BAKER, DR. SARA JOSEPHINE (15 November 1873–22 February 1945), physician and author. A public-health pioneer, Dr. Baker was the first director of the New York Division of Child Hygiene, where she implemented prevention and educational measures. Her work saved countless lives and was a catalyst for pivotal shifts in government policy regarding children’s health.
Sara was born into a Quaker family in Poughkeepsie, New York. When she was sixteen her father and brother died of typhoid, a tragedy that led her to abandon her plans to study the liberal arts and instead to pursue a medical career as a means to financially support her mother and sister. Since women were not yet allowed to work in hospitals in New York City, Sara moved to Boston for an internship at the New England Hospital for Women and Children after graduating from the New York Infirmary Medical College in 1898. It was during her time there that she came to understand the inextricable link between poverty and disease. Moving back to New York, Dr. Baker took up private practice. For supplemental income she also served as a medical inspector for the New York Life Insurance Company and as a part-time medical inspector for the Department of Health.
In 1907 she was appointed assistant health commissioner of New York City, where she developed programs for preventive health care for children and identifying infectious disease. In this role Dr. Baker was instrumental in locating and identifying Mary Mallon, also known as “Typhoid Mary,” an Irish cook who worked in several households and inadvertently spread typhoid throughout the city.
The following year Dr. Baker was appointed the first director of the New York Division of Child Hygiene, the first gubernatorial agency devoted to children’s health in the world. With a team of nurses under her direction she set about improving conditions in the Hell’s Kitchen neighborhood—at the time one of New York City’s worst slums—teaching mothers and caregivers proper hygiene, ventilation, nutrition, and feeding practices. Over the course of one summer the district recorded twelve hundred fewer cases of infant mortality than the previous summer, confirming Dr. Baker in her belief that child mortality was a crisis of education as much as one of sanitation.
Because access to clean milk for infants had been an issue in the city for decades, Dr. Baker pioneered the establishment of city-funded milk depots. She also invented a new kind of infant formula made of water, lactose, calcium carbonate, and cow’s milk. In the course of her tenure she also implemented strict training and licensing protocols for midwives; appointed nurses and doctors to work in schools; mandated the use of silver-nitrate eyedrops for infants; and mobilized various methods of distributing information regarding health and illness to the poor. In 1910 Dr. Baker organized the Little Mothers Leagues, which trained girls aged twelve and older about proper infant care. This program offered financial relief to low-income families. And in 1911 she founded and became president of the Babies Welfare Association (later the Children’s Welfare Federation of New York).
When New York University-Bellevue Hospital Medical School invited her to lecture on children’s health, Dr. Baker accepted on condition that she be allowed to enroll in the school. Her proposition was initially turned down, but when the school failed to find a male lecturer with comparable expertise, she became the first woman to receive a doctorate in public health, in 1917.
Though by this time she was already an influential figure, during World War I Dr. Baker gained widespread publicity with her comment to the New York Times that it was “six times safer to be a soldier in the trenches of France than to be a baby born in the United States.” She was able to exploit the resulting publicity to start a citywide school lunch program.
She was the first woman to be a League of Nations representative and receive a federal government position when she was appointed assistant surgeon general. She was also president of the American Women’s Medical Association.
Though Dr. Baker retired in 1923, she continued her work, lecturing at New York University, writing articles, serving as a member of more than two dozen medical societies, and acting as a consultant to the Federal Children’s Bureau.
As a result of her efforts, the infant mortality rate in New York City decreased from 144 per 1,000 live births in 1908 to 66 in 1923, the lowest rate of any major American city. Her work reverberated around the country: her school health program was eventually copied by thirty-five states. Dr. Baker wrote over 250 articles and four books; her autobiography, Fighting for Life, was published in 1939. Before succumbing to cancer in 1945 she destroyed all of her personal papers.