CREDIT: Library of Congress Prints and Photographs Division/George Grantham Bain Collection
ALICE HAMILTON was a physician whose patient was America’s working class. She was a brilliant scientist and an untiring reformer who founded the field of occupational medicine, which has helped save tens of millions of workers from unnecessary workplace injuries, diseases, and deaths. She is a giant in the annals of public health not only because of her important research but also because she helped educate and mobilize the public and promoted legislation to protect workers and their communities. The first woman professor at Harvard Medical School and the first to receive the prestigious Lasker Award in public health, Hamilton faced and overcame enormous obstacles due to gender discrimination. It is an ironic symbol of her pioneering accomplishments that one of her distinctions is having been listed in a book of eminent scientists called Men of Science, published in 1944.
Born to an affluent family, Hamilton was raised in the growing industrial city of Fort Wayne, Indiana, and educated at home and at Miss Porter’s School, a finishing school in Connecticut. She received her medical degree from the University of Michigan in 1893. (In 1900 only 5 percent of American physicians were women. By 1960 that number was still only 6 percent. Today it is about half). After internships in Minneapolis and Boston, she spent a year studying at universities in Munich and Leipzig in Germany. Neither university had permitted women students before, but they allowed Hamilton to attend lectures in bacteriology and pathology if she promised to remain inconspicuous to male students and professors.
In 1897 she accepted a teaching position at the Women’s Medical School of Northwestern University in Chicago and moved into Hull House, where she could bring together her scientific training and her zeal for social reform. She had heard Jane Addams speak at her Methodist church in Fort Wayne years earlier and was drawn to the culture and commitment of the settlement house.
Hamilton opened a well-baby clinic for poor families in the Hull House neighborhood. She learned about the daily lives of these families. She observed the strange deaths that blighted them, the prevalence of lead palsy and wrist drop (both the result of lead poisoning), and the significant number of widowed women. Hamilton quickly realized that these problems were not simply medical issues but the result of social and economic conditions.
The rise of big industrial cities and overcrowded working-class neighborhoods had led to new dangers in workplaces and communities. Journalists, union activists, and others had written and organized against dangerous workplaces. But scientists in Europe—such as Sir Thomas Oliver, whose 1902 book Dangerous Trades influenced Hamilton—had devoted much more attention to these problems than their American counterparts. Hamilton decided to change this.
In 1902 Chicago was struck with a typhoid epidemic. Hamilton recognized that flies were transmitting the disease because of the haphazard way that sewage was disposed of. She brought this to the attention of the Chicago Health Department, which was reorganized to address the issue. She also observed that the health problems suffered by many poor immigrants were connected to unsafe conditions and noxious chemicals, especially lead dust, that they were exposed to at work. In 1908 Hamilton published one of the first scientific articles on occupational disease in the United States, and she was soon a recognized expert on the topic.
Hamilton combined the new laboratory science of toxicology with “shoe leather epidemiology”—firsthand visits to workplaces to examine conditions and track down examples of workers poisoned by exposure to lead and other toxins. Workers were often too intimidated by their bosses to talk to Hamilton at work, so she visited them at home, where they could speak more openly. With the help of the American Association for Labor Legislation and the American Public Health Association—along with the public outrage triggered by her friend Upton Sinclair’s 1906 novel The Jungle, which exposed the awful conditions in Chicago’s slaughterhouses—Hamilton’s research reached a wide audience. Her work was so persuasive that it led to sweeping state and federal reforms to improve workers’ health and safety.
In 1910 Illinois governor Charles Deneen created the Occupational Disease Commission, the first such agency in the world, and appointed Hamilton director. Speaking to a group of executives in the lead industry, she described the consequences to workers’ health of inhaling and ingesting lead in their factories. “All the factories in Illinois and St. Louis are so dangerous to their women that they would be closed by law in any European country,” Hamilton told them. Recalling those experiences in her 1943 autobiography, Hamilton wrote, “There is something strange in speaking of ‘accident and sickness compensation.’ What could ‘compensate’ anyone for an amputated leg or a paralyzed arm, or even an attack of lead colic, to say nothing of the loss of a husband or son?”
Hamilton was a prime mover in campaigns to pass several workers’ compensation laws in Illinois over the opposition of business groups. These laws reflected a radical new idea: that workers were entitled to compensation for the injuries and health problems they sustained on the job. After Hamilton issued her report on workers’ compensation, Charles Neill, the U.S. commissioner of labor, asked her to replicate her research on a national level. She examined hazards posed by exposure to lead, arsenic, mercury, organic solvents, and radium (used in the manufacture of watch dials). One of her studies examined the poisonous effects of manufacturing explosives, a study undertaken during World War I at the request of the National Research Council. She stayed in this unsalaried position from 1911 to 1921, when her program was canceled after probusiness Republicans regained control of the White House.
In 1919, Hamilton was offered a position in the new Department of Industrial Medicine. This made her the first woman appointed to the Harvard Medical School faculty, but the school imposed three conditions on her employment: she would not be allowed to use the Faculty Club, she would have no access to football tickets, and she would not be allowed to march in commencement processions. At Harvard all her students were male, because the school did not admit women students until World War II. Hamilton, however, insisted on some conditions of her own: she would only be required to teach one semester a year so she could continue her investigations and return to Hull House for part of each year.
Hamilton served on the League of Nations Health Committee between 1924 and 1930, which led her to explore industrial health conditions in other countries. Her books, including Industrial Poisons in the United States (1925) and Industrial Toxicology (1934), were pioneering works and widely cited.
Despite these remarkable accomplishments, when Hamilton retired from Harvard in 1935, at age sixty-six, she was still ranked as an assistant professor, which means that she never received a promotion.
Although best known for her scientific work, Hamilton was deeply involved in many reformist and radical causes throughout her career—not surprising for someone who spent many years in Hull House’s stimulating environment. Along with Jane Addams and Emily Balch, she was part of the delegation that traveled to Europe to encourage the end of World War I. The group later became the Women’s International League for Peace and Freedom.
From 1944 to 1949 she served as president of the National Consumers League, the activist group that had played a key role in many of the important workers’ rights, child labor, and women’s workplace reforms of the 20th century. While in her eighties and nineties, Hamilton took an active role in campaigning against the hysteria of McCarthyism and the Cold War. In 1963, at ninety-four, she signed an open letter to President John F. Kennedy asking for an early withdrawal of US troops from Vietnam.
Hamilton died on September 22, 1970, at the age of 101. Three months later, Congress passed the landmark Occupational Safety and Health Act, a major legacy of Hamilton’s scientific and political work.