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The American Public Health Association as a force for change in medical care.

As a force for change in medical care, the APHA has reflected the larger social environment. A Sociological Section (1910-22) was followed by a plea from President C.-E.A. Winslow, in 1926, for health officers to tackle medical care problems. In the 1930's, APHA played little role in the Committee on the Costs of Medical Care or related movements. By the 1940's, a schism developed between conservative local Health Officers and others favoring a widened definition of public health. The Subcommittee on Medical Care (1944) was a turning point, followed by organization in 1948 of the Medical Care Section, soon becoming the largest in the Association. This section helped to legitimate the field, develop training programs, and strengthen medical care in the federal health establishment. It also led APHA to reexamine its whole structure in 1956. By the 1960's, medical care became a major current in the APHA, liberalizing its posture on all health issues. Nevertheless, the major new medical care programs of the 1960's (Medicare, Medicaid, OEO, RMP, etc.) developed outside the jurisdiction of official public health agencies. Personnel from these new programs joined and strengthened APHA, but this did not modify health department roles appreciably. A Council on Personal Health Services, after the 1970 reorganization, finally unified APHA technical work on preventive (public health) and curative (medical care) services. Recognition of the primacy of prevention is consistent with efforts to improve medical care.