The Department of Health, Education, and Welfare: A Historical Overview

The Department of Health, Education, and Welfare (HEW) was a cabinet-level department in the United States federal government. Established in 1953, it played a crucial role in overseeing national health, education, and social welfare programs. HEW's primary mission was to implement programs and policies aimed at improving public health and well-being. The need for grouping such activities into a Cabinet-level Department had long been recognized.

Formation and Early Years

The Department of Health, Education, and Welfare (HEW) was created on April 11, 1953, when Reorganization Plan No. 1 of 1953 became effective. HEW thus became the first new Cabinet-level department since the Department of Labor was created in 1913. The Reorganization Plan abolished the Federal Security Agency and transferred all of its functions to the Secretary of Health, Education, and Welfare and all components of the Agency to the Department.

The establishment of HEW was a direct response to the growing recognition of social issues like poverty, health disparities, and educational inequities in post-war America. By consolidating agencies under one department, the government aimed to create a more efficient approach to tackling these pressing challenges. This move symbolized a shift towards a more interventionist role by the federal government in ensuring that citizens had access to essential services that would improve their quality of life.

President Warren G. Harding proposed a Department of Education and Welfare as early as 1923, which also was to include health functions. In 1924, the Joint Committee on Reorganization recommended a new department similar to that suggested by President Harding. The President's Committee on Administrative Management in 1937 recommended the placing of health, education and social security functions in a Department of Social Welfare. A new department could not be proposed at that time because the Reorganization Act of 1939 prohibited the creation of additional executive departments.

The first Secretary of HEW was Oveta Culp Hobby, a native of Texas, who had served as Commander of the Women's Army Corps in World War II and was editor and publisher of the Houston Post. A major objective of the Department's establishment was to improve the administration of Federal responsibilities in the fields of health, education, and social security.

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Key Components of HEW

There were six major components of the new Department:

The Public Health Service
The Office of Education
The Food and Drug Administration
The Social Security Administration
The Office of Vocational Rehabilitation
Saint Elizabeths Hospital

In one of the earliest actions of the new Department, a group of consultants thoroughly studied the social security system. The result was a legislative proposal that would extend social security to farm and domestic workers and the self-employed. It was enacted September 1, 1954, adding 10 million persons to social security rolls.

HEW During the War on Poverty Era

HEW played a critical role in implementing various social programs during the War on Poverty era, aiming to reduce poverty and improve living standards through education and health initiatives. HEW's programs had a profound impact on American society by directly addressing issues of poverty through initiatives like Head Start and nutritional assistance. These programs not only provided immediate relief but also focused on long-term solutions such as education and healthcare improvements. The department's efforts contributed significantly to raising awareness about poverty and set the groundwork for future social welfare policies that expanded government support systems.

During its operation, HEW administered significant programs like Head Start, food assistance programs, and community health services that aimed to lift Americans out of poverty. The department was pivotal in enforcing civil rights laws in schools and healthcare settings during the 1960s and 1970s.

Key Initiatives and Accomplishments

NIH Clinical Center Dedication: A highlight of the first year was the dedication on July 2, 1953, of the NIH Clinical Center, a 500-bed research hospital to serve physicians and patients throughout the Nation in the fields of cancer, mental illness, arthritis, heart disease, and other chronic illnesses.
Social Security Expansion: In one of the earliest actions of the new Department, a group of consultants thoroughly studied the social security system. The result was a legislative proposal that would extend social security to farm and domestic workers and the self-employed. It was enacted September 1, 1954, adding 10 million persons to social security rolls.
Polio Vaccine Licensing: Development by Dr. Jonas Salk of a vaccine against paralytic poliomyelitis was one of the most dramatic medical accomplishments of the decade. On April 12, 1955, upon recommendation of the Public Health Service, the Secretary of HEW licensed six manufacturers to produce the vaccine.
White House Conference on Education: The White House Conference on Education was held in the fall of 1955, resulting in 72 specific recommendations for improvement of elementary and secondary schools.
Hill-Burton Hospital Construction Program: Ten years of operating the Hill-Burton hospital construction program was marked in 1956. By June 30, more than 2,000 federally aided hospitals and health centers were in operation, including 550 new general hospitals.
National Health Survey: In June 1956, the President signed a bill authorizing the Public Health Service to conduct a continuing national health survey, the first in 20 years.

