Joycelyn Elders 1933–

U.S. Surgeon General

Found Inspiration in Black Woman Doctor

Took Action Against Societal Health Crises

Fought with Conservatives and Religious Groups

Stood Ground during Confirmation Process

Sources

During a press conference in 1987, then-Arkansas governor Bill Clinton introduced renowned physician and endocrinologist Dr. Joycelyn Elders as his choice to head that state’s health department. When asked by reporters whether she would pursue the distribution of condoms in school-based clinics as a means of reducing teenage pregnancy, Elders answered, according to the New York Times, “Well, we’re not going to put them on their lunch trays, but yes.” In her five years as a member of Clinton’s gubernatorial cabinet, Elders, with unwavering brash-ness and zeal, tackled the public health crises that were increasingly alarming both her colleagues and lay citizens throughout the country: teenage pregnancy, AIDS (acquired immunodeficiency syndrome), and sexual abuse, among others. Her approach, which emphasizes sex education and the availability of contraceptives and abortion services, predictably antagonized both political and religious conservatives.

In 1993, when President Clinton announced his nomination of Elders to serve as U.S. surgeon general, opponents of the appointment mounted a campaign to torpedo her confirmation. But neither Clinton nor Elders stepped back, even in the face of blistering attacks. Deemed “a verbal bomb thrower” by Time magazine contributor Margaret Carlson, Elders has likened the crusade against teen pregnancy to the civil rights struggle; she would not be silenced.

Joycelyn Elders was born August 13, 1933, in the southwestern farming community of Schaal, Arkansas. She was the first of Haller and Curtis Jones’s eight children. Living in a poor, segregated pocket of the country, she and her siblings struck a balance between laboring in the cotton fields and attending an all-black school 13 miles from home. At night, Joycelyn—encouraged primarily by her grandmother—read books by the light of kerosene lamps. By the time she neared graduation from high school, she had earned a scholarship to the all-black, liberal arts Philander Smith College in Little Rock, the state’s capital. Her brothers and sisters picked extra cotton and did chores for neighbors to earn the $3.43 for her bus fare. She was the first in her family to take the road to higher education.

Found Inspiration in Black Woman Doctor

At school, Joycelyn was particularly drawn to the study of biology and chemistry and concluded that being a lab technician was her highest calling, the professional

At a Glance…

Born Joycelyn Minnie Jones, August 13, 1933, in Schaal, AR; daughter of Curtis and Haller Jones; married Oliver B. Elders (a high school basketball coach), February 14, 1960; children: Eric and Kevin. Education: Philander Smith College, B.A., 1952; received M.D. from University of Arkansas School of Medicine.

University of Minnesota, pediatric intern, 1960-61; University of Arkansas Medical Center, pediatric resident, 1961-63, chief pediatric resident, 1963-64, pediatric research fellow, 1964-67, assistant professor, 1967-71, associate professor, 1971-76, professor of pediatrics, 1976-87; director, Arkansas Department of Health, 1987-93; U.S. Surgeon General, 1993—. Former board member of the National Bank of Arkansas. Military service: Trained as a physical therapist in the U.S. Army.

Awards: Woman of Distinction Award, Worthen Bank, 1987; Arkansas Democrat Woman of the Year, statewide newspaper, 1988.

Addresses: Office —U.S. Surgeon General’s Office, 5600 Fishers Ln., Rockville, MD 20857.

mountaintop. But her ambitions rose a notch when she heard Edith Irby Jones (no relation), the first African American to study at the University of Arkansas School of Medicine, speak at a college sorority. Suddenly, Joycelyn Jones, who had not even met a doctor until she was 16 years old, imagined herself as a healer.

After graduation, with the idea of ultimately using the G.I. Bill to fund post-graduate study, Joycelyn enlisted in the U.S. Army, where she was trained as a physical therapist. She entered the University of Arkansas School of Medicine in 1956, two years after the Supreme Court, in its Brown v. Board of Education decision, had ruled that separate but equal education was unconstitutional. But while segregation in some areas had been declared illegal by judicial order, an underlying discriminatory mindset in American society could not be erased so easily. As the lone black woman and one of only three students of color in her class, she was required to use a separate university dining room, where the cleaning staff ate. But she accepted this arrangement without argument, as this was the only social world to which she was accustomed. She met her future husband, Oliver Elders, when, in order make additional money, she performed the physicals for high school students on the basketball team he managed. They were married in 1960.

