There is no nice way to say it. Dr. Florence Sabin and the Health Committee of the Colorado State Post-War Planning Committee in 1947 did not trust Colorado’s politicians to care for the public’s health.
History supported their skepticism.
The health of Colorado was abysmal. More than 40% of Colorado draftees for World War II were found to be “not physically fit for the Armed Services.”
Colorado had high rates of diphtheria, typhoid, dysentery and maternal and infant mortality. It was one of the six worst states in regard to smallpox.
Colorado was 20 years behind more progressive states in the use of scientific methods for protecting the purity of the water supply, pasteurizing milk, properly disposing of sewage and controlling the spread of disease.
It had the highest death rate of any state from rheumatic heart disease, and of the 20 leading causes of death in the country, Colorado’s rates for 13 of them were higher than the national average. At times, one in three Colorado residents had tuberculosis. Epidemics and pandemics constantly battered this mid-continental state.
In 1944, as Colorado prepared for the return of soldiers from World War II, Gov. John Vivian appointed numerous planning committees, including a committee on health. The governor had no real interest in public health and was convinced by an aide that the retired Dr. Sabin was an innocuous, white-haired, “little old lady.” He appointed her as the chair of the committee.
Florence Sabin was indeed a little, white-haired “old lady,” but she was far from innocuous. Born in Central City in 1871, Florence had graduated from the prestigious Johns Hopkins University School of Medicine. She was hand-picked to serve as an intern for the famous Dr. William Osler.
She became the first female professor at Johns Hopkins University, the first female president of the American Association of Anatomists and the first woman elected into the National Academy of Sciences.
By the time Dr. Sabin retired to Colorado, she was a world-famous physician herself. Evidently Gov. Vivian’s aide did not read her resume.
As chair of the Health Committee, Dr. Sabin did things unconventionally. She held meetings around the state instead of just in Denver. She didn’t “waste” time talking to the state’s legislators, but worked instead with the legislators’ spouses, educating them about the abysmal state of public health in Colorado.
In 1948, the legislature passed the “Sabin Health Laws,” creating a professional public health system in Colorado.
The public health system the Sabin Health Laws established required a professionally trained staff of physicians and scientists, hired on the basis of merit, not political bias. Her constant message was that the health of the public was too important to leave to politics. Local county and district health departments were encouraged.
Educational training programs were set up. Laboratories were built, and Dr. Sabin advocated for a stronger state medical school and the creation of a school of public health (which did not occur for another 60 years).
I have frequently been asked why it is that an unelected “bureaucrat” has the power to promulgate public health orders in Colorado. It is Florence Sabin and the Health Committee’s “fault.”
To prevent the perpetuation of political cronyism that had led Colorado to have such abysmal health records, they insisted that public health decisions be taken out of the hands of politicians and left to scientifically trained public health professionals. You may disagree with this arrangement, but it has been in the state’s statutes for over 70 years.
I have served as Jefferson County’s public health director for 30 of those years, and this is the first time I have authorized a public health order.
I believe my public health colleagues and I have acted judiciously with the power granted to us by that innocuous, little old white-haired champion of Colorado’s public health.
Mark B. Johnson, MD, MPH, is the Executive Director of Jefferson County Public Health, where he has served in his role for 30 years.
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