On July 13, 2018, Public Health Reports marks its 140th year of publication. It began in 1878 as a small weekly government bulletin of disease reports and tables. During the past 140 years, this, the official journal of the surgeon general and the US Public Health Service (USPHS), has adapted continually to new public health challenges and innovations in medical communications (Box). From a simple bulletin publishing mostly reports from USPHS officers, through the decades the journal has evolved into a seasoned peer-reviewed journal publishing articles from all parts of the public health enterprise. In this editorial, we celebrate the journal’s anniversary and the contributions it has made to public health. We offer a short history of the journal; announce the reinstatement of Public Health Chronicles, a department in the journal dedicated to the history of public health; and reflect on the future of the journal.

Preventive services are available for nine of the ten leading causes of death in the United States. The Affordable Care Act (ACA) has reduced cost as a barrier to care by expanding access to insurance and requiring many health plans to cover certain recommended preventive services without copayments or deductibles. To establish a baseline for the receipt of these services for monitoring the effects of the law after 2012, CDC analyzed responses from persons aged ≥18 years in the National Health Interview Survey (NHIS) for the years 2011 and 2012 combined. NHIS is an in-person interview administered annually to a nationally representative sample of the noninstitutionalized, U.S. civilian population. This report summarizes the findings for nine preventive services covered by the ACA. Having health insurance or a higher income was associated with higher rates of receiving these services, affirming findings of previous studies. Securing health insurance coverage might be an important way to increase receipt of clinical preventive services, but insurance coverage is not sufficient to ensure that everyone is offered or uses clinical services proven to prevent disease. Greater awareness of ACA provisions among the public, public health professionals, partners, and health care providers might help increase the receipt of recommended services.

A while ago, I read a remarkable observation somewhere that thousands of years ago human beings learned how to count, and thousands of years ago human beings learned how to distinguish various cases of disease. But it was only relatively recently, perhaps 400 years ago, that human beings learned to put those two concepts together, to count cases of disease. | | Counting cases of disease is part of “public health surveillance,” often defined as “the ongoing systematic collection, analysis, and interpretation of health-related data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those who need to know … and the application of these data to prevention and control.”1 Ultimately, surveillance is about knowing. The importance of it comes from the simple recognition that we cannot effectively prevent or control disease unless we know how much disease is occurring, where, and in what populations.2 Until perhaps the 1970s, surveillance was aimed mainly at controlling communicable diseases, but over time surveillance for chronic and occupational diseases and injuries has come to the fore. In the past 20 years, with the advent of wide-scale digital communications, our ways of knowing about the occurrence of disease have multiplied. Where we once depended mainly on paper reports, increasingly we know about disease occurrence rapidly through electronic channels, such as Internet-based disease intelligence systems, as well as electronic health records, laboratory reports, and biosurveillance systems.3 Many other innovative methods of electronic disease surveillance are being developed.4

The Affordable Care Act requires many health plans to provide coverage for certain recommended clinical preventive services without charging copays or deductible payments. This provision could lead to greater uptake of many services that can improve health and save lives. Although the coverage provision is broad, there are many caveats that also apply. It is important for providers and public health professionals to understand the nuances of the coverage rules to help maximize their potential to improve population health.

This supplement is the second of a series of periodic reports from a CDC initiative to monitor and report on the use of a set of selected clinical preventive services in the U.S. population in the context of recent national initiatives to improve access to and use of such services. Increasing the use of these services can result in substantial reductions in the burden of illness, death, and disability and lower treatment costs. This supplement focuses on services to improve the health of U.S. infants, children, and adolescents. The majority of clinical preventive services for infants, children, and adolescents are provided by the health-care sector. Public health agencies play important roles in increasing the use of these services by identifying and implementing policies that are effective in increasing use of the services and by collaborating with stakeholders to conduct programs to improve use. Recent health-reform initiatives, including efforts to increase the accessibility and affordability of preventive services, fund community prevention programs, and improve the use of health information technologies, offer opportunities to improve use of preventive services. This supplement, which follows a previous report on adult services, provides baseline information on the use of a set of selected clinical preventive services to improve the health of infants, children, and adolescents before implementation of these recent initiatives and discusses opportunities to increase the use of such services. This information can help public health practitioners, in collaboration with other stakeholders that have key roles in improving infant, child, and adolescent health (e.g., parents or guardians and their employers, health plans, health professionals, schools, child care facilities, community groups, and voluntary associations), understand the potential benefits of the recommended services, address the problem of underuse, and identify opportunities to apply effective strategies to improve use and foster accountability among stakeholders.

Each year in the United States, an estimated 100,000 deaths could be prevented if persons received recommended clinical preventive care. The Affordable Care Act has reduced cost as a barrier to care by expanding access to insurance and requiring many health plans to cover certain recommended preventive services without copayments or deductibles. To establish a baseline for the receipt of these services and to begin monitoring the effects of the law, CDC analyzed responses from persons aged ≥18 years in the National Health Interview Survey (NHIS) for the years 2011 and 2012 combined. This report summarizes the findings for six services covered by the Affordable Care Act. Among the six services examined, three were received by less than half of the persons for whom they were recommended (testing for human immunodeficiency virus [HIV] and vaccination for influenza and zoster [shingles]). Having health insurance or a higher income was associated with higher rates of receiving these preventive services, affirming findings of previous studies. Securing health insurance coverage might be an important way to increase receipt of clinical preventive services, but insurance coverage is not all that is needed to ensure that everyone is offered and uses clinical services proven to prevent disease. Greater awareness of Affordable Care Act provisions among public health professionals, partners, health care providers, and patients might help increase the receipt of recommended services.