After an internship in pediatrics at the University of Minnesota, Joycelyn Elders returned to Little Rock in 1961 for her residency and was quickly appointed chief pediatric resident, in charge of the all-white and all-male battery of residents and interns. Over the next 20 years, Elders combined a successful clinical practice with research in pediatric endocrinology (the study of glands), publishing well over 100 papers, most dealing with growth problems and juvenile diabetes. Her pioneering work captured the attention of the state’s medical community, and physicians routinely referred to her their cases of juveniles with insulin-dependent diabetes.

It was this branch of science that led to her study of sexual behavior and planted the seeds for her public sector advocacy. Recognizing that diabetic females face a health risk if they become pregnant at too young an age—the hazards include spontaneous abortion and possible congenital abnormalities in the infant—Elders saw the urgent need to talk about the dangers of pregnancy with her patients and to distribute contraceptives in order to limit those dangers. “If I wanted to keep those kids healthy, I decided I had no choice but to take command of their sexuality at the first sign of puberty,” Elders told the New York Times. “I’d tell them, ‘You’re gonna have two good babies, and I’m gonna decide when you’re gonna have them.’” The results were clear: of the 520 juvenile diabetics Elders treated, approximately half were female, and only one became pregnant.

Took Action Against Societal Health Crises

But for every young adult in her care, there were thousands throughout the state whose sexual behavior went unmonitored and whose irresponsible, uneducated actions were contributing to America’s dubious distinction of having the highest rate of teenage pregnancy in the industrialized world. Elders could not turn her back on this situation. She had done that once before, when she was a pediatric resident. A young girl with a thyroid condition, upon being told that she could go home from the hospital, had confided to Elders that she didn’t want to leave the safety of her room—that her father and uncles and brothers sexually abused her every Saturday night. Elders was reluctant to believe her. This was also a time before doctors could report suspected child abuse with immunity. So Elders did nothing, and sent the child home. Inaction, she vowed, would be a sin of which she would never again be guilty.

In 1986, the year before Clinton named Elders director of the Arkansas Department of Health, 20 percent of that state’s total births were to teenage mothers, compared to approximately 13 percent on a national level. The costs of this birthrate profile were, in Elders’s view, enormous. Taxpayers in Arkansas dished out more than $82 million in fiscal 1987 for Arkansas adolescents and their children. Equally, if not more important, was the unquantifiable price paid by a society in which a frighteningly large number of emotionally immature young adults become parents to unwanted children. The Boston Globe quoted Elders as describing a poor teenager with a baby as “captive to a slavery the 13th Amendment [the Emancipation Proclamation abolishing slavery] did not anticipate.” With the incidence of sexually transmitted diseases on the rise, and the specter of AIDS hanging over the heads of all sexually active people, Elders recognized the urgent need for bolder government involvement and an intense public education campaign.

Fought with Conservatives and Religious Groups

Elders glimpsed one of the approaches she would champion in office when she visited the state’s first school-based health clinic in the Ozark mountain community of Lincoln, where contraceptives were given to students on request and where senior class pregnancies had subsequently fallen from 13 to one. Under Elders, 18 other school clinics opened, though only four of them were authorized by their local boards of education to distribute condoms. As Elders campaigned for the clinics and expanded sex education throughout the state, she became engaged in a heated battle with both political conservatives—who criticized her effort to increase the government’s role in the lives of U.S. citizens, particularly in an area as private as sexual behavior—and members of some religious groups—who feared that the distribution of condoms would encourage sexual activity, and who rejected the introduction of sex education in schools as a means of institutionally sanctioning abortion.

Elders, who is pro-choice but admits she personally opposes abortion, retaliated with both sober and emotion-laden arguments. She said she would gladly teach abstinence if she felt such an approach would work. But in the real world, she maintained, kids will continue to have sex, and it is the job of adults—and the U.S. government—to turn an irresponsible action into a responsible one. She said she considered every abortion her own personal failure, and her role, simply put, was to prevent unwanted pregnancy from ever occurring. She accused anti-abortion activists of having a “love affair with the fetus,” and pointed out in the Washington Post that even some abortion foes did not “want to support any [social] programs that will make [these unwanted children] into productive citizens.”

