Physician who led launch of Head Start dies

Served as surgeon general in Carter administration

Dr. Julius B. Richmond taught at Harvard.

Poverty undercuts the ability of the young to learn, Dr. Julius B. Richmond realized during research nearly half a century ago, and he drew from his findings to launch Project Head Start, a federal program that has helped millions of children since its inception in 1965.

"It really is a remarkable legacy to his career how many graduates of Head Start programs there are all over the country who have benefited from early-childhood care and education," said Allan Brandt, dean of the Graduate School of Arts and Sciences at Harvard University.

Dr. Richmond, who also served as US surgeon general under President Carter, died in his Chestnut Hill home Sunday. He was 91 and as recently as May was still spending a few hours each day in his office at Harvard, where he was a professor emeritus, despite having been diagnosed with cancer a few years ago.

"Jimmy and I are saddened to learn of the loss of our dear friend and colleague, Dr. Julius Richmond," Rosalynn Carter said in a statement issued yesterday. "Julie was a wonderful and compassionate champion in the fight to improve health, mental health, and educational opportunities for our nation's children. All Americans have benefited from his decades of leadership in advancing the healthcare needs of our country."

In a career that ranged from serving as a flight surgeon in the Army Air Corps during World War II to the US surgeon general from 1977 to 1981, Dr. Richmond left few areas of medicine untouched - including some that engendered public controversy.

While the health and well-being of the nation's children were a focus all his life, he also issued a key report in 1979 that set quantitative benchmarks for public health. And Dr. Richmond waded into the legal battles involving the tobacco industry during the 1990s when he was the lead-off witness in a class-action lawsuit brought by flight attendants who believed their health was compromised by secondhand smoke.

In 1979, he issued a memo ending the policy that allowed US quarantine officers to detain those arriving from foreign countries who they believed were gay or lesbian on the grounds that their sexual orientation was the product of a mental disease or defect. And the following year, he announced that the government had approved plans to let cancer specialists prescribe synthetic marijuana pills to control nausea and vomiting for patients undergoing chemotherapy.

Even at 90, Dr. Richmond was weighing in on national medical issues, decrying the absence of universal health coverage.

"The financiers don't want government intervention," Dr. Richmond told the Globe in October 2006. "It's such an embarrassment that I think the issue will resurface, but it's difficult for the political figures in Washington to formulate a plan."

The intersection of public need, political will, and public policy was something Dr. Richmond thought about frequently.

"He often used three variables to describe the most significant elements of public policy," Brandt said. "He would ask, 'Do we know enough; what's the knowledge base?' Then he would ask, 'Is there the political will to apply what we know?' Then he would ask, 'Do we have a social strategy to bring the knowledge and the politics together in a productive way?' He was a great analytic thinker and was always thinking about what we need to do to improve a particular situation."

Dr. Richmond grew up in rural Illinois and for a time worked on a sheep farm during the Depression. When the time came for college, he considered both medicine and animal husbandry.

"I chose people," he told the Globe in October 2006.

He studied at the University of Illinois campuses in Urbana and Chicago, receiving bachelor's and master's degrees. In 1939, he received a medical degree from what is now the University of Illinois College of Medicine in Chicago.

"He was a very compassionate and thoughtful guy who really had a remarkable life," Chuck Richmond of Indianapolis said of his father. "He was the son of Russian immigrants who rose to be the nation's chief health officer, and he was always wholly supportive - first and foremost - of his family and extended family. And he really took great pride in mentoring young colleagues, which made his extended family quite a huge one."

Dr. Richmond began expanding his extended professional family the moment he was out of school, entering pediatrics residencies and postgraduate training that was interrupted by World War II. After the war, he taught at his alma mater and in New York State at what is now Upstate Medical University in Syracuse.

He went to work for the Johnson administration in the mid-1960s and was the first director of what was then called Project Head Start.

In 1967, he went back to Syracuse, where he was dean of the medical faculty, and left four years later to join the faculty at Harvard Medical School.

While teaching there he also served as chief of psychiatry at what was then Children's Hospital Medical Center and also was director of Judge Baker Children's Center, a Harvard Medical School affiliate that works to improve the lives of children with mental health problems.

Appointed surgeon general and assistant secretary for health in the US Department of Health, Education, and Welfare, Dr. Richmond returned to Washington in 1977.

Four years later he went back to Harvard as the John D. MacArthur professor of health policy, teaching at the medical school and the School of Public Health, which named its top award for Dr. Richmond.

His first wife, Rhee (Chidekel), died in 1985. In addition to his son, Dr. Richmond leaves his wife, Jean Berger Richmond of Chestnut Hill; another son, Barry of Bethesda, Md.; two stepsons, Steven Berger of West Lafayette, Ind., and Michael Berger of Detroit; four grandsons; five stepgranddaughters; three great-grandsons; and two great-granddaughters.

The family plans to hold a private service, and Harvard will announce a public memorial service.

Although Dr. Richmond's accomplishments were many, Brandt said his mentor and role model wasn't one to rest on laurels.

"He was a very forceful and determined person, and he never looked back at successes," Brandt said. "It was always a question of what should we do now, what's the next way to make the world a better place for kids? He'd have a success, and the next day he would be back in the office. Literally right up to his death he was thinking, 'What are we going to do next?' "