Transformation and Legacy

In 1979, the Department of Education Organization Act was signed into law, providing for a separate Department of Education. The act created two cabinet-level departments: the Department of Education and the Department of Health and Human Services. Operation of both departments began in May 1980.

The dissolution of HEW into the Department of Health and Human Services and the Department of Education allowed for a more specialized approach to health and education policies. This separation enabled each department to focus more effectively on its specific mandates, resulting in targeted strategies that addressed diverse challenges within their domains.

The legacy of HEW's initiatives contributed to shaping modern social safety nets and health policies that are still influential today.

Department Secretaries

Secretaries of health, education, and welfare (1953-79) and health and human services (1979- ):

Oveta Culp Hobby: April 11, 1953-July 31, 1955 (Pres. Dwight D. Eisenhower)
Marion B. Folsom: August 1, 1955-July 31, 1958 (Pres. Dwight D. Eisenhower)
Arthur S. Flemming: August 1, 1958-January 1, 1961 (Pres. Dwight D. Eisenhower)
Abraham A. Ribicoff: January 20, 1961-July 13, 1962 (Pres. John F. Kennedy)
Anthony J. Celebrezze: July 31, 1962-August 17, 1965 (Pres. John F. Kennedy; Pres. Lyndon B. Johnson)
John W. Gardner: August 18, 1965-February 29, 1968 (Pres. Lyndon B. Johnson)
Wilbur J. Cohen: May 9, 1968-January 19, 1969 (Pres. Lyndon B. Johnson)
Robert H. Finch: January 22, 1969-June 24, 1970 (Pres. Richard Nixon)
Elliot L. Richardson: June 24, 1970-January 29, 1973 (Pres. Richard Nixon)
Caspar W. Weinberger: February 12, 1973-August 10, 1975 (Pres. Richard Nixon; Pres. Gerald Ford)
Forrest David Mathews: August 8, 1975-January 20, 1977 (Pres. Gerald Ford)
Joseph A. Califano, Jr.: January 26, 1977-July 19, 1979 (Pres. Jimmy Carter)
Patricia Roberts Harris*: July 27, 1979-January 19, 1981 (Pres. Jimmy Carter)
Richard S. Schweiker: January 22, 1981-February 3, 1983 (Pres. Ronald Reagan)
Margaret M. Heckler: March 9, 1983-December 12, 1985 (Pres. Ronald Reagan)
Otis R. Bowen: December 13, 1985-January 20, 1989 (Pres. Ronald Reagan)
Louis Sullivan: March 1, 1989-January 20, 1993 (Pres. George H.W. Bush)
Donna Shalala: January 22, 1993-January 19, 2001 (Pres. Bill Clinton)
Tommy G. Thompson: February 2, 2001-January 25, 2005 (Pres. George W. Bush)
Mike Leavitt: January 26, 2005-January 20, 2009 (Pres. George W. Bush)
Kathleen Sebelius: April 28, 2009-June 2, 2014 (Pres. Barack Obama)
Sylvia Burwell: June 9, 2014-January 20, 2017 (Pres. Barack Obama)
Tom Price: February 10, 2017-September 29, 2017 (Pres. Donald Trump)
Alex Azar: January 29, 2018-January 20, 2021 (Pres. Donald Trump)
Xavier Becerra: March 19, 2021-January 20, 2025 (Pres. Joe Biden)
Robert F. Kennedy, Jr.: February 13, 2025-

*Department of Health, Education, and Welfare reorganized into the Department of Health and Human Services and the Department of Education.