In 1989, in great measure because of Elders’s lobbying, the Arkansas State Legislature mandated a kindergarten-through-twelfth-grade course curriculum encompassing not only sex education, but instruction in hygiene, substance-abuse prevention, self-esteem, and the proposition, often overlooked, that contraceptive responsibility does not belong exclusively to the female. Between 1987 and 1990, though the rate of teenage pregnancy in Arkansas was up, the national rate was considerably higher.

Stood Ground during Confirmation Process

President Clinton’s nomination of Elders for the post of U.S. surgeon general made her the second African American and fifth woman tapped for a cabinet position—and galvanized on a national level the activist critics who had fought her locally in Arkansas. Writing in the National Review, Floyd G. Brown, in a rebuttal to her favoring abortion on demand, criticized her for making what in his view is a cavalier judgment that quality of life—that is, a loving, financially sound environment—”means more than life itself.” Still others questioned her support of the abortion-inducing RU 486 pill, the medicinal use of marijuana, and her urging of television networks to lift their ban on airing condom ads. “I find it rather strange that we can advertise cigarettes and beer to the young but then get nervous when there is talk of something [condoms] that can save lives but not about some things that kill,” she remarked in Advertising Age.

Some of the most persistent attacks against her nomination concerned her involvement with the National Bank of Arkansas. She and others serving on the bank’s board of directors were sued by the bank; they had allegedly violated the National Banking Act by authorizing $1.5 million in bad loans. The suit was settled, but the terms were not disclosed. And in July of 1993, Elders resigned from her position as director of the Arkansas Health Department after questions were raised about her drawing a full-time salary there while also working two days a week as a paid consultant to U.S. Health and Human Services secretary Donna Shalala.

Although some Republicans succeeded in delaying the confirmation vote, Elders gained the backing of the American Medical Association and former U.S. surgeon general c. Everett Koop. On September 7, 1993, the Senate gave Elders the nod, 65-34. Democratic senator Edward Kennedy, citing the lashing doled out by several of his colleagues, was quoted in the Boston Globe as saying, “She has come through this unfair gantlet of excessive criticism with flying colors.”

Elders confirmed her willingness to articulate controversial thinking when she suggested in December of 1993 that the Clinton administration launch a study “of the possibility of legalizing illicit drugs,” as was reported by Time. The White House took great pains to distance itself from Elders’s remarks, which some media observers viewed as an unfortunate regression from the president’s campaign rhetoric of “less interdiction, more treatment.” Though conservatives were once again outraged, Elders was applauded by others who saw little harm in a mere study, the long-term effects of which could perhaps positively impact one of the nation’s thorniest social issues.

A collection of Elders’s lectures and remarks, titled Dancing with the Bears, was scheduled for publication by Abingdon Press in 1994.

Sources

Advertising Age, January 11, 1993, p. 3.

Boston Globe, July 20, 1993, p. 14; September 8, 1993, p. 3. National Review, April 26, 1993, p. 38. Newsweek, July 26, 1993, p. 4. New York Times, October 15, 1989, p. 39; December

25, 1992, p. A25. Publishers Weekly, September 20, 1993, p. 7. Time, July 19, 1993, p. 52; December 20, 1993, p. 35. Washington Post, December 17, 1992, p. A16.

Additional information for this entry was obtained from a Dateline NBC profile of Elders that first aired on NBC-TV on July 13, 1993.

—Isaac Rosen

Joycelyn Elders

Confirmed as the 16th Surgeon General of the United States on September 7, 1993, Joycelyn Elders (born 1933) was the first African American and only the second female to head up the U.S. Public Health Service. In her brief 15-month tenure, Elders added tobacco use, national health care, and drug and alcohol abuse to her platform.

Jocelyn Elders was born Minnie Jones on August 13, 1933, in the southwestern farming community of Schaal, Arkansas. She took the name Jocelyn in college. She was the first of Haller and Curtis Jones's eight children. Living in a poor, segregated pocket of the country, she and her siblings struck a balance between laboring in the cotton fields and attending an all-black school 13 miles from home. One of her earliest childhood memories was being taught to read by her mother, Haller, who had an eighth grade education which was quite remarkable for an African American woman at that time. By the time she neared graduation from high school, Elders earned a scholarship to the all-black, liberal arts Philander Smith College in Little Rock, the state's capital. Initially, higher education looked doubtful for Elders as her father did not want to let her go. He felt that her contribution to the family was much more important. He did not see the long-term value of education. With all her pleading, Haller Jones could not get her husband to budge. Elders had resigned herself to staying home and continuing to pick cotton. She hadn't counted on her paternal grandmother, for whom she was named, to come to her aid, but whatever grandma Minnie said, she was allowed to go to college in September. Her family picked extra cotton to earn the $3.43 for her bus fare. She was the first in her family to take the road to higher education.

