A whole nation has been his patient

Julius Richmond, who served as surgeon general during the Carter administration, witnessed the history of American healthcare throughout most of the 20th century, and he's not too happy about where we stand today. The lack of universal health insurance, he says, is embarrassing.

"The financiers don't want government intervention," says Richmond, who, at a buoyant 90 years, still goes to work every day at Harvard as the John D. MacArthur Professor of Health Policy, emeritus. "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."

Richmond is an old hand at telling politicians what's best for the public health. Currently, he's leading the launch of Harvard's new Center on the Developing Child, an interdisciplinary group that aims to pull together resources and come up with practical solutions to problems in child development.

But Richmond is probably best known for his work in the 1970s devising a set of "quantifiable goals" for public health -- official, concrete figures that would be used to steer policy on Americans' physical well-being. From spearheading Project Head Start, to opening neighborhood health centers, to being a vocal opponent of the tobacco industry, Richmond has spent 60 years defending the body public.

It hasn't been enough to make Americans healthy, though.

"With all our affluence, we're not abiding by health promotional lifestyles," he says. Obesity, of course, is on the rise. Worse is the problem of poverty and the unequal distribution of health services. Last year he published a book with Rashi Fein titled "The Health Care Mess: How We Got Into It And What It Will Take to Get Out."

Richmond grew up in rural Illinois during the Great Depression. His mother died when he was 10, so he entered a school for "dependent boys," where he worked on a farm among the sheep. When he entered the University of Illinois, he was torn between animal husbandry and medicine. "I chose people," he says.

During World War II, he spent four years as flight surgeon in the Air Force. "It was then that I saw all these cadets with health problems as young adults, and I realized that we had to help kids grow up in healthier ways." After the war, Richmond moved into pediatrics, landing at the State University of New York at Syracuse College of Medicine. He and his colleague Bettye Caldwell began a series of investigations into pediatric psychology, producing seminal findings linking poverty to delayed childhood development. Their studies caught the attention of President Lyndon Johnson's Office for Economic Opportunity.

"So with a lot of help, we initiated Head Start," says Richmond. The result was a national attempt to improve preschool nutrition, health, and education. It was the first of many initiatives that Richmond headed, all of them sharing the goal of improving the psychological and social environments of children.

In 1971, Richmond left Washington for Harvard Medical School and Boston's Children's Hospital Medical Center. He laid down roots in Massachusetts and, apart from his stint in the capital during the Carter years, he's been teaching at Harvard ever since.

Despite his successes and his influence on generations of health policymakers, Richmond isn't self-congratulatory. "We haven't dealt adequately with inequity," he says. "There are too many children in poverty -- 20 percent in this country. It's one of my disappointments."

When asked about his own good health, he says, "I'm fortunate in that I have good insurance."

Hometown: Chestnut Hill.

Family: His wife, Jean, whom he married in 1987. His first wife died of colorectal cancer in 1985. Also, two of his three grown sons are alive, and he has four grandchildren and four great-grandchildren.

Hobbies: Attending concerts, visiting museums. "We have a place on Martha's Vineyard to get out of a suburban setting."

Regrets: "Since the 1960s, we've stopped focusing on bringing people out of poverty."

Triumphs: "There's been steady progress in reducing smoking." He wears a tie dotted with tiny "no smoking" symbols.

Advice on living to a ripe old age: "Have worthwhile goals and work hard at achieving them. I can't think of anything better than enjoying your work."

To hear him: Richmond will speak at an award ceremony this afternoon from 4:30 to 6 at the Harvard School of Public Health's Snyder Auditorium, 677 Huntington Ave, in Boston. A recent interview with him is online at hsph.harvard.edu/richmond/.