DENVER — Colorado is known to rank among the healthiest – if not the healthiest – states in the nation due to the lifestyle of its residents. But things were not always this way, and it’s thanks to the tireless work of Dr. Florence Sabin that the Centennial State can boast about such rankings.
Florence Rena Sabin was born on Nov. 9, 1871, in Central City, Colo. The daughter of George and Serena Sabin, Florence would eventually move to Denver in 1875 before her family moved to Vermont, where she would eventually discover her love for science and medicine.
As she grew older, she knew she wanted to become a doctor and would eventually apply (and get accepted) to Johns Hopkins Medical School in 1897, after working three years as a teacher in Denver.
“Basically people did not think women were smart enough to be doctors, so getting there was very difficult and then being taken seriously was very difficult,” said Mark Johnson, the former president of the Colorado Medical Society. “Females were to be nurses, to be mothers, they were not to be physicians in the early 20th century. And so she had to fight that, and that’s really one of the reasons she didn’t go into clinical medicine.”
During medical school, “she published her first article while she was still a medical student and was chosen for a very prestigious internship with William Osler, who was probably the greatest medical clinician of his time,” said Johnson, who spoke with Denver7 this week about her life and legacy in public health.
During her time at Johns Hopkins, Dr. Sabin was the first woman to be hired as faculty at the school, where she taught embryology (the study of embryos), immunology (the study of the immune system) and histology (the study of the microscopic structure of tissues).
She eventually went on to be the first full professor at the School of Medicine at Johns Hopkins University and wrote a standard medical textbook on the anatomy of the midbrain and the medulla – breaking the glass ceiling for women in science and medicine in the early 20th century.
Among other remarkable accolades: Dr. Sabin became the first woman elected president of the American Association of Anatomy in 1924, the first woman elected to the National Academy of Sciences in 1925, and the first woman to head a department at the Rockefeller Institute for Medical Research, according to Johnson.
In 1938 and at the age of 67, Dr. Sabin retired from the Rockefeller Institute and returned to Denver to live with her sister, but her work would be far from over.
Public health activism after retirement
About six years later, in 1944, Colorado Governor John Vivian asked Dr. Sabin to head a committee on health in Colorado to improve the health of residents after the end of World War II – a task she was more than happy to do.
“She took the task very seriously,” Johnson said, explaining how 40% of men in Colorado at the time could not be recruited into the Army to fight because of bad health. “Colorado had a terrible reputation for health. About a third of our population, or up to a third of our population, had tuberculosis.”
Johnson said it was believed back then that the high-altitude and thin air found in Colorado was good for tuberculosis, which led many people to move here from out-of-state.
But tuberculosis was one of many problems the state was facing in terms of public health.
Dr. Sabin discovered people died in Colorado at twice the rate of other states, with many of those deaths being attributed to preventable disease, Johnson said. She also learned the state’s health laws were out-of-date, having last been updated in 1876 – when the state was first founded.
“We had problems with our produce. When we sent it to cities in the in the East, they would have outbreaks of dysentery,” Johnson said.
All those problems pushed Dr. Sabin to work hard and come up with solutions, which she eventually did. One of the roadblocks she faced was how to get politics out of health care in Colorado, Johnson said, as at the time, the State Board of Health was directly under the control of governor, which meant any public health role was influenced by whoever held political power.
To accomplish that goal, Dr. Sabin was smart and worked through the legislature, but not in the way one might think.
“Instead of working directly with the legislators — although she did work with them — she went around the state, she visited every county in Colorado, and focused on working with the legislators’ wives,” Johnson said.
The goal was to try to get them to understand what was going on with public health in Colorado, how it was impacting the health of the of the state’s youth, and then, hopefully, through influencing the legislators’ wives, eventually influence the legislators themselves, he said.
“She basically said, ‘Health is too important to be run by politicians, it needs to be run by people who are trained in medicine and public health,’” according to Johnson.
Her work eventually led to the passage of what is now known as the Sabin Health Bills, which became law in 1947.
One of the bills allowed counties to put together their own health departments, as most counties back then were not large enough to have the resources to have a health department of their own. One of the first health departments to come out of that law was the Tri-County Health Department, which was recently dissolved over disputes about how the department was handling the response to the coronavirus pandemic in late 2021.
But a couple of bills she fought for did not pass, despite her efforts.
Johnson said both bills dealt with infectious disease – tuberculosis and brucellosis, the former which affects humans, the latter which affects cattle.
“She tried to get programs in place to take care of those (diseases) and got the dairy industry on her side but was unable to get the livestock industry on her side, so that bill was also killed,” Johnson said.
Despite those failures, Dr. Sabin continued — and succeeded — in working hard to improve restaurant inspection, sanitation in hospitals, reduce rat infestations, and overall improve public health in Colorado.
“Probably the thing she was most famous for is something that nobody really cares much about today – or at least doesn’t study much today – (which) was the origin of the lymphatic system,” Johnson said. “She was the one who discovered that the lymphatic system actually grew out of the venous system, out of veins, whereas prior to that, it was thought that it had gone the other direction.”
That wasn’t her only contribution, according to Denver Public Library records.
“One of her most important contributions was a free X-ray program, which could detect tuberculosis in its early stages,” the library's entry on her life states. “These measures cut the rate of tuberculosis in Denver in half. The milk and restaurant safety ratings both increased by about half.”
Dr. Sabin retired for good at the age of 80 and died on Oct. 3, 1953, at the age of 82.
Despite the success that her work accomplished, Johnson said her life's accomplishments and work has not come without a price.
“To one degree, public health is a victim of its own success in that we have been so successful that people have forgotten what it's like to have smallpox outbreaks and outbreaks of tuberculosis and those kinds of things,” he said.
As to how he sees where public health is going?
“We need to continue to think about what she was about," Johnson said. "Health is too important to let politics run it."