Found Inspiration in African American Woman Doctor

At school, Elders was particularly drawn to the study of biology and chemistry and concluded that being a lab technician was her highest calling, the professional mountaintop. But her ambitions rose a notch when she heard Edith Irby Jones (no relation), the first African American to study at the University of Arkansas School of Medicine, speak at a college sorority. Jocelyn Jones, who had not even met a doctor until she was 16 years old, imagined herself as a healer.

After graduation from college, Elders married briefly and then joined the U. S. Army's Women's Medical Specialist Corps. In 1956, she entered the Arkansas Medical School on the G.I. Bill two years after the Supreme Court, in its Brown v. Board of Education decision, ruled that separate but equal education was unconstitutional. But while segregation in some areas had been declared illegal by judicial order, an underlying discriminatory mindset in American society could not be so easily erased. As the lone black student and only one of three students of color in her class, she was required to use a separate university dining room, where the cleaning staff ate. But she accepted this arrangement without argument, as this was the only social world to which she was accustomed. She met her second husband, Oliver Elders, when, in order to make additional money, she performed the physicals for high school students on the basketball team he managed. They were married in 1960.

After an internship in pediatrics at the University of Minnesota, Jocelyn Elders returned to Little Rock in 1961 for her residency and was quickly appointed chief pediatric resident, in charge of the all-white and all-male battery of residents and interns. Over the next 20 years, Elders combined a successful clinical practice with research in pediatric endocrinology (the study of glands), publishing well over 100 papers, most dealing with growth problems and juvenile diabetes. Her pioneering work captured the attention of the state's medical community, and physicians routinely referred to her their cases of juveniles with insulin-dependent diabetes.

It was this branch of science that led her to the study of sexual behavior and planted the seeds for her public sector advocacy. Recognizing that diabetic females face a health risk if they become pregnant at too young an age—the hazards include spontaneous abortion and possible congenital abnormalities in the infant—Elders saw the urgent need to talk about the dangers of pregnancy with her patients and to distribute contraceptives in order to limit those dangers. "If I wanted to keep those kids healthy, I decided I had no choice but to take command of their sexuality at the first sign of puberty," Elders told the New York Times. "I'd tell them, you're gonna have two good babies, and I'm gonna decide when you're gonna have them." The results were clear: of the 520 juvenile diabetics Elders treated, approximately half were female, and only one became pregnant.

Taking Action Against Societal Health Crises

But for every young adult in her care, there were thousands throughout the state whose sexual behavior went unmonitored and whose irresponsible, uneducated actions were contributing to America's dubious distinction of having the highest rate of teenage pregnancy in the industrialized world. Elders could not turn her back on this situation. She had done that once before, when she was a pediatric resident. A young girl with a thyroid condition, upon being told that she could go home from the hospital, had confided to Elders that she didn't want to leave the safety of her room—that her father, uncles and brothers sexually abused her every Saturday night. Elders was reluctant to believe her. This was also a time before doctors could report suspected child abuse with immunity. So Elders did nothing, and sent the child home. Inaction, she vowed, would be a sin of which she would never again be guilty.

In 1986, the year before Clinton named Elders director of the Arkansas Department of Health, 20 percent of the state's total births were to teenage mothers, compared to approximately 13 percent on a national level. The costs of the birthrate profile were, in Elder's view, enormous. Taxpayers in Arkansas dished out more than $82 million in fiscal 1987 for Arkansas adolescents and their children. Equally, if not more important, was the unquantifiable price paid by a society in which a frighteningly large number of emotionally immature young adults became parents to unwanted children. The Boston Globe quoted Elders as describing a poor teenager with a baby as "captive to a slavery the 13th Amendment [the Emancipation Proclamation abolishing slavery] did not anticipate." With the incidences of sexually transmitted diseases on the rise, and the specter of AIDS hanging over the heads of all sexually active people, Elders recognized the urgent need for bolder government involvement and an intense public education campaign.

