Sara Josephine Baker

• Sara Baker
• Born: November 15, 1873
• Died: February 22, 1945

Public health reformer, was born in Poughkeepsie, New York, the third of the four children—and the third daughter—of Orlando Daniel Mosher Baker and Jenny Harwood (Brown) Baker. An eminent lawyer of Quaker lineage, Orlando Baker had run away from his Hyde Park, New York, home to Poughkeepsie. Jenny Baker, descended from Samuel Danforth (who helped establish Harvard College), was part of the initial student group at Vassar College.

As a young, contented child Josephine Baker played in a tomboyish fashion. At the age of six she also discovered social consciousness, which crystallized her altruistic impulses. Describing an incident when a black child became envious of her fine attire, she wrote: “I took off every stitch I had on, right down to the blue shoes that were the joy of my infantile heart and gave everything, underwear and all, to the little black girl. I watched her as she scampered away ... choked with bliss. Then I walked back into the house, completely naked, wondering why I had done it and how to explain my inexplicable conduct.” Her prosperous parents, although conventional, understood.

When she grew older, Baker mingled with students at nearby Vassar and attended the Misses Thomas’ private school for girls in her hometown. Her father and brother died during Josephine Baker’s sixteenth year, and the family suffered a financial crisis, destroying her plans to enter Vassar. Thus—with the idea of eventually providing income and despite criticism from relations as well as others—she prepared for medical study, successfully undergoing the New York State Regents examinations in 1894. The last portion of Orlando Baker’s financial accumulations enabled her to begin studies that year at the Woman’s Medical College of the New York Infirmary for Women and Children. There she worked with Dr. Emily Blackwell, sister of medical reformer Elizabeth Blackwell. Baker particularly valued this college’s hygiene course. Second out of eighteen graduating students, she became a medical doctor in 1898 and interned the following year in Boston’s New England Hospital for Women and Children, working at the same time for a clinic in one of that city’s poorer districts.

After moving back to New York City, Baker did not earn enough as a private practitioner; so in 1901 she also became a medical inspector for the New York City health department. As she searched the West Side of Manhattan for ailing Irish and black babies or sought to handle the health problems of indigents on the Lower East Side, the “odds and ends of experience began to take form” in her eyes. She was shocked by the “ancient scandal” of the hygienically dangerous tenement dwellings crowded with immigrants.

Her work in the slums sealed her commitment to public health. As an assistant to the city commissioner of health from 1907 (retaining her own practice for the next three years), Baker achieved national fame by identifying, along with others, “typhoid Mary” Mallon, a restaurant-kitchen worker who unknowingly had spread typhoid fever to thousands of patrons. In addition Baker launched a fight against infection among schoolchildren, requiring sick students to be sent home (and finding in many cases that the classrooms became practically empty). Working with New York’s Bureau of Municipal Research, which provided useful data over the years, she became aware of the high proportion of children “who swelled the death rate to fantastically massive proportions.” The summer death of infants often rose to 1,500 a week in the city. This problem could be ameliorated, she felt, by preventive detection and care that would keep children from falling ill. Therefore during 1908 she organized thirty nurses to work in a predominantly Italian-American East Side area, encouraging bathing, suitable ventilation and clothing, and breast-feeding of infants to prevent infection from commercial—unpasteurized— milk. The area’s infant mortality rate in 1908 fell compared with the preceding year.

Baker’s accomplishments contributed to the creation in New York City of a child hygiene division, which became a bureau of the Department of Health, the first such agency in the world to be funded by public taxation. As director she began with the premise that the infant death rate was “the quickest and easiest point” of controlling child hygiene. An innovator of preventive medicine, Baker built on French experience to establish “baby health stations,” which provided pure milk, consultation, referrals for specialized care, and tests of contaminating diseases. Fighting current pediatric opinion, she risked her professional reputation by modifying milk content according to the weight of individual babies, a tactic that proved nutritionally effective.

Baker concerned herself with the “whole cycle of child life,” bringing health education systematically into the schools, helping children and parents understand new medical methods, circulating booklets, teaching and licensing mid-wives. Always creative, she helped design such items as receptacles for drugs to fight blindness at birth and patterns for hygienic baby garments (subsequently used by McCall Pattern Company). Mortality rates decreased when she began to find maternal foster care for orphaned infants. She founded Little Mothers’ Leagues, which gave instruction on hygiene to daughters of working women who stayed at home to care for their younger siblings.

