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Sara Josephine Baker (November 15, 1873 – February 22, 1945) was an American physician notable for making contributions to
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
, especially in the immigrant communities of
New York City New York, often called New York City or NYC, is the List of United States cities by population, most populous city in the United States. With a 2020 population of 8,804,190 distributed over , New York City is also the L ...
. Her fight against the damage that widespread urban poverty and ignorance caused to children, especially newborns, is perhaps her most lasting legacy. In 1917, she noted that babies born in the United States faced a higher mortality rate than soldiers fighting in
World War I World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was List of wars and anthropogenic disasters by death toll, one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, ...
, drawing a great deal of attention to her cause. She also is known for (twice) tracking down Mary Mallon, better known as Typhoid Mary.


Early life

Baker was born in
Poughkeepsie, New York Poughkeepsie ( ), officially the City of Poughkeepsie, separate from the Town of Poughkeepsie around it) is a city in the U.S. state of New York. It is the county seat of Dutchess County, with a 2020 census population of 31,577. Poughkeeps ...
, in 1873 to a wealthy
Quaker Quakers are people who belong to a historically Protestant Christian set of denominations known formally as the Religious Society of Friends. Members of these movements ("theFriends") are generally united by a belief in each human's abili ...
family. After her father and brother died of
typhoid Typhoid fever, also known as typhoid, is a disease caused by ''Salmonella'' serotype Typhi bacteria. Symptoms vary from mild to severe, and usually begin six to 30 days after exposure. Often there is a gradual onset of a high fever over several d ...
, Baker felt pressure to support her mother and sister financially."Sara Josephine Baker." ''Notable Scientists: From 1900 to the Present''. Online. Gale Group, 2008. So, at the age of 16, Baker decided on a career in medicine. 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 Elizabeth Blackwell (3 February 182131 May 1910) was a British physician, notable as the first woman to receive a medical degree in the United States, and the first woman on the Medical Register of the General Medical Council for the United Ki ...
and Emily Blackwell."Sara Josephine Baker." ''World of Health''. Thomson Gale, 2006. 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". Upon graduation as second in her class in 1898, Baker began a year-long internship at the
New England Hospital for Women and Children The New England Hospital for Women and Children was founded by Marie Zakrzewska on July 1, 1862. The Hospitals goal was to provide patients with competent female physicians, educate women in the study of medicine and train nurses to care for the ...
in Boston. Baker began practicing as a private physician in New York City following her internship. In 1901, Baker passed the
civil service The civil service is a collective term for a sector of government composed mainly of career civil servants hired on professional merit rather than appointed or elected, whose institutional tenure typically survives transitions of political leaders ...
exam and qualified to be a medical inspector at the Department of Health, and worked as a part time inspector in 1902. Known as “Dr. Joe,” she wore masculine-tailored suits and joked that colleagues forgot that she was a woman.


Career

After working diligently in the school system, Baker was offered an opportunity to help lower the
mortality rate Mortality rate, or death rate, is a measure of the number of deaths (in general, or due to a specific cause) in a particular population, scaled to the size of that population, per unit of time. Mortality rate is typically expressed in units of d ...
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 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 probability of deaths of children under one year of age per 1000 live births. The under-five morta ...
rate in particular, as babies accounted for some 1,500 of the weekly deaths. Most of the infant deaths were caused by
dysentery Dysentery (UK pronunciation: , US: ), historically known as the bloody flux, is a type of gastroenteritis that results in bloody diarrhea. Other symptoms may include fever, abdominal pain, and a feeling of incomplete defecation. Complications ...
, though parental ignorance and poor hygiene were often indirectly to blame. 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. 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 Lactose is a disaccharide sugar synthesized by galactose and glucose subunits and has the molecular formula C12H22O11. Lactose makes up around 2–8% of milk (by mass). The name comes from ' (gen. '), the Latin word for milk, plus the suffix ' ...
, and cow milk. This enabled mothers to go to work so they could support their families. Baker aided in the prevention of infant
blindness Visual impairment, also known as vision impairment, is a medical definition primarily measured based on an individual's better eye visual acuity; in the absence of treatment such as correctable eyewear, assistive devices, and medical treatment� ...
, a scourge caused by
gonorrhea Gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium ''Neisseria gonorrhoeae''. Infection may involve the genitals, mouth, or rectum. Infected men may experience pain or burning with u ...
bacteria transmitted during birth. To prevent blindness, babies were given drops of
silver nitrate Silver nitrate is an inorganic compound with chemical formula . It is a versatile precursor to many other silver compounds, such as those used in photography. It is far less sensitive to light than the halides. It was once called ''lunar causti ...
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 Beeswax (''cera alba'') is a natural wax produced by honey bees of the genus ''Apis''. The wax is formed into scales by eight wax-producing glands in the abdominal segments of worker bees, which discard it in or at the hive. The hive work ...
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. 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. But there was still one area where infancy was dangerous: at birth. Babies were often delivered by
midwives A midwife is a health professional who cares for mothers and newborns around childbirth, a specialization known as midwifery. The education and training for a midwife concentrates extensively on the care of women throughout their lifespan; c ...
, who were excluded from the formal training available to doctors. Baker convinced New York City to license midwives to ensure some degree of quality and expertise. 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 The head louse (''Pediculus humanus capitis'') is an obligate ectoparasite of humans. Head lice are wingless insects that spend their entire lives on the human scalp and feeding exclusively on human blood. Humans are the only known hosts of thi ...
and the eye infection
trachoma Trachoma is an infectious disease caused by bacterium '' Chlamydia trachomatis''. The infection causes a roughening of the inner surface of the eyelids. This roughening can lead to pain in the eyes, breakdown of the outer surface or cornea of ...
, diseases once rampant in schools, became almost non-existent. Early in her career, Baker had twice helped to catch Mary Mallon, also known as "Typhoid Mary". Mallon was the first known
healthy carrier An asymptomatic carrier is a person or other organism that has become infected with a pathogen, but shows no signs or symptoms. Although unaffected by the pathogen, carriers can transmit it to others or develop symptoms in later stages of th ...
of
typhoid Typhoid fever, also known as typhoid, is a disease caused by ''Salmonella'' serotype Typhi bacteria. Symptoms vary from mild to severe, and usually begin six to 30 days after exposure. Often there is a gradual onset of a high fever over several d ...
, who instigated several separate outbreaks of the disease and is known to have infected more than 50 people through her job as a cook. At least three of the people she infected died. 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 suffer any ill-effects of the disease and in that she was ultimately the only patient placed in isolation for the rest of her life.