The Patient Protection and Affordable Care Act, which was enacted by the US Congress in 2010, marks the greatest change in US health policy since the 1960s. The law is intended to address fundamental problems within the US health system, including the high and rising cost of care, inadequate access to health insurance and health services for many Americans, and low health-care efficiency and quality. By 2019, the law will bring health coverage-and the health benefits of insurance-to an estimated 25 million more Americans. It has already restrained discriminatory insurance practices, made coverage more affordable, and realised new provisions to curb costs (including tests of new health-care delivery models). The new law establishes the first National Prevention Strategy, adds substantial new funding for prevention and public health programmes, and promotes the use of recommended clinical preventive services and other measures, and thus represents a major opportunity for prevention and public health. The law also provides impetus for greater collaboration between the US health-care and public health systems, which have traditionally operated separately with little interaction. Taken together, the various effects of the Patient Protection and Affordable Care Act can advance the health of the US population.

MMWR was established to disseminate the results of public health surveillance and owes much of its existence to the founder of modern surveillance, William Farr (1807--1883). In 1878, under the sway of Farr, Lemuel Shattuck, and other pioneers of surveillance, the U.S. government created the first precursor of MMWR and entered the business of publishing surveillance statistics. Farr's influence touched MMWR again in 1961 when one of his adherents, Alexander D. Langmuir (Figure 1), brought MMWR to Atlanta and CDC from a federal office in Washington, D.C. (1). Since its beginnings, MMWR has played a unique role in addressing emerging public health problems by working with state and local health departments to announce problems even before their cause is known, rapidly disseminating new knowledge about them weeks or months before articles appear in the medical literature, and publishing recommendations for their control and prevention. MMWR has played this role time after time---the discovery of Legionnaires disease in the 1970s, AIDS and toxic-shock syndrome in the 1980s, hantavirus pulmonary syndrome in the 1990s, and severe acute respiratory syndrome (SARS) in the 2000s. At the same time, MMWR also has reported on nearly all the major noninfectious public health problems of the day---environmental emergencies, chronic diseases, injuries, and new public health technologies. To a great extent, the history of MMWR is the history of disease and injury prevention and control in the United States

This supplement of MMWR celebrates the 50th anniversary of CDC's first publication of MMWR on January 13, 1961 (Figure 1). MMWR was not new in 1961, but it was new to CDC, an agency that itself had been founded only 15 years earlier, in 1946 (1). The longer history of MMWR traces back to July 13, 1878, when the first predecessor of MMWR, called simply The Bulletin of the Public Health, was inaugurated. The Bulletin was established in accordance with the first National Quarantine Act, passed by Congress 2 months earlier. The Act ordered the Surgeon General of the U.S. Marine-Hospital Service to begin publishing abstracted disease reports collected from U.S. consuls in foreign lands to alert U.S. quarantine officials about what diseases could be expected among passengers arriving on steamships (2,3). In the 83 years from 1878 to 1961, MMWR went through several incarnations. By 1952, the publication had its current name and was being published by the National Office of Vital Statistics, an agency within the U.S. Department of Health, Education and Welfare. In 1960, CDC's renowned chief of epidemiology, Alexander D. Langmuir, decided that MMWR should be transferred to CDC (then known as the Communicable Disease Center). After much discussion, and as Langmuir later said in an interview, "all sorts of pulling out teeth by the roots without anesthesia and all kinds of internal frictions," in 1960, MMWR was transferred to CDC (4). | | In 2009, as the 50th anniversary of MMWR loomed, the MMWR Editor (F.E.S.) began discussions with leaders at CDC and the MMWR Editorial Board about how best to commemorate this date. Members of the Board, editors, and friends of MMWR offered many good ideas. In the end, the most persuasive idea was to celebrate the 50th anniversary simply by doing what MMWR has done best for 5 decades at CDC: publish articles of high value to its readers. The title of the supplement is "Public Health Then and Now: Celebrating 50 Years of MMWR at CDC." The supplement's guest editors (F.E.S., K.S.K., L.M.L., S.B.T.) selected a cadre of expert authors who have long experience in their respective fields of public health---enough to enable them to look back over the past 50 years and trace the most important influences and developments. The guest editors asked the authors to answer three key questions. What was the state of the art in 1961? How did it develop through 50 years into its present form? What does the future hold? Thus, with few exceptions, the 16 articles that make up this supplement are not meant to be about MMWR but instead are meant to trace the development of key areas of public health through the 50-year era of MMWR at CDC. | | The authors took up the challenge admirably. The result is a diverse set of articles that portray public health in 1961 and forward in time to the present and beyond. The articles range from detailed historical review, to analyses of MMWR content, to the more whimsical. They are not meant to be exhaustive, nor can they treat their topics as thoroughly as would a longer text, but they do depict the main events, developments, and innovations that led public health to where it stands today.