As head of a public agency, particularly a pathfinding one, Baker sought constantly to mobilize backing for her views on child health and specifically for the needs of children in the city. She got along very well with political bosses, seeking and receiving their aid on her projects, but she maintained her autonomy by not allowing them to dictate appointment of city nurses as part of their patronage system. Tammany Hall, she found, often acted more quickly in response to her pleas regarding funds for medical emergencies than did organized charity. Despite her popularity, she became the target of New York City’s Mayor John F. Hylan in 1919. But newspapers rallied to the side of this “woman of rare intelligence” who had contributed to the city and the nation.

Having become a recognized authority through her work, Baker began to speak and write nationally on child health, attracting a far-reaching general, professional audience. In 1916 she agreed to lecture intermittently at the New York University-Bellevue Hospital Medical School in exchange for her admission to its young program in public health. Her dissertation evaluated the connection between respiratory sicknesses and ventilation; in 1917 she was the first woman to receive the Doctorate of Public Health. For the next fifteen years, Baker discoursed on child hygiene at the school. She wrote prolifically, publishing Healthy Babies, Healthy Mothers, and Healthy Children in 1920. The Growing Child and Child Hygiene appeared respectively during 1923 and 1925. She kept up a stream of contributions to lay periodicals and those in her field, such as the American Journal of Public Health.

Baker worked closely with such nonpolitical groups as the New York Association for Improving the Condition of the Poor, whose sociological data proved the correctability of defects in children prior to the age of six. She became president and then, from 1914 to 1917, chairman of the executive committee of the Babies Welfare Association (subsequently the Children’s Welfare Federation of New York), which she had established in 1911. Baker was also active as president in 1917-18 of the renamed American Child Health Association, which she had helped organize in 1909. After leaving the Child Hygiene Bureau in 1923 she remained involved with various medical groups, continuing as an adviser to the national Children’s Bureau, the United States Public Health Service, and the Department of Health in New York State; and serving as the American delegate to the Health Committee of the League of Nations (1922-24).

President of the American Medical Women’s Association from 1935 to 1936, Baker had entered more strictly feminist activity through a self-described process of “psychological suction.” She joined the College Women’s Equal Suffrage League at its inception in 1908, spoke on street corners in the financial district for the suffrage cause, and was part of a representative women’s rights group that met President Woodrow Wilson at the White House. A Democrat, Baker gained slight identification as a radical partly because of her association with such nonconformists as Fola La Follette, Crystal Eastman, Mabel Dodge Luhan, and Rose Pastor Stokes in the Heterodoxy Club, which gathered for informal debate. Before American entry into World War I, she was a member of “the war brotherhood”—an organization that hoped to “keep doctors neutral.” Using the war to illustrate her own concerns, she made the popularly circulated remark: “It’s six times safer to be a soldier in the trenches of France than to be born a baby in the United States.”

Baker never married. At the age of seventy-one, she died of cancer, in New York, and was buried at the Rural Cemetery of Poughkeepsie.

S. Josephine Baker (she used the S as an adult to differentiate herself from the well-known singer) made a significant contribution to child hygiene and the preventive medical care of children, as well as to the mobilization of organizational resources on behalf of those causes. During 1923 she allowed herself to retire when the United States Department of Labor included a Children’s Bureau, and there were similar agencies throughout the nation and in some countries overseas. Deaths of infants in New York City had decreased to approximately 65 from over 100 in 1,000 successful births, a lower rate than in any large American or European city to that date. Her “baby health stations” had ministered to half the infants in New York City. Baker set an example as a woman pioneering in public service.

Baker’s well-written autobiography, Fighting for Life (1939), furnishes essential information about her professional and intellectual development. See also The New York Times Index, 1913-45; Woman’s Who’s Who of America, 1914-1915 (1914); the National Cyclopaedia of American Biography, vol. 36 (1950); Who Was Who in America (1950); Notable American Women (1971); and The Dictionary of American Biography, supplement 3 (1973). An obituary appeared in the Journal of the American Medical Association, March 17. 1945.