The Federal Security Agency: A Precursor to HEW

The Federal Security Agency (FSA) was established on July 1, 1939, under the Reorganization Act of 1939, P.L. 76-19. The objective was to bring together in one agency all Federal programs in the fields of health, education, and social security. The first Federal Security Administrator was Paul V. McNutt. The origins of these components, however, could be traced back to the early days of the Republic.

Historical Roots of FSA Components

Marine Hospital Service: On July 16, 1798, President John Adams signed an act creating the Marine Hospital Service to furnish treatment to sick and disabled American merchant seamen. On April 29, 1878, the first Federal Quarantine Act enlarged the Service's responsibilities to include prevention of epidemics from abroad. On August 14, 1912, the name was changed to the Public Health Service. On May 26, 1930, the Hygienic Laboratory of the Service was redesignated the National Institute of Health.
Education Initiatives: Even though the first steps toward public education were taken in 1647 by the Massachusetts Bay Colony and land was set aside for public schools by the Congress of the Confederation in 1785, the idea of universal, free public schools did not become firmly established until the Civil War era. Even then, only half of the States had an efficient public school system. In 1867, Congress established the Department of Education to promote the cause of education and collect and disseminate facts and statistics about education.
Civilian Conservation Corps (CCC): The Civilian Conservation Corps, which was born during the great depression to provide employment for American youth and advance conservation of the Nation's natural resources, operated from April 5, 1933, until June 30, 1942. During that time, the CCC provided work training to 3 million men and advanced conservation by more than 25 years.
Social Security Programs: The Nation's social security and public assistance programs also were born during the depression with approval of the Social Security Act on August 14, 1935. The initial Act of 1935 established the Social Security Board to administer Titles I, II, III, IV, and X of the Act, and it remained an independent organization until its transfer to FSA.
American Printing House for the Blind: Organized in 1855 and incorporated by the Kentucky Legislature in 1858, the American Printing House for the Blind was established to produce educational materials for the blind and since 1879 has received an allocation of Federal funds to help support this activity.
National Youth Administration: Established in 1935 to provide youth with work training, the National Youth Administration later trained young people for jobs in war industries.
Food and Drug Administration (FDA): As a result of pressure for the Federal Government to control adulterated and misbranded foods and drugs, the Food and Drugs Act was enacted on June 30, 1906. These responsibilities were entrusted to the Bureau of Chemistry in the Department of Agriculture in 1907 and were organized into a Food, Drug and Insecticide Administration in 1927, renamed the Food and Drug Administration in 1931.
Saint Elizabeths Hospital: Saint Elizabeths Hospital, created by Act of Congress in 1852 as the Government Hospital for the Insane, received its first patients on January 15, 1855. Founder of Saint Elizabeths was Dorothea Dix, the most prominent humanitarian of the era.
Freedmen's Hospital: Freedmen's Hospital was an outgrowth of the Bureau for the Relief of Freedmen and Refugees authorized by the Act of March 3, 1865. In 1871, the Hospital was transferred to the Department of the Interior.
Howard University: Howard University was established by an act of March 2, 1867, to provide higher education for Negroes.
Columbia Institution for the Deaf: Education for the deaf was made available in the District of Columbia through the Columbia Institution for the Deaf, which was established by the Act of February 16, 1857.
Office of Vocational Rehabilitation: The Vocational Rehabilitation Act Amendments of 1943 expanded functions relating to vocational rehabilitation and assigned them to the Federal Security Administrator, who established the Office of Vocational Rehabilitation on September 4, 1943, to carry out these functions.

