Joseph Bates (1933–)
Joseph (Joe) Bates—a pulmonologist, epidemiologist, microbiologist, and public health official—pioneered safe and effective outpatient treatment for tuberculosis in the 1960s and 1970s. He subsequently was instrumental in directing tobacco settlement money to public health initiatives and developing the Fay W. Boozman College of Public Health at the University of Arkansas for Medical Sciences (UAMS).
Joe Bates was born on September 19, 1933, and grew up in rural Pulaski County. He was an only child; his father was a farmer and businessman, and his mother—whom he credits with his interest in education—was briefly a schoolteacher.
Bates was educated in the Little Rock (Pulaski County) public school system. He attended Hendrix College in Conway (Faulkner County) and graduated from the University of Arkansas in Fayetteville (Washington County) with a BS in 1954. He received an MD from what is now UAMS in 1957, also doing post-graduate training in internal medicine and infectious disease. He became assistant professor of medicine in 1963, associate professor in 1968, and professor in 1971. He served as chief of medical services at the Little Rock Veterans Administration Medical Center from 1968 to 1998, when he began working with the Arkansas Department of Health (ADH) in a number of roles including deputy state health officer and chief science officer (2005–2017). Early in his tenure at ADH, he recognized that only a few employees out of 5,000 had training in public health, a problem he worked to correct. Bates became of epidemiology and an associate dean at the College of Public Health after retiring from ADH.
The death of an uncle, not much older than he, from tuberculous sparked Bates’s early interest in the disease. He became increasingly aware of the problem in Arkansas, which often had the highest death rate in the country from TB. During his residency, he investigated conditions at the Arkansas Boys’ Reformatory School in Wrightsville (Pulaski County), where tuberculosis was rampant among the juvenile inmates. Another researcher had worked with guinea pigs, which are highly susceptible to tuberculosis. Based on that research, Bates demonstrated that, even without close contact, tuberculosis spread randomly throughout the school by aerosol droplets. His seminal work on tuberculosis transmission was eventually published as the lead article in the New England Journal of Medicine in 1964.
Bates, with William Stead and Paul Reagan, showed that drug therapy could be administered twice weekly for a shorter duration than it had been, a protocol that improved compliance and paved the way for short (two-week) inpatient stays at community hospitals followed by outpatient treatment. This method would lessen reliance on the Arkansas State Tuberculosis Sanatorium at Booneville (Logan County), which had opened in 1909.
However, Bates’s group had to overcome both medical and political resistance to treating patients this way. The Arkansas Tuberculosis Association was one of their formidable opponents, but Bates’s group was able to persuade the Arkansas General Assembly to designate part of the sanatorium operating budget to the Department of Health for so-called chest clinics, which they developed and staffed. When the Thomas C. McRae Memorial Sanatorium, which had opened in the 1930s for African-American TB patients, closed in 1968, those few remaining African-American patients were reluctant to be transferred to the Booneville sanatorium, previously reserved for whites only. As a result, African Americans became a significant proportion of the patients treated in the chest clinics and in selected general hospitals. In addition, as Bates’s group showed that the short stays and outpatient treatment were effective, the Booneville sanatorium patient census fell sharply, and the institution was closed in 1973.
In another significant contribution to public health, Bates and Richard Smith, professor of psychiatry at UAMS, cofounded the Arkansas Center for Health Improvement just as the state became a beneficiary of tobacco settlement money in the late 1990s. The center leadership authored a “white paper” intended for the state legislature asking that the settlement funds be used exclusively for health and healthcare initiatives. Although their recommendations were incorporated in a bill that sailed through the state Senate, it was not voted out of a House committee. However, with the support of Governor Mike Huckabee, the bill was redrafted as an initiated act, the Tobacco Settlement Proceeds Act, and the voters approved it in 2000.
Bates and Dr. Fay Boozman advocated successfully for a portion of the settlement funds to be used to create the College of Public Health. Within twenty years, the college had a faculty of over fifty, and more than 700 students had earned graduate degrees in various public health disciplines. Bates continued to mentor medical students at UAMS also enrolled in the College of Public Health.
Bates received many honors throughout his career. He was awarded scores of research grants, co-chaired the World Health Organization’s committee on mycobacteriae, and was a traveling fellow at the University of London. Lead and co-author of more than 170 articles in national and international publications (including a chapter on tuberculosis in Harrison’s Principles of Internal Medicine), he also served on numerous editorial boards and as a guest reviewer. After his residency, he received a National Institutes of Health (NIH) training grant for graduate work at the University of Arkansas, Emory University, and the CDC in Atlanta. Following graduate school, he was awarded a Clinical Investigator Award from the U.S. Veterans Administration, which provided three years of funding for a research laboratory.
Bates was married to Patsy McGinnis Bates for fifty-one years until her death, and they had four children: Patricia, Susan, Joseph Henry, and Elisabeth. He married his second wife, Donna Dudney Bates, in 2008.
For additional information:
Bates, J. H., W. E. Potts, and M. Lewis. “The Epidemiology of Primary Tuberculosis in an Industrial School.” New England Journal of Medicine 272 (714).
Gunnels, J. J., J. H. Bates, and H. Swindoll. “Infectiousness of Culture-Positive Tuberculosis Patients on Chemotherapy.” American Review of Respiratory Diseases 4 (1974): 216.
“Joseph H. Bates, MD, MS.” Fay W. Boozman College of Public Health. https://publichealth.uams.edu/team/joseph-h-bates-md-ms/ (accessed May 4, 2021).
Thompson, Joseph W. “Inquiry, Commitment, Resolve: How Dr. Joe Bates Changed the Face of Tuberculosis.” HealthCare Journal of Little Rock, January/February 2017, 50–51.
Taggart, Sam. The Public’s Health: A Narrative History of Health and Disease in Arkansas. Little Rock: Arkansas Times, 2014.
Steve Anton Jones
El Dorado, Arkansas
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