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 unsuccessfully for a male lecturer to match her knowledge. In 1917, Baker became the first woman to receive a doctorate in
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
. After the United States entered
World War I World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was List of wars and anthropogenic disasters by death toll, one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, ...
, Baker became even better known. Most of this publicity was generated from her comment to a ''
New York Times ''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid ...
'' 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." 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. Baker was offered a job in
London London is the capital and List of urban areas in the United Kingdom, largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary dow ...
as health director of public schools, a job in
France France (), officially the French Republic ( ), is a country primarily located in Western Europe. It also comprises of Overseas France, overseas regions and territories in the Americas and the Atlantic Ocean, Atlantic, Pacific Ocean, Pac ...
taking care of war refugees, and a job in the United States as Assistant Surgeon General.


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 Australia, officially the Commonwealth of Australia, is a sovereign country comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands. With an area of , Australia is the largest country by ...
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 Princeton is a municipality with a borough form of government in Mercer County, in the U.S. state of New Jersey. It was established on January 1, 2013, through the consolidation of the Borough of Princeton and Princeton Township, both of w ...
, with their friend Louise Pearce. 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''.'' Beyond the memoir, little is known about Baker's life, as she "appears to have destroyed all her personal papers."


Retirement

In 1923, Baker retired, but she did not stop working. She became the first woman to be a professional representative to the
League of Nations The League of Nations (french: link=no, Société des Nations ) was the first worldwide intergovernmental organisation whose principal mission was to maintain world peace. It was founded on 10 January 1920 by the Paris Peace Conference th ...
when she served on the Health Committee for the United States from 1922 to 1924. She was also active in many groups and societies including over twenty-five medical societies and the
New York State Department of Health The New York State Department of Health (NYSDOH) is the department of the New York state government responsible for public health. It is headed by Health Commissioner Mary T. Bassett, who was appointed by Governor Hochul and confirmed by the S ...
. 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. Sara Josephine Baker died from cancer on February 22, 1945, in New York City.


References

* *


Further reading

* Baker, S. J. (1939). Fighting for life. New York: The Macmillan company. The book was re-issued in September 2013 in th
''NTRB Classics'' series
with an introduction by Helen Epstein . * Leavitt, Judith Walzer (1996) Typhoid Mary. Captive to the Public's Health. Boston: Beacon Press. * Matyas, M.L. (1997). �
Sara Josephine Baker, Physician & Public Health Worker, 1873–1945
” in Matyas, M.L. & Haley-Oliphant, A.E. (Editors). (1997). Women Life Scientists: Past, Present, and Future – Connecting Role Models to the Classroom Curriculum. Bethesda, MD:
American Physiological Society The American Physiological Society is a non-profit professional society for physiologists. It has nearly 10,000 members, most of whom hold doctoral degrees in medicine, physiology or other health professions. Its mission is to support research an ...
, p. 81–106. * Scholer, A.M. (1997) Louise Pearce, (1885–1959) In, Women in the biological sciences: a bibliographic sourcebook. *Grinstein, L.S., C. A. Biermann, & R. K. Rose. Greenwood Press.


External links

* * BBC Future, Leila McNeill
S.J. Baker: The woman who transformed public health 17 May 2020
{{DEFAULTSORT:Baker, Sara Josephine 1873 births 1945 deaths American women physicians American Quakers People from Poughkeepsie, New York New York University Grossman School of Medicine alumni New York University Grossman School of Medicine faculty American women academics American LGBT scientists American public health doctors Women public health doctors