On Sept. 8, 1993, Joycelyn Elders, an American pediatrician and public health administrator and the first African American appointed by President Clinton, was confirmed as Surgeon General of the U.S.

During her fifteen months in office she faced skepticism regarding her progressive policies yet continued to bring controversial issues up for debate. As she later concluded, change can only come about when the Surgeon General can get people to listen and talk about difficult subjects.

Clinton appointed Joycelyn Elders head of the Arkansas Department of Health in 1987. As she campaigned for clinics and expanded sex education, she caused a storm of controversy among conservatives and some religious groups. Yet, largely because of her lobbying, in 1989 the Arkansas Legislature mandated a K-12 curriculum that included sex education, substance-abuse prevention, and programs to promote self-esteem.

From 1987 to 1992, she nearly doubled childhood immunizations, expanded the state’s prenatal care program, and increased home-care options for the chronically or terminally ill.

Dr. Elders left office in 1994 and in 1995 she returned to the University of Arkansas as a faculty researcher and professor of pediatric endocrinology at the Arkansas Children’s Hospital. In 1996 she wrote her autobiography, Joycelyn Elders, M.D.: From Sharecropper’s Daughter to Surgeon General of the United States of America.