Dr. Sara Josephine Baker: A Lasting Legacy in Public Health
Photo: U.S. National Library of Medicine
Honoring a queer champion of maternal & childhood health
Sara Josephine Baker, MD, PhD, lived life on her own terms. With a spirit of nonconformity that can be traced back to her Quaker upbringing, she defied gender stereotypes and societal pressures to study medicine and join the ranks of America’s first female physicians.
As a New York City medical inspector, Dr. Baker used her skills and knowledge to reform public health standards and implement institutional change on a local, national, and global scale. Her work ethic, intelligence, and compassion for society’s most vulnerable groups helped her become a leader and true visionary in maternal and childhood health during the early decades of the twentieth century.
An openly gay woman and proud suffragette, Dr. Baker chose to live authentically and fight for equality in a political and cultural context that rebuffed female independence. Her work and legacy make her an indisputable queer feminist icon, and we are honored to share her story during Pride Month.
Purpose through tragedy
Dr. Baker was born in 1873 in Poughkeepsie, New York. Her father Daniel Mosher Baker, a Quaker lawyer, and mother Jenny Harwood Brown, one of the first graduates of the all-women Vassar College, instilled in her the importance of education from an early age. At just 16, Dr. Baker earned a scholarship to her mother’s alma mater. However, around that time, her father and brother passed tragically of typhoid — devastating the family and threatening their financial stability. Heartbroken but determined to support her mother and sister, Dr. Baker passed up her scholarship and started down the path to become a physician.
In 1898, Dr. Baker graduated second in her class from the Woman's Medical College of the New York Infirmary, a women-only medical program founded in 1868. At the time, only six percent of all physicians were women. After graduation, Dr. Baker left New York for an internship at Boston’s New England Hospital for Women and Children, an outpatient clinic that served some of the city’s poorest residents, seeing firsthand the cyclical linkage between ill health and poverty.
As a newly minted physician, Dr. Baker opened a private practice in New York in 1899 while working part-time as a city medical inspector. A few years later, she rose to assistant to the commissioner of health and worked on several high-profile cases, including the famous apprehension of "Typhoid Mary.”
Her most notable achievement, however, was transforming the city’s basic infectious disease inspection protocol into a comprehensive approach to preventative healthcare for children. During the summer of 1908, Dr. Baker led a team of 30 nurses into the city’s slums and taught mothers with infants basic hygiene skills. By August, the infant mortality rate began to sharply fall.
With such promising results, the Department of Health established the Division of Child Hygiene (later raised to Bureau) and appointed Dr. Baker as its director in August 1908, making her the first woman in the U.S. to hold an executive position in a health department. During her tenure, Dr. Baker served as a leading voice on children and women’s health in New York and introduced numerous groundbreaking policies: mandatory licensure for midwives; appointments of school nurses and doctors; required inspections of schoolchildren for infectious diseases; compulsory use of silver nitrate drops in the eyes of all newborns; and “Little Mothers’ Leagues” to provide training to young girls required to care for infant family members.
Dr. Baker also founded and became president and later chairman of the Children’s Welfare Federation of New York. Under her governance, the city’s infant mortality rate fell from 144 per 1,000 live births in 1908 to 88 in 1918. Upon retirement in 1923, Dr. Baker remained a consultant to the city and was made a representative on child health issues to the League of Nations in the aftermath of World War I.
Paving the way for women
Despite her career success and impact, Dr. Baker faced setbacks due to her gender. In 1916, Dr. Baker was approached by the New York University Medical School to lecture on child hygiene. She said she would only lecture if she could enroll in the school, which barred women at the time. The university initially refused; however, after a year of unsuccessfully searching for a male lecturer to match Dr. Baker’s skillset, the administration acquiesced and opened its doors to female students. Dr. Baker went on to become the first woman to receive a doctorate in public health in 1917.
Dr. Baker enjoyed a lifelong partnership with novelist Ida Wylie. Together, they regularly attended the Heterodoxy Club, a feminist debating group based in New York’s Greenwich Village that served as a forum for college-educated women to discuss radical ideas, as well as a safe space to explore sexuality and gender identity. Nearly a quarter of the club’s 100 members were lesbian or bisexual. After retiring, Dr. Baker, Wiley, and their close friend Louise Pierce purchased a two-hundred-year-old farm in Princeton, New Jersey. There, Dr. Baker penned and published her autobiography Fighting for Life (1939). All three women lived together on their New Jersey farm until their deaths.
Immeasurable impact
At the turn of the century, rapidly growing cities like New York City struggled with containing infectious disease and protecting its most at-risk residents — namely children, women, and the poor — from falling victim to avoidable illnesses. Dr. Baker’s innovative approach to preventative healthcare for babies and mothers, especially those in poverty, not only saved countless lives, but also delineated children’s health as a separate and unique dimension of public health.
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