Fought with Conservatives and Religious Groups

Elders glimpsed one of the approaches she would champion in office when she visited the state's first school-based health clinic in the Ozark mountain community of Lincoln, where contraceptives were given to students on request and where senior class pregnancies had subsequently fallen from 13 to one. Under Elders, 18 other school clinics opened, though only four of them were authorized by their local boards of education to distribute condoms. As Elders campaigned for the clinics and expanded sex education throughout the state, she became engaged in a heated battle with both political conservatives—who criticized her effort to increase the government's role in the lives of U.S. citizens, particularly in an area as private as sexual behavior—and members of some religious groups—who feared that the distribution of condoms would increase sexual activity, and who rejected the introduction of sex education in schools as a means of institutionally sanctioning abortion.

Elders, who is pro-choice but admits she personally opposes abortion, retaliated with both sober and emotional arguments. She said she would gladly teach abstinence if she felt that approach would work. But in the real world, she maintained, kids will continue to have sex, and it is the job of adults—and the U.S. government—to turn an irresponsible action into a responsible one. She said she considered every abortion her own personal failure, and her role, simply put, was to prevent unwanted pregnancy from ever occurring. She accused anti-abortion activists of having a love affair with the fetus, and pointed out in the Washington Post that not even abortion foes want to support "any [social] programs that will make [these unwanted children] into productive citizens."

In 1989, in great measure because of Elder's lobbying, the Arkansas State Legislature mandated a kindergarten-through-twelfth-grade course curriculum encompassing not only sex education, but instruction in hygiene, substance-abuse prevention, self-esteem, and the proposition, often overlooked, that sexual responsibility does not belong exclusively to the female. Between 1987 and 1990 though the rate of teenage pregnancy in Arkansas was up, the national rate was considerably higher.

Stood Ground during Confirmation Process

President Clinton's nomination of Elders for the post of U.S. Surgeon General made her the second African American and fifth woman tapped for a cabinet position—and galvanized on a national level the active critics who had fought her locally in Arkansas. Writing in the National Review, Floyd G. Brown, in a rebuttal to her favoring abortion on demand, criticized her for making what in his view is a cavalier judgment that the quality of life—that is, a loving, financially sound environment—"means more than life itself." Still others questioned her support of the abortion-inducing RU-486 pill, the medicinal use of marijuana, and her urging of television networks to lift their ban on airing condom ads. "I find it rather strange that we can advertise cigarettes and beer to the young but then get nervous when there is talk of something [condoms] that can save lives but not about some things that kill," she remarked in Advertising Age.

Some of the most persistent attacks against her nomination concerned her involvement with the National Bank of Arkansas. She and others serving on the bank's board of directors were sued by the bank for allegedly violating the National Banking Act by authorizing $1.5 million in bad loans. The suit was settled, but the terms were not disclosed. Elders resigned from her position as director of the Arkansas Health Department in July 1993 after questions were raised about her drawing a full-time salary there while also working two days a week as a paid consultant to U.S. Health and Human Services secretary Donna Shalala.

Although some Republicans succeeded in delaying the confirmation vote, Elders gained the backing of the American Medical Association and former U.S. Surgeon General C. Everett Koop. On September 7, 1993, the Senate gave Elders the nod 65-34. Democratic senator Edward Kennedy, citing the lashing doled out by several of his coleagues, was quoted in the Boston Globe as saying, "She has come through this unfair gauntlet of excessive criticism with flying colors."

Elders platform as U.S. Surgeon General was to continue with her work regarding teen pregnancy, she was also concerned with tobacco use, national health care, AIDS, and drug and alcohol abuse. In late 1993 she sparked a great debate regarding the legalization of street drugs such as heroin and cocaine which was misrepresented in the media and by her opponents. What Elders, in fact, proposed was that the issue be studied. She did not back away from this stance even after the arrest and conviction of her son, Kevin, who was appealing a ten-year sentence for selling an eighth of an ounce of cocaine to a police informant in July of 1993. Claiming entrapment, Kevin Elders, nevertheless, openly acknowledged a decade-long drug problem.

Gun control was a major issue for Elders. Every day 135,000 youngsters take guns to school, more than 100 are shot, and 30 are killed, she told the Journal of the American Medical Association (JAMA). She sees this issue as being intrinsic to the health of the nation.

The Surgeon General Resigns Amid Controversy

Amidst a sea of controversy over a statement made at World AIDS Day at the United Nations regarding the teaching of masturbation in schools, Dr. Jocelyn Elders was forced to resign her post as U.S. Surgeon General in December 1994. The Surgeon General had just finished a routine speech at the conference on the spread of communicable diseases when, Dr. Rob Clark a New York psychologist, asked her if she would consider promoting masturbation as a means of preventing young people from engaging in riskier forms of sexual activity. Elder, as quoted in US News & World Report responded, "With regard to masturbation, I think that it is something that is a part of human sexuality and a part of something that should perhaps be taught." That statement so enraged both conservatives and moderates alike, that it ended in Elder's termination. For Elders the political climate in Washington at that time was less than favorable for even the most minor misstep. The Republicans had just taken over the House of Representatives—for the first time in more than 40 years—and the Clinton administration was reeling. Elders infraction could not be overlooked.

While her departure was stongly applauded by the conservative faction, many were dismayed over the events that transpired and felt that Elders was lassoed and sacrificed to satisfy the chants of conservatives, and the desperation of Democrats to quiet them, as typified in an article by Susan Ager, Detroit Free Press. Elders responded not with anger but with grace. She did not buck, nor did she apologize. She stood by her comment, all of her comments, saying "Jocelyn Elders was Jocelyn Elders and I've always tried to speak what I knew to be the truth." Ager went on to say, "[Elders was a] rare public official, she said clearly and fearlessly what we didn't want to hear, but need to think about. I suspect she will be saying the same thing two years from now."

What Lies Ahead

In January 1995, Jocelyn Elders returned to the University of Arkansas as a faculty researcher, a professor of pediatric endocrinology at Arkansas Children's Hospital. Elders had both strong opponents and supporters as surgeon general. To the conservatives—her strongest opponents—she was "warped, dangerous, and a lunatic." To her supporters she was "noble, heroic, and fearless." Jocelyn Elders saw her mission as Surgeon General to create dialogue on America's health and welfare and the only way to do that, according to Elders, was to get their attention. "I think the Surgeon General's office is the office where it is very important to be able to get people listening to you, thinking about it, and talking about it … that is where you get change," she told Dr. Paula Wilson, assistant profession of communication studies Lynchburg College in Virginia.

Elders has no intention of fading into the background now that she is no longer U.S. Surgeon General. She made an impact on the audience she was most concerned about, the youth, and she intends to continue to be their advocate. When asked if there were any hard feelings about being asked to step down, Elders, in an interview with Steve Barnes of the Progressive Interview, responded candidly. "No, I don't have any hard feelings. I feel that the President, and the President alone, asked me to be Surgeon General. He gave me an opportunity to serve as Surgeon General, one that I would not have had without him…. I would not be the Jocelyn Elders I am today without the things the President did for me."

In February 1997, speaking to a group of 350 physicians at a conference in Long Beach, California, the former Surgeon General spoke "with the same clarity and passion … that won her confirmation to the post of U.S. Surgeon General in 1993, that led to her resignation in 1994," according to the Press-Telegram. A generation of youth is drowning in an ocean surrounded by the sharks of drugs, homicide and suicide, while many of us are sitting on the moral beach of Just say no, she told the opening session. Challenging her audience to become actively involved, Elders said, "There's a great big difference between being concerned and being committed. When you're concerned, its negotiable." On a more personal note she added, "When I went to Washington, I was committed. And what I was about was not negotiable."

When asked what the future holds for Dr. Jocelyn Elders, she told Progressive in a March 1995 interview, "I'm going to be the very best doctor I can be. I'm going to try to do some research, looking at problems that impact adolescents. And I'm going to become a real advocate. I'm going to do a lot of public speaking."

Further Reading

Detroit Free Press, December 14, 1994; October 1994; Jet, December 26-January 2, 1995; Lancet, December 24, 1994; People, November 4, 1996; Playboy, June 1995; The Nation, January 2, 1995; The Progressive, March 1995; The Progressive Interview, March 1995; USA Today, May 1997; Washington Monthly, January-February 1997. □

Joycelyn Elders

Born: August 13, 1933
Schaal, Arkansas
African American federal government official and surgeon general

Confirmed as the sixteenth surgeon general of the United States on September 7, 1993, Joycelyn Elders is the first African American and the second female to head the U.S. Public Health Service. During her fifteen months as surgeon general, Elders added tobacco use, national health care, and drug and alcohol abuse to her list of major concerns.

Childhood and education

Jocelyn Elders was born Minnie Jones on August 13, 1933, in the farming community of Schaal, Arkansas. She took the name Jocelyn in college. Living in a poor, segregated (separated based on race) area, she and her seven siblings worked in the cotton fields and attended an all-black school thirteen miles from home. Home itself was a three-room cabin that lacked an indoor toilet and electricity.

One of Elders's earliest memories was of being taught to read by her mother, who had an eighth grade education, which was quite remarkable for an African American woman at that time. By the time Elders neared graduation from high school, she had earned a scholarship to the all-black Philander Smith College in Little Rock, Arkansas. Initially college looked doubtful for Elders because her father did not want to let her go. However, her grandmother persuaded Elders's father to let her attend. Elders's family picked extra cotton to earn the $3.43 for her bus fare to Little Rock, and she became the first in her family to attend college.

Becoming a doctor

At school, Elders was especially interested in the study of biology and chemistry and wanted to become a lab technician. Her goal changed when she heard a speech by Edith Irby Jones (1927–), the first African American to study at the University of Arkansas School of Medicine. Elders, who had not even met a doctor until she was sixteen, realized that she wanted to be a physician. After graduating from college, she joined the U.S. Army's Women's Medical Specialist Corps. In 1956 she entered the Arkansas Medical School on the G.I. Bill, which provided financial aid for schooling to former members of the armed forces. During this time she met her second husband, Oliver Elders, and they married in 1960.

After studying pediatrics (an area of medicine involving the care of children) at the University of Minnesota, Elders returned to Little Rock in 1961 for her residency, or medical training period. Over the next twenty years, she combined a successful office practice with research in pediatric endocrinology, the study of glands. She became an expert in growth problems and juvenile diabetes (a disorder that causes the body to have difficulty maintaining a healthy blood sugar level).

It was this branch of science that led her to study sexual behavior. Recognizing that diabetic females face a health risk if they become pregnant too young, Elders saw the urgent need to talk about the dangers of pregnancy with her patients and to distribute contraceptives (items used to prevent pregnancy) in order to limit those dangers. The results of her actions were clear. Of the 520 juvenile diabetics Elders treated, approximately half were female, and only one became pregnant.

Combating teen pregnancy

In 1986, the year before then-governor Bill Clinton (1946–) named Elders director of the Arkansas Department of Health, twenty percent of Arkansas's total births were to teenage mothers. By comparison, the national teenage birth rate was thirteen percent. Arkansas taxpayers paid huge amounts for the care of young Arkansas parents and their children. Elders was equally concerned with the large number of emotionally immature young adults who were becoming parents to unwanted children. She saw an urgent need for bolder government involvement and an intense public education campaign.

Elders glimpsed one of the approaches she would later support when she visited Arkansas's first school-based health clinic in Lincoln, where contraceptives were given to students on request and where senior-class pregnancies had fallen from thirteen to one. Under Elders, eighteen other school clinics opened, though only four of them distributed condoms (a specific type of contraceptive). As Elders campaigned for the clinics and expanded sex education throughout Arkansas, she battled with political conservatives who criticized her effort to increase the government's role in citizens' lives. She was also opposed by members of some religious groups who feared that the distribution of condoms would increase sexual activity and promote abortion (a woman's right to end a pregnancy).

Elders fought back by saying that she would gladly teach abstinence (the practice of not having sex) if she felt that such an approach would work. But in the real world, she argued, teens would continue to have sex, and it was the job of adults and of government to turn an irresponsible action into a responsible one. Such arguments proved convincing. In 1989 the Arkansas State Legislature ordered the creation of a kindergarten-through-twelfth-grade curriculum (courses that the students would study) including not only sex education but also instruction in hygiene (cleanliness that is important for health), substance-abuse prevention, self-esteem, and equal sexual responsibility among both males and females.

The surgeon general

President Clinton's nomination of Elders for the post of U.S. surgeon general made her the second African American and fifth woman to be chosen for a cabinet position. However, some people were strongly against the president's choice. Elders was criticized for favoring abortion on demand (abortion without restriction). Her critics also did not agree with her support for medicinal use of marijuana, U.S. legalization of the RU-486 pill (which may be taken by a woman to end a pregnancy), and her urging television networks to air condom ads. She was also involved in a scandal regarding the National Bank of Arkansas, for which she had served on the board of directors. Nevertheless, Elders gained the backing of the American Medical Association and former U.S. surgeon general C. Everett Koop (1916–). In September 1993 the Senate approved her nomination by a sixty-five to thirty-four vote.

As U.S. surgeon general, Elders continued her work regarding teen pregnancy. She was also concerned with tobacco use, national health care, acquired immune deficiency syndrome (AIDS; a disease of the immune system), gun control, and drug and alcohol abuse. However, Elders was forced to resign in December 1994 after she was surrounded by controversy over a statement she made at World AIDS Day at the United Nations. Asked if she would consider promoting masturbation (pleasuring oneself sexually without engaging in sexual intercourse) as a means of preventing young people from engaging in riskier forms of sexual activity, Elders had responded, as quoted in US News & World Report, that "masturbation … is something that is a part of human sexuality and a part of something that should perhaps be taught." Elders's statement enraged both conservatives and moderates, and she was asked by the Clinton administration to give up her position as surgeon general.

In January 1995 Elders returned to the University of Arkansas as a faculty researcher and a professor of pediatric endocrinology at Arkansas Children's Hospital. She continues to promote discussion of health-care issues as a public speaker and through such projects as assisting in the development of SexHealth.com, a website on sexual health.

For More Information

Detroit Free Press (December 14, 1994).

Elders, M. Joycelyn, and David Chanoff. Joycelyn Elders, M.D. New York: Morrow, 1996.

Jet (December 26–January 2, 1995).

Elders, Joycelyn

August 13, 1933

Born in Schaal, Arkansas, Minnie Joycelyn Jones, who would become U.S. surgeon general, was the eldest daughter of Haller and Curtis Jones. She attended Philander Smith College in Little Rock, Arkansas, where she received her B.A. in 1952. Wishing to become a doctor, she joined the U.S. Army and trained in physical therapy at the Brooke Army Medical Center at Fort Sam Houston, Texas. In 1956 she left the army and enrolled at the University of Arkansas Medical School, one of the first African Americans to attend, and received her M.D. degree in 1960, the same year she married Oliver Elders. Joycelyn Elders served an internship in pediatrics at the University of Minnesota, then returned to the University of Arkansas in 1961 for her residency period. Elders was ultimately named chief resident, and also received an M.S. in biochemistry in 1967. In 1971 the University of Arkansas Medical School hired Elders as an assistant professor in pediatrics and five years later named her a full professor. Over the succeeding years, she published 138 articles, mostly on child growth problems and diabetes.

In 1987 Arkansas governor Bill Clinton named Elders as the Arkansas Health Commissioner. Her advocacy of making birth control information and condoms available in schools as ways of fighting teenage pregnancy and AIDS caused a storm of controversy. Conservative critics decried her supposedly permissive attitudes toward sex and her implementation of a kindergarten-to-college health education program that included sex education as well as the usual information about hygiene, substance abuse, and other matters.

In 1993 Clinton, by then president of the United States, appointed Elders U.S. surgeon general. Despite conservative opposition in Congress over her advocacy of abortion rights and sex education, she was confirmed and was sworn in on September 10, 1993. During her first year as surgeon general, Elders faced continued opposition by conservatives to her advocacy of condom distribution and sex education in schools and stirred debate through several controversial stands, such as her support of the medical and compassionate use of marijuana, her warnings to parents against purchasing toy guns for children, and most notably her proposal that the question of legalizing drugs in order to "markedly reduce" the nationwide crime rate be studied. Her supporters claimed that opponents of the administration were simply using Elders as a target, and her courageous, forthright style made her a hero to thousands of African Americans and whites throughout the United States. In the wake of continuing controversy, however, President Clinton asked for her resignation; she left the surgeon general's office on December 30, 1994. Since her resignation, Elders has worked as an endocrinologist at the University of Arkansas Medical School. Her autobiography, Jocelyn Elders, M.D., was published in 1996.

In 2002 the American Medical Women's Association inducted Elders into the International Women in Medicine Hall of Fame.

Bibliography

Barnes, Steve. "The Crusade of Dr. Elders." New York Times Magazine (October 15, 1989): 38–41.

Elders, Jocelyn, and David Chanoff. Jocelyn Elders, M.D.: From Sharecropper's Daughter to Surgeon General of the United States of America. New York: Morrow, 1996.

Rosellini, Lynn. "The Prescriptions of Dr. Yes." U.S. News and World Report (July 26, 1993): 60–61.

greg robinson (1996)
Updated by publisher 2005