This project considers why women, instead of city officials, took charge of public health in Los Angeles at the turn of the twentieth century. The purpose of exploring this question is to provide a context for thinking about the role of women in constructing urban healthcare systems prior to the 1930s, when local municipalities in the United States were predominantly responsible for protecting the public's health. This study analyzes how gender influenced the identification of public health hazards and how women crafted the healthcare structures that would eventually become part of local government. Thinking about their work prompts questions about the relationship between volunteerism and government-run public health programs. Who is best at taking the initiative to protect the public's health: volunteer organizations or the government? If an ostensibly private group accepts public funds to experiment with and maintain health-related programs for the public, does it fundamentally alter the character of the health program and the role of the state? The current fervor over the distribution of federal resources for healthcare-most notably, President George W. Bush's faith-based initiative for subsidizing drug rehabilitation-indicates that these questions are not only difficult to answer, but also raise basic concerns over how to define the government's role and responsibilities. This historical study affords insights into how previous generations have addressed these questions through an in-depth analysis of a broad variety of archival sources (institutional reports, newspapers, court records, census manuscripts, city directories, manuscript collections, contemporary social reform and medical trade journals). These documents demonstrate how female reformers rationalized policy decisions and their success and failure at capturing the public's support. This research demonstrates that Los Angeles is an excellent model for studying the pivotal role women played in determining and managing public health policy, and the ramifications of their influence.