First Latina & First Woman US Surgeon General - Champion of Children's Health
August 23, 1944 – Present
🇵🇷 Puerto Rico / 🇺🇸 United StatesAntonia Coello was born on August 23, 1944, in Fajardo, Puerto Rico, a coastal town on the island's eastern edge. Her birth came with a serious medical condition: she was born with a congenital megacolon, a painful disorder affecting her large intestine. For the first eight years of her life, Antonia endured chronic pain, repeated hospitalizations, and the frustration of doctors telling her family that surgery would have to wait until she was older.
Those childhood years of illness profoundly shaped Antonia's future. She spent countless hours in hospitals, watching doctors and nurses care for sick children, witnessing the anxiety of parents, and experiencing the vulnerability that comes with being young and sick. Rather than becoming bitter, these experiences ignited in her a determination to help other children avoid unnecessary suffering. She decided at a young age that she would become a doctor specializing in pediatrics.
When Antonia was finally able to have corrective surgery