Felix Joel Underwood, a physician and the longtime executive officer of the State Board of Health, was the most prominent public health leader in Mississippi during the first half of the twentieth century. The son of Marion Milton Underwood and Amanda Capitola Battle Underwood, he was born on 21 November 1882 in Nettleton, a small railroad town located on the border of Lee and Monroe Counties. At the age of ten he watched helplessly as his mother died of childbirth fever, an experience that played a crucial role in his decision to study medicine. To earn money for medical school, he worked as a clerk in a local drugstore; wrote stories for the local newspaper, the Nettleton Advance; and taught in the local schools. In 1904 he married Sarah Beatrice Tapscott, a coworker at the newspaper, and soon thereafter he enrolled at the University of Tennessee in Memphis, receiving his medical degree in 1908.
Underwood returned to his hometown to practice horse-and-buggy medicine for more than twelve years. Early in his career he displayed an interest in both public health and politics. From 1917 to 1920 he served as Monroe County’s health officer, and in 1919 he was elected president of the Mississippi State Medical Association.
In January 1921 he began to devote himself exclusively to what he would call “the great and necessary work of protecting life and health in Mississippi” after receiving an appointment to serve as director of the Mississippi State Board of Health’s Bureau of Child Hygiene and Welfare. He moved to the state capital, Jackson, where he lived for the rest of his life. Underwood distinguished himself in his new position, and in 1924 he became executive officer and secretary of the State Board of Health, a position he held until his retirement in 1958. He once told his wife, “As a private doctor, I can never care for more than two or three thousand people. As a public health officer, I can care for millions.”
Working out of the Board of Health offices at the Old Capitol building, Underwood worked tirelessly to improve public health practices in the state. Opposing local boards of health, he organized a state-centered public health system, imposing uniform services and quality standards across the state. His accomplishments included developing sanitary standards on the shellfish industry, obtaining fluoridated water, registering marriages, organizing training stations for public health workers, initiating postgraduate medical education, inaugurating industrial health and hygiene programs, registering midwives, creating county health units, instituting mental health units, and adopting milk ordinances. He was not afraid to confront subjects often taboo in conservative Mississippi. Asking for “social courage” on the part of physicians, he criticized the “national hush-hush policy concerning syphilis” and encouraged “giving of adequate sex information to younger age groups. The safeguarding of this one growth process can be considered preventive medicine of a high order.” He was an early proponent of a “planned parenthood program,” calling it “vital” for public health. In 1927 he called the nicotine in tobacco “a deadly poison.” He also battled tuberculosis, rabies, malaria, polio, diphtheria, and infant and maternal mortality.
In an era when race dominated all aspects of Mississippi life, Underwood did not overlook the medical problems of African Americans and included them among the recipients of medical education scholarships. He also directed public attention to black morbidity: “With Negroes comprising more than 50 percent of our population, our infant and maternal death rate will continue unreasonably high unless vigorous measures are taken to improve the health of Negro mothers and babies,” he said in 1937. He fought indifference to the plight of blacks and argued that poor housing and poverty rather than racial differences caused high levels of disease among African Americans.
In the 1930s Underwood served as a public health adviser to the President’s Social Security Committee. Underwood used his national connections when state funding for health dropped during the depression and took advantage of federal New Deal programs to initiate a free immunization program for Mississippi’s poor.
After World War II, Underwood stepped up his battle to increase the number of hospitals in the state. In 1946 the legislature set up a Commission on Hospital Care, and Underwood was a force on the commission. With his leadership, Mississippi became the first state to secure Public Health Service approval for a statewide hospital plan. On 9 June 1948 Booneville received the first contract in the nation to build a hospital under the Hill-Burton Act.
From 1945 to 1955 Underwood also battled to relieve state physician deficiencies. As vice chair of the State Medical Education Board, he persuaded the 1946 legislature to establish a program to provide loans for medical students willing to spend two years in rural general practice after they received their degrees. Even more important in solving the postwar physician shortage was the creation of a four-year medical school in Mississippi. He strategized and lobbied relentlessly until the legislature established the University Medical Center in Jackson in 1950.
As president of the State Board of Examiners for Nurses he signed every nurse’s license awarded in Mississippi from 1931 to 1958, and as the executive officer of the State Board of Health he signed the license of every Mississippi physician who practiced between 1924 and 1958. He also worked closely with Dr. Henry Boswell to develop and support the Mississippi State Tuberculosis Sanatorium at Magee, which the State Board of Health supervised.
The construction of a new State Board of Health Building represented a fitting climax to Underwood’s career. The state legislature named the building in his honor, overlooking the long taboo against naming a public building after a living person. After Underwood’s death on 9 January 1959, the state and national press praised him as “the man who saved a million lives.”
- Annual Reports of the Mississippi Board of Health, 1924–60; Karen Evers, Journal of the Mississippi State Medical Association (November 1999)
- Lucius M. Lampton, Journal of the Mississippi State Medical Association (September 1999)
- James Grant Thompson and E. F. Howard, History of the Mississippi State Medical Association (2nd ed., 1949)
- Felix J. Underwood and R. N. Whitfield, Public Health and Medical Licensure in the State of Mississippi, 2 vols. (1938, 1950)