The Commissioned Corps of the US Public Health Service (USPHS; or USPHS Commissioned Corps) is one of the nation’s 8 uniformed services and the only uniformed service solely dedicated to protecting and promoting public health. 1 Despite contributions of the USPHS Commissioned Corps to disease prevention, emergency response, and national preparedness, the Corps remains underrecognized in public discourse, underleveraged in policy strategy, underrepresented in national preparedness frameworks, underfunded relative to its capacity, and largely unknown to the public.1,2 The USPHS Commissioned Corps has a vital role in addressing current and emerging public health threats. However, strategic reinvestment, visibility, and integration are needed to fully harness the unique capabilities of the USPHS Commissioned Corps. 3
Why the Nation Needs a Public Health Service
Public health is an important aspect of national security. As global health threats multiply in scale and frequency, from pandemics and opioid epidemics to climate-related disasters and cross-border outbreaks, our public health response must be proactive, strategic, and deployable to meet community needs.4-6 The USPHS Commissioned Corps, an unarmed and uniformed service of trained health professionals, is prepared to respond swiftly and effectively to protect, promote, and advance public health.
The COVID-19 pandemic illuminated vulnerabilities in the US health system, especially in rural areas and areas that are medically underserved, and demonstrated the vital role of the USPHS Commissioned Corps. 7 During this crisis, USPHS officers deployed across the country to staff overwhelmed clinics, support vaccine distribution, and provide clinical and other critical services to tribal health systems. 7 This model of clinical deployment, community support, and federal partnership is not only effective but essential for building resilient health systems.
A Legacy of Service: Historical Content and Evolution
In 1798, the Marine Hospital Service was formed to care for merchant seamen at a time when maritime commerce was vital to national growth. 8 By 1889, the USPHS Commissioned Corps was formalized to provide a ready cadre of public health professionals. 9 Throughout its history, the USPHS Commissioned Corps has played a frontline role in disease control, including screening immigrants at Ellis Island, eradicating smallpox, and helping contain yellow fever and cholera outbreaks. 10
During the 20th century, USPHS officers contributed to tobacco control policy, 11 expanded immunization campaigns, and supported the fight against HIV/AIDS. The 21st century has only intensified the role of USPHS. In the past 2 decades, USPHS officers have responded to the 9/11 terrorist attacks; Hurricane Katrina; the Deepwater Horizon oil spill; Ebola outbreaks in West Africa 7 ; outbreaks of Zika virus, mpox, and syphilis; the COVID-19 pandemic; the Maui Wildfire; tuberculosis outbreaks; and other emergencies. 10
The ability of the USPHS Commissioned Corps to mobilize interdisciplinary teams across multiple federal agencies, including the Centers for Disease Control and Prevention (CDC), the US Food and Drug Administration, the National Institutes of Health, and the Indian Health Service (IHS), makes it an indispensable component of the public health workforce. 12
Mission and Mobilization Capacity
The USPHS Commissioned Corps is tasked with the following:
Deploying rapidly in response to natural disasters, pandemics, and humanitarian crises
Delivering care to medically underserved and remote populations
Promoting public health through chronic disease prevention, maternal–child health, and health education
Supporting health diplomacy through international collaborations and global outbreak responses
USPHS officers serve in active-duty roles in the US Department of Health and Human Services and can be detailed across agencies to respond to evolving public health needs. This cross-functional capability makes the USPHS Commissioned Corps agile and uniquely capable of supporting federal health priorities.
The USPHS Commissioned Corps, led by the assistant secretary for health for the US Department of Health and Human Services and the US surgeon general, includes professionals across 11 categories. 9 While the assistant secretary for health and the US surgeon general are presidentially appointed and confirmed by the Senate, with tenures shaped by changing administrations, the USPHS Commissioned Corps comprises career officers, of whom >67% have served 20 years or longer. In 2025, 941 of 5347 USPHS officers (17.6%) served in other branches of the uniformed services (USPHS, internal files, October 5, 2025). This display of people who leave a service and join USPHS underscores the long-term institutional continuity and dedication of the USPHS Commissioned Corps, independent of political cycles. Officers undergo fitness standards such as cardiovascular endurance, upper-body endurance, core endurance, and flexibility to ensure they can be mobilized rapidly, both domestically and internationally. Officers are encouraged to communicate with their supervisors before their on-call month so that adequate coverage can be provided without delay of daily duties or deployment.
Supporting National Security Through Health Optimization
Public health readiness is a cornerstone of national security. Health optimization, the systematic improvement of health services to maximize outcomes, 13 reduce disparities, and ensure access, strengthens the nation’s ability to field both a medically ready force and a ready medical force. 14
A Medically Ready Force
The US Department of Defense reported that only 23% of young people aged 17 to 24 years are currently eligible for military service, often due to preventable chronic disease. 15 USPHS officers support population-level interventions that improve the health of potential recruits and reduce chronic disease (which affects nearly 60% of US adults and accounts for about 90% of national health expenditures). 16
A Ready Medical Force
The USPHS Commissioned Corps provides surge staffing for frontline care in austere, resource-constrained environments. USPHS officers support en route stabilization, resuscitative care, and long-term recovery during crises, including wildfires, hurricanes, and public health emergencies.
Public Health Infrastructure
USPHS officers work with tribal nations, correctional facilities, and community health centers to expand access to care and reinforce the resilience of health systems. This infrastructure plays a vital role in emergency preparedness, especially in regions prone to natural disasters and effects from climate change. 17
Multidisciplinary Expertise Across 11 Professional Categories
One of the greatest strengths of the USPHS Commissioned Corps is the breadth of professional expertise across its 11 professional categories12,18; this multidisciplinary expertise allows the USPHS Commissioned Corps to respond to a wide range of public health challenges, both domestically and internationally. The interdisciplinary structure of the USPHS Commissioned Corps enables USPHS officers to work in integrated teams across clinical care, environmental health, engineering, scientific research, and emergency preparedness. A prominent example is the National Park Service, where USPHS officers support health care delivery, environmental protection, and occupational health initiatives. Similarly, USPHS officers serve in federal agencies, such as the Federal Bureau of Prisons, IHS, and the US Environmental Protection Agency, where they contribute to advancing health and safety in underserved, high-need, and logistically complex environments (Table).
Table.
The 11 professional categories of the Commissioned Corps of the US Public Health Service
| Discipline | Role | Example |
|---|---|---|
| Dentist | Provide preventive and restorative care in underserved communities and lead public health dental programs | At IHS, delivering critical oral health care to American Indian and Alaska Native populations, reducing rates of untreated dental disease |
| Dietitian | Lead clinical nutrition care, community education, and disease prevention programs | At the Federal Bureau of Prisons, managing nutrition therapy for chronic conditions, improving inmate health outcomes |
| Engineer | Ensure environmental health through the design and oversight of water, waste, and safety infrastructure | At EPA, improving drinking water systems for tribal communities and supporting environmental recovery after disasters |
| Environmental health officer | Mitigate risks from waterborne illness, food contamination, and vector-borne diseases | With Federal Emergency Management Agency during Hurricane Maria, assessing water safety and shelter conditions in Puerto Rico |
| Health service officer | Manage programs, logistics, IT systems, and emergency planning to optimize operational readiness | At CMS, supporting national health care policy implementation and improvement initiatives on access to care |
| Medical officer | Provide direct care and lead public health and emergency responses | During COVID-19, working at quarantine stations and federal medical shelters, including at IHS facilities |
| Nurse officer | Deliver triage, occupational health, and preventive services in remote and high-demand environments | At Federal Occupational Health clinics, supporting employee wellness, delivering vaccinations, and providing emergency care to the federal workforce |
| Pharmacist | Oversee pharmaceutical logistics, clinical consultations, and medication safety | At the FDA, contributing to national drug safety through review and surveillance processes |
| Scientist | Conduct surveillance, epidemiologic research, and risk analysis to inform policy and response | At CDC, tracking and analyzing Zika virus transmission, thus informing public health interventions |
| Therapist | Provide rehabilitation and injury recovery services to personnel in demanding environments | At IHS, delivering physical and occupational therapy to tribal members with limited access to care |
| Veterinarian | Advance food safety, monitor zoonotic diseases, and support One Health initiatives 19 | At USDA, conducting food safety inspections and responding to outbreaks, such as avian influenza |
Abbreviations: CDC, Centers for Disease Control and Prevention; CMS, Centers for Medicare & Medicaid Services; EPA, US Environmental Protection Agency; FDA, US Food and Drug Administration; IHS, Indian Health Service; IT, information technology; USDA, US Department of Agriculture.
Dentists provide preventive and restorative care in underserved communities and lead public health dental programs. According to CDC, about 46% of adults aged 30 years and older have some form of untreated dental decay or periodontal disease, with higher prevalence among American Indian and Alaska Native populations. 20
Dietitians lead clinical nutrition care, community education, and disease prevention programs. In the Federal Bureau of Prisons, dietitians manage nutrition therapy for chronic conditions, improving inmate health outcomes. 21
Engineers ensure environmental health through the design and oversight of water, waste, and safety infrastructure. At the US Environmental Protection Agency, engineers improve drinking water systems for tribal communities and support environmental recovery after disasters. 22
Environmental health officers mitigate risks from waterborne illness, food contamination, and vector-borne diseases. During Hurricane Maria, environmental health officers deployed with the Federal Emergency Management Agency to assess water safety and shelter conditions in Puerto Rico. 23
Health services officers manage programs, logistics, information technology systems, and emergency planning to optimize operational readiness. At the Centers for Medicare & Medicaid Services, health services officers support national health care policy implementation and initiatives to improve access to health care.
Medical officers provide direct care and lead public health and emergency responses. During COVID-19, medical officers staffed quarantine stations and federal medical shelters, including IHS facilities. 4
Nurse officers deliver triage, occupational health, and preventive services in remote and high-demand environments. In federal occupational health clinics, nurse officers support employee wellness, deliver vaccinations, and provide emergency care to the federal workforce.
Pharmacists oversee pharmaceutical logistics, clinical consultations, and medication safety. At the US Food and Drug Administration, pharmacists contribute to national drug safety through review and surveillance processes.
Scientists conduct surveillance, epidemiologic research, and risk analysis to inform policy and response. At CDC, scientists tracked and analyzed Zika virus transmission, thus informing public health interventions. 4
Therapists provide rehabilitation and injury recovery services to personnel in demanding environments. At IHS, therapists deliver physical and occupational therapy to tribal members who have limited access to care.
Veterinarians advance food safety, monitor zoonotic diseases, and support One Health initiatives. 19 At the US Department of Agriculture, veterinarians conduct food safety inspections and respond to outbreaks such as avian influenza.
Aligning With Today’s Public Health Priorities
The USPHS Commissioned Corps strengthens federal, state, and tribal responses to critical health priorities:
Health optimization: USPHS officers address health disparities in rural areas, tribal communities, correctional systems, and urban clinics. Their work aligns national goals to advance equity and eliminate barriers to care for historically marginalized populations.
Disaster preparedness and response: Deployed officers support state, local, and federal partners during wildfires, hurricanes, and pandemics through clinical surge staffing, continuity planning, and mass vaccination campaigns. 24
Chronic and behavioral health: Officers work with CDC, the Substance Abuse and Mental Health Services Administration, and IHS to implement community-level interventions that address rising rates of depression, suicide, diabetes, hypertension, and substance use.
Health communication and literacy: Officers support culturally tailored education campaigns to promote vaccination, reduce stigma, and improve community trust in public health.
Data-driven decision-making 25 : Officers contribute to surveillance systems, national dashboards, and predictive modeling tools that inform policy, allocate resources, and assess interventions in real time.
Gaps and Opportunities: Recommendations for Policy and Practice
To optimize the role of USPHS Commissioned Corps in the nation’s public health ecosystem, improvements in public visibility, strategic preparedness frameworks, investments, and global health engagement are needed.
Elevate Public Visibility
Develop national campaigns that highlight the contributions of USPHS officers during crises and routine public health service.
Integrate USPHS officer visibility into public service announcements, agency branding, and public health education.
Promote the importance of partnership and interdependency of all 8 uniformed services to strengthen the workforce to optimize public health care in communities.
Integration of USPHS Into Strategic Preparedness Frameworks
Ensure representation in interagency coordination efforts, including with the National Disaster Medical System, the Strategic National Stockpile, and local, state, and federal emergency planning, to include representation in advisory committees and strategic health security frameworks.
Assign leadership roles in public health security planning at state and regional levels.
Invest in the USPHS Commissioned Corps
Increase relevant legislation and appropriated funding to support mental health services, readiness training, and deployment infrastructure.
Expand recruitment pipelines through scholarships, academic partnerships, and incentives to attract candidates from underrepresented backgrounds.
Expand Global Health Engagement
Formalize contributions of the USPHS Commissioned Corps to international disaster relief, partnerships, and health diplomacy through interagency agreements.
Strengthening Access in Communities With Barriers to Health Services
The USPHS Commissioned Corps is committed to reaching communities that face persistent barriers to health services, including tribal nations, incarcerated populations, rural residents, and urban minority groups. USPHS officers deliver culturally responsive care, support language access, and implement community-informed outreach to improve health outcomes and strengthen trust in public systems. The USPHS Commissioned Corps also prioritizes inclusive representation by recruiting from diverse backgrounds, fostering partnerships with minority-serving institutions, and supporting leadership development across all professional categories. This inclusive approach enhances mission readiness and enables USPHS officers to provide responsive care across a broad range of settings. In times of crisis, USPHS officers are trained to recognize how social, geographic, and economic factors affect health risks and recovery. By embedding these considerations into preparedness, deployment, and recovery operations, the USPHS Commissioned Corps helps ensure that public health efforts are responsive, effective, and aligned with the needs of the populations they serve.
Conclusion
The USPHS Commissioned Corps represents one of the most versatile and underused tools in the nation’s public health arsenal. At a time when public health emergencies are escalating in scope and complexity, the need for a disciplined, mission-ready, and deployable health workforce is undeniable. The USPHS Commissioned Corps provides this capacity and more, supporting population health, addressing social determinants of health, and responding where civilian systems cannot. For example, during the height of the COVID-19 pandemic, USPHS officers were deployed to tribal nations and rural communities that had limited infrastructure to staff overwhelmed clinics and deliver vaccines where local public health departments lacked sufficient personnel or logistical capacity. 26
A stronger, more visible, and better integrated USPHS Commissioned Corps will enhance the nation’s health security and reflect a renewed commitment to proactive, equitable, and resilient public health. 27 As the United States faces the public health challenges of the 21st century, the USPHS Commissioned Corps stands ready to lead, with science, compassion, and service as its core.
Footnotes
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The authors received no financial support for the research, authorship, and/or publication of this article.
Ethics Statement: This commentary did not involve human subjects or the collection of identifiable private information. Therefore, institutional review board approval and informed consent were not required. All data analyzed were publicly available or anonymized aggregate data from humanitarian incident databases.
ORCID iD: Jamla Rizek, DNP, MBA, RN, CEN, CPEN, NHDP-BC, NRP 
https://orcid.org/0009-0002-2212-6969
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