Sara Josephine Baker

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Sara Josephine Baker
S Josephine Baker MD.jpg
Sara Josephine Baker, 1922
BornNovember 15, 1873
DiedFebruary 22, 1945 (aged 71)
Nationality United States
Alma mater New York Infirmary Medical College
Known for public health
AwardsAssistant Surgeon General,
Professional Woman Rep.
to the League of Nations

Sara Josephine Baker (November 15, 1873 – February 22, 1945) was an American physician notable for making contributions to public health, especially in the immigrant communities of New York City. Her fight against the damage that widespread urban poverty and ignorance caused to children, especially newborns, is perhaps her most lasting legacy. [1] In 1917, she noted that babies born in the United States faced a higher mortality rate than soldiers fighting in World War I, drawing a great deal of attention to her cause. [2] She also is known for (twice) tracking down Mary Mallon, the infamous index case known as Typhoid Mary.

Public health preventing disease, prolonging life and promoting health through organized efforts and informed choices of society and individuals

Public health has been defined as "the science and art of preventing disease, prolonging life and promoting human health through organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the health of a population and the threats it faces is the basis for public health. The public can be as small as a handful of people or as large as a village or an entire city; in the case of a pandemic it may encompass several continents. The concept of health takes into account physical, psychological and social well-being. As such, according to the World Health Organization, it is not merely the absence of disease or infirmity.

New York City Largest city in the United States

The City of New York, usually called either New York City (NYC) or simply New York (NY), is the most populous city in the United States. With an estimated 2018 population of 8,398,748 distributed over a land area of about 302.6 square miles (784 km2), New York is also the most densely populated major city in the United States. Located at the southern tip of the state of New York, the city is the center of the New York metropolitan area, the largest metropolitan area in the world by urban landmass and one of the world's most populous megacities, with an estimated 19,979,477 people in its 2018 Metropolitan Statistical Area and 22,679,948 residents in its Combined Statistical Area. A global power city, New York City has been described as the cultural, financial, and media capital of the world, and exerts a significant impact upon commerce, entertainment, research, technology, education, politics, tourism, art, fashion, and sports. The city's fast pace has inspired the term New York minute. Home to the headquarters of the United Nations, New York is an important center for international diplomacy.

World War I 1914–1918 global war starting in Europe

World War I, also known as the First World War or the Great War, was a global war originating in Europe that lasted from 28 July 1914 to 11 November 1918. Contemporaneously described as "the war to end all wars", it led to the mobilisation of more than 70 million military personnel, including 60 million Europeans, making it one of the largest wars in history. It is also one of the deadliest conflicts in history, with an estimated nine million combatants and seven million civilian deaths as a direct result of the war, while resulting genocides and the resulting 1918 influenza pandemic caused another 50 to 100 million deaths worldwide.


Early life

Baker was born in Poughkeepsie, New York in 1873 to a wealthy Quaker family. After her father and brother died of typhoid, Baker felt pressure to support her mother and sister financially. [3] [4] So, at the age of 16, Baker decided on a career in medicine. [5] [6]

Poughkeepsie, New York City in New York, United States

Poughkeepsie, officially the City of Poughkeepsie, separate from the Town of Poughkeepsie, is a city in the state of New York, United States, which is the county seat of Dutchess County. As of the 2010 census it had a population of 32,736. Poughkeepsie is in the Hudson Valley midway between New York City and Albany, and is part of the Poughkeepsie–Newburgh–Middletown Metropolitan Statistical Area. The name derives from a word in the Wappinger language, roughly U-puku-ipi-sing, meaning "the reed-covered lodge by the little-water place", referring to a spring or stream feeding into the Hudson River south of the present downtown area.

After studying chemistry and biology at home, she enrolled in the New York Infirmary Medical College, a medical school for women, founded by the sisters and physicians Elizabeth Blackwell and Emily Blackwell. [7] The only class she failed—"The Normal Child", taught by Dr. Anne Daniel—led to her fascination with the future recipient of her attention, "that little pest, the normal child". [1] Upon graduating second in her class in 1898, Baker began a year-long internship at the New England Hospital for Women and Children in Boston. [1] [8]

Emily Blackwell English-born American physician

Emily Blackwell was the second woman to earn a medical degree at what is now Case Western Reserve University, and the third woman to earn a medical degree in the United States. In 1993, she was inducted into the National Women's Hall of Fame.