FSA During World War II

World War II had a broad impact on the social programs of FSA. Between 1941 and 1947, the Government recognized the need to maintain essential health and welfare services. The Federal Security Administrator also served as coordinator of the Office of Health, Welfare, and related Defense Activities, renamed the Office of Defense, Health, and Welfare Services in September 1941, which provided health care, education, and related services necessitated by the war effort. It was responsible for adjusting the distribution of remaining professional personnel to meet the requirements of the population. The Food and Drug Administration during the war was charged with maintaining food standards to insure delivery of properly tested foods and drugs to the military establishment.

Reorganization Plan No. 2 of 1946, effective July 16, 1946, abolished the three-man Social Security Board, creating in its place, the Social Security Administration, headed by a Commissioner of Social Security. The plan transferred the Children's Bureau (created in 1912), exclusive of its Industrial Division, from the Department of Labor to FSA, where it became part of the Social Security Administration; the U. S. In 1947, the Administrator directed the establishment of a central library, consolidating the resources of three independent libraries at the Social Security Administration, the Office of Education, and the Office of Vocational Rehabilitation.

Post-War Developments in FSA

By 1948, the retail price of food had risen 114 percent over the 1935-39 base, yet the monthly benefits under social security had not changed since the 1939 amendments had established a base level. Other key pieces of legislation passed in 1948 included bills creating the National Heart Institute and the National Institute of Dental Research. On June 16, 1948, the name of the National Institute of Health was changed to the National Institutes of Health. On June 30, 1948, the President signed the Water Pollution Bill, delegating national water pollution responsibilities to the Public Health Service.

During 1949, the Federal Security Agency began the establishment of 10 FSA regional offices to replace the 11 previously operated by the Social Security Administration and consolidated those being operated by other FSA constituents into one common regional office structure. On May 24, 1950, Reorganization Plan No. 19 of 1950 transferred from FSA to the Department of Labor the Bureau of Employees Compensation and the Employees Compensation Appeals Board. Then, the Federal Security Administrator abolished the Office of Special Services, which had administered the two transferred units plus the Office of Vocational Rehabilitation and the Food and Drug Administration.

Key National Conferences in 1950

In 1950, two important national conferences required months of staff work by FSA personnel. The Mid-century White House Conference on Children and Youth was held in Washington, D.C. in December 1950. In September 1950, Congress authorized the impacted aid program-to relieve the impact on local school facilities of a heavy influx of Federal civilian and military personnel-and in FY 1951 appropriated $96.5 million for school construction under P.L. 81-815, September 23, 1950, and $23 million for school operating expenses under P.L.

The Social Security Act Amendments of 1950 added to the social security rolls about 10 million persons who previously had been ineligible. These persons included agricultural workers and selfemployed small shop owners. Others who benefitted from the changes were the elderly and those who had job-related disabilities. In May of 1951, a citizens committee, the National Mid-century Committee for Children and Youth, was established to provide national follow-up to the problems discussed at the White House Conference.

Transition and Reorganization

The year 1952 was a period of transition for FSA. Despite the contributions made by the Agency during and before the Korean War, most of the defense-related activities in FSA were being phased out. The Food and Drug Administration continued to study chemical and bacteriological warfare agents but other FSA components were mobilized to provide disaster relief and health care assistance to a number of foreign countries. Technical assistance, under the Federal "Point IV" and Mutual Security Agency programs, provided needed help to many underdeveloped countries. The Agency also furnished guidance for foreign representatives sent to this country to study American programs and methods in the fields of health and education.

Consequently, in accordance with the Reorganization Act of 1949, President Eisenhower submitted to the Congress on March 12, 1953, Reorganization Plan No. Department of Health, Education, and Welfare. All of the responsibilities of the Federal Security Administrator would be transferred to the Secretary of Health, Education, end Welfare and the components of FSA would be transferred to the Department. A major objective of the reorganization was to improve administration of the functions of the Federal Security Agency.

HHS Today

HHS consists of several agencies including the Administration for Children and Families, the Administration for Community Living, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, the Indian Health Service, the National Institutes of Health, and the Substance Abuse and Mental Health Services Administration.

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