Local and State Boards of Health
In the first decades of the twentieth century, municipal and state boards of health across the United States professionalized. By the early 1920s, the Oregon State Board of Health was divided into six departments: Vital Statistics, Prevention and Control of Disease, Diagnostic Laboratory, Child Hygiene and Public Health Nursing, Sanitary Engineering, and Rural Sanitation. The diagnostic laboratory, as shown in this table, examined cultures to determine cases of communicable diseases such as diphtheria and tuberculosis, conducted Wasserman and Kahn tests on blood samples to diagnose syphilis, and inspected water supplies. The lab’s findings supported statistical reports produced by the State Board of Health.
The Board continued its fight against epidemics, battling the same diseases it had since its inception, such as tuberculosis and diphtheria, but also new ones like polio and Rocky Mountain spotted fever. With assistance of federal funding during the 1930s, the State Board of Health was able to expand its services as well as establish much needed rural health programs.
By the 1930s, the organization of public health at the local level had greatly improved. All counties and cities were required to employ health officers, who had to also be licensed physicians. Local health officers regularly reported public health data to the Oregon State Board of Health. Dr. Joseph Mountin’s 1934 survey for the Oregon Legislature illustrates some of increased efficiency of statewide public health efforts. In 1933, as the table shows, twenty-six of Oregon’s thirty-six counties sent at least ten monthly reports to the State Board of Health. Data reported included: cases of communicable diseases, persons immunized, sanitary inspections, and children examined.
In 1971, a Health Division was formed within the newly established Department of Human Resources, later renamed the Department of Human Services, and charged with administering public health services. Two years later the Oregon Legislature abolished the State Board of Health and its responsibilities were transferred to the State Health Commission. The Oregon Legislature created the Oregon Health Authority (OHA) in 2009 and transferred to it all health duties in the state. Within OHA is the Public Health Division, led by the Public Health Director and supported by the Public Health Officer, Deputy Public Health Director, and State Epidemiologist/Chief Science Office. The division’s Center for Public Health Practice oversees the collection of vital statistics, with local data compiled by Oregon’s thirty-four public health departments.
The National Health Survey Act of 1956 greatly influenced the collection of modern health statistics. The act tasked the United States Public Health Service with gathering national morbidity statistics. In 1960 the National Health Survey merged with the National Office of Vital Statistics to form the National Center for Health Statistics (NCHS). Data is collected from interview surveys, birth and death records, medical records, and laboratory testing. The information collected by NCHS as well as by state and local survey programs informs public health policy and medical research in the twenty-first century.