Anne Daniel was an American physician and public health reformer who focused on improving living conditions of the tenement population and female prison population in New York City.

Baker began practicing as a private physician in New York City following her internship. [9] In 1901, Baker passed the civil service exam and qualified to be a medical inspector at the Department of Health. Known as “Dr. Joe,” she wore masculine-tailored suits and joked that colleagues forgot that she was a woman. [10]

The civil service is independent of government and is also composed mainly of career bureaucrats hired on professional merit rather than appointed or elected, whose institutional tenure typically survives transitions of political leadership. A civil servant or public servant is a person employed in the public sector on behalf of a government department or agency. A civil servant or public servant's first priority is to represent the interests of citizens. The extent of civil servants of a state as part of the "civil service" varies from country to country. In the United Kingdom, for instance, only Crown employees are referred to as civil servants whereas county or city employees are not.


The way to keep people from dying from disease, it struck me suddenly, was to keep them from falling ill. Healthy people don’t die. It sounds like a completely witless remark, but at that time it was a startling idea. Preventative medicine had hardly been born yet and had no promotion in public health work.

Sara Josephine Baker, Fighting For Life, page 83

After working diligently in the school system, Baker was offered an opportunity to help lower the mortality rate in Hell's Kitchen. It was considered the worst slum in New York at the turn of the century, with as many as 4,500 people dying every week. Baker decided to focus on the infant mortality rate in particular, as babies accounted for some 1,500 of the weekly deaths. Most of the infant deaths were caused by dysentery, though parental ignorance and poor hygiene were often indirectly to blame. [3]

Mortality rate measure of the number of deaths in a population

Mortality rate, or death rate, is a measure of the number of deaths in a particular population, scaled to the size of that population, per unit of time. Mortality rate is typically expressed in units of deaths per 1,000 individuals per year; thus, a mortality rate of 9.5 in a population of 1,000 would mean 9.5 deaths per year in that entire population, or 0.95% out of the total. It is distinct from "morbidity", which is either the prevalence or incidence of a disease, and also from the incidence rate.

Hells Kitchen, Manhattan Neighborhood of Manhattan in New York City

Hell's Kitchen, sometimes known as Clinton, is a neighborhood on the West Side of Midtown Manhattan in New York City. It is traditionally considered to be bordered by 34th Street to the south, 59th Street to the north, Eighth Avenue to the east, and the Hudson River to the west.

Infant mortality

Infant mortality is the death of young children under the age of 1. This death toll is measured by the infant mortality rate (IMR), which is the number of deaths of children under one year of age per 1000 live births. The under-five mortality rate, which is referred to as the child mortality rate, is also an important statistic, considering the infant mortality rate focuses only on children under one year of age.

Baker and a group of nurses started to train mothers in how to care for their babies: how to clothe infants to keep them from getting too hot, how to feed them a good diet, how to keep them from suffocating in their sleep, and how to keep them clean. [1] [11] She set up a milk station where clean milk was given out. Commercial milk at that time was often contaminated, or mixed with chalky water to improve colour and maximize profit. Baker also invented an infant formula made out of water, calcium carbonate, lactose, and cow milk. [12] This enabled mothers to go to work so they could support their families.

Calcium carbonate Chemical compound

Calcium carbonate is a chemical compound with the formula CaCO3. It is a common substance found in rocks as the minerals calcite and aragonite (most notably as limestone, which is a type of sedimentary rock consisting mainly of calcite) and is the main component of pearls and the shells of marine organisms, snails, and eggs. Calcium carbonate is the active ingredient in agricultural lime and is created when calcium ions in hard water react with carbonate ions to create limescale. It is medicinally used as a calcium supplement or as an antacid, but excessive consumption can be hazardous.

Lactose chemical compound

Lactose is a disaccharide. It is a sugar composed of galactose and glucose subunits and has the molecular formula C12H22O11. Lactose makes up around 2–8% of milk (by weight). The name comes from lac (gen. lactis), the Latin word for milk, plus the suffix -ose used to name sugars. The compound is a white, water-soluble, non-hygroscopic solid with a mildly sweet taste. It is used in the food industry.

Baker aided in the prevention of infant blindness, a scourge caused by gonorrhea bacteria transmitted during birth. To prevent blindness, babies were given drops of silver nitrate in their eyes. Before Baker arrived, the bottles in which the silver nitrate was kept would often become unsanitary, or would contain doses that were so highly concentrated that they would do more harm than good. Baker designed and used small containers made out of antibiotic beeswax that each held a single dose of silver nitrate, so the medication would stay at a known level of concentration and could not be contaminated. [5] [11]

Through Josephine Baker's efforts, infants were much safer than they had been the previous year; blindness decreased from 300 babies per year to 3 per year within 2 years.[ citation needed ] But there was still one area where infancy was dangerous: at birth. Babies were all too often delivered by midwives, who did not necessarily receive any training and who often relied upon various folk practices. Baker convinced New York City to license midwives to ensure some degree of quality and expertise. [13]

While Baker was campaigning to license midwives, treat blindness, encourage breastfeeding, provide safe pasteurized milk, and educate mothers, older children were still getting sick and malnourished. Baker worked to make sure each school had its own doctor and nurse, and that the children were routinely checked for infestations. This system worked so well that head lice and the eye infection trachoma, diseases once rampant in schools, became almost non-existent. [12]

Early in her career, Baker had twice helped to catch Mary Mallon, also known as "Typhoid Mary". Mallon was the first known healthy carrier of typhoid, who instigated several separate outbreaks of the disease and is known to have infected over 50 people through her job as a cook. At least three of the people she infected died. [14] Mallon was not the only repeat offender nor the only typhoid-contagious cook in New York City at the time, but she was unique in that she did not herself suffer from any ill-effects of the disease and in that she was ultimately the only patient placed in isolation for the rest of her life. [15]

Professional recognition

Josephine Baker was becoming famous, so much so that New York University Medical School asked her to lecture there on children’s health, or "child hygiene", as it was known at the time. Baker said she would if she could also enroll in the school. The school initially turned her down, but eventually acquiesced after looking for a male lecturer to match her knowledge. [4] [16] So, in 1917, Baker graduated with a doctorate in public health.

Many government positions, departments, and committees were created because of her work including the Federal Children's Bureau and Public Health Services (now the Department of Health and Human Services) and child hygiene departments in every state.

After the United States entered World War I, Baker became even better known. Most of this publicity was generated from her comment to a New York Times reporter. She told him that it was "six times safer to be soldier in the trenches of France than to be a baby born in the United States." [17] She was able to start a lunch program for school children due to the publicity this comment brought. She made use of the publicity around the high rate of young men being declared 4F (not eligible for draft due to poor health) as a motivating factor for support in her work on improving the health of children.[ citation needed ]

Baker was offered a job in London as health director of public schools, a job in France taking care of war refugees, and a job in the United States as Assistant Surgeon General. [16]

Personal life

Baker spent much of the later part of her life with Ida Alexa Ross Wylie, a novelist, essayist, and Hollywood scriptwriter from Australia who identified as a "woman-oriented woman." When Baker retired in 1923, she started to run their household while writing her autobiography, Fighting For Life. In 1935 and four years before her autobiography was published, Baker and Wylie decided to move to Princeton, New Jersey, with their friend Louise Pearce. [18] Based on the similarity of tone and phrasing of Fighting for Life to Wylie's memoir, My Life with George, writer Helen Epstein postulates that Wylie may have helped Baker write her autobiography. [1] Beyond the memoir, little is known about Baker's life, as she "appears to have destroyed all her personal papers." [1] [19]


In 1923, Baker retired but she did not stop working. [18] [20] She became the first woman to be a professional representative to the League of Nations when she served on the Health Committee for the United States from 1922 to 1924. [4] She was also active in many groups and societies including over twenty-five medical societies and the New York State Department of Health. She became the President of the American Medical Women's Association and wrote four books, an autobiography, and 250 articles across the professional and popular press. [12] [21]

Sara Josephine Baker died from cancer on February 22, 1945, in New York City. [4] [20]

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Further reading