially supported your appointmentto the committee. A letter of recommendation, along with yourbiographical statement, was sent to President Nixon. We followedup by phone several times. Support phone calls also were madefrom our colleagues in the National Education Association. It seemsinconceivable that school health would not be represented. Couldyour congressman help?"
"Thank you. Let me think about that approach."
In my hotel room, I thought about this option, but I decided not tocontact my local congressman, Alphonzo Bell. I knew several othercongressmen better; one in particular had been an elementary-schoolclassmate of mine and a lifelong friend. We were both raised in thelittle rural town of Blanchester, Ohio. We once competed in the samearithmetic and spelling bees and often saw each other in the sameswimming holes. On one occasion, we were fined for swimmingtogether off an island in Lake Cowan.
Two days later, I had lunch with Congressman Clarence J. BrownJr. at the House of Representatives Dining Room in the CannonBuilding. His nickname was Buddy. He was a big man, over six feetin height and weighing over two hundred pounds. He was of the"Brown Dynasty" among Ohio Republications, dating back to the1920s, when his father Clarence J. Brown Sr. was a congressmanfrom Ohio.
I said, "I'm deeply concerned about what is happening nationally.How can President Nixon appoint a committee on health educationwithout any representation from school health? Ninety percent of thehealth educators in this nation are teaching in school health. Can youimagine a study on medical education without representation fromthe largest professional group of physicians?"
"Absolutely not. What is the charge to the committee?"
I paraphrased the charge for Buddy.
"Yes," he replied. "School health educators must berepresented."
I said, "There are several outstanding leaders throughout thenation who I am certain were recommended for membership on thecommittee."
"Joy, is that the committee brochure? May I see it?"
"Yes. There are already representatives on the committee from theUniversity of Michigan and the AMA."
"Weren't you recommended for the committee?"
"Yes, by the AAHPER-NEA. Secretary Elliot Richardson invitedthe association to suggest nominees for the committee."
"Well then, let's find out what happened to your recommendation.Finish your coffee while I make a call."
Brown knew of my lifelong commitment to national health-educationaffairs, my leadership role in the AAHPER-NEA, as wellas at state and regional affiliates, over the years and of my morerecent effort to bring unity to several professional health-educationorganizations through a coalition.
Putting down his phone, Brown said, "I have some good news. Icontacted William E. Timmons, head of the Congressional RelationsTeam and assistant to the president for legislative affairs. He wasa close friend of Dad's when he was in Congress. Usually, theirappointments are made by H. R. Haldeman, assistant to the president,and in charge of White House operations. You will be in the citytomorrow, won't you?"
"Yes, I will be here through Sunday."
"Give me your local phone number before you leave. If you havetime this evening, you should prepare a brief vitae."
"I'll go back to the hotel now and prepare the vitae."
Early the next morning, an AAHPER secretary prepared myvitae.
Shortly after nine o'clock, I received a phone call from RobertLaur, member of the staff council on the President's Committee,Department of Health Education and Welfare, who wanted me tocome to his office. I immediately caught a cab, and I was ushered intohis office before ten. He interviewed me about my professional workin health education. The vitae I had prepared the night before servedas an outline for our discussion.
At the conclusion of the interview, we talked about a mutualcolleague, Dr. Roger O. Egeberg. In addition to several leadershippositions in California, Roger became dean of the school of medicineat USC from 1994 to 1996. During that time, I was a member of his taskforce that went into the Watts area, during the riots in 1992, to offerhealth-care services and establish a neighborhood health center.
In 1969, as a democrat, Roger was Nixon's second choice forassistant secretary of health and scientific affairs, HEW, the number-onehealth position in the nation. In 1971, Dr. Egeberg was giventhree prestigious positions within the Nixon Administration.
Mr. Laur said, "Before you leave, I would also like to have JudithMoore interview you."
Moore was a research assistant in the office of assistant secretaryof planning and research, HEW. We went into another conferenceroom, and I was queried again about my professional work. I learnedlater that Moore was serving as a HEW staff liaison to the President'sCommittee on Health Education. At the conclusion of the interviews,no commitments were made. I was merely thanked for my time.
Before returning to the West Coast, I spent a couple of days inBlanchester with my dad. These brief visits with my dad and mycherished friends always served as a tonic. I knew almost everyoneliving in the town. As a teenager, I had taken the local census duringthe summer to determine how many students would be expected toattend school in the fall.
Upon returning to my office at the USC School of Medicine, Ihad a phone message indicating Timmons had called from the WhiteHouse and I was to return his call ASAP.
He said, "Our records show school health was not appropriatelyrepresented on the committee. Your recommendations, interviews,and security check are all in order. I am pleased to announce on behalfof President Nixon that you have been appointed to his Committeeon Health Education to represent the school health sector. You willbe hearing from Victor Weingarten, director of the committee, thisweek."
I conveyed my deepest appreciation to Timmons, but he made itclear that Congressman Brown had made the appointment possible.
If I knew then what I know now, this appointment would havehad the opposite impact on my emotions. In my state of "pride," I hadno idea that this was the beginning of a long-standing nightmare.Interestingly, two unrelated individuals by the name of Brown mademy appointment possible. I guess, once again, it was meant to be.
Among several letters of congratulations, I received:
It is with great pleasure that I congratulate you uponyour recent appointment to serve on President Nixon'sCommittee on Health Education. We are proud thatyou have received this opportunity to continue yourfine work in the area of community medicine andpublic health. Your participation on this committeeshould contribute much to the present effort to solvemany of the nation's problems. You and the committeehave my best wishes for the success of this significantendeavor.
John E. HubbardPresidentUniversity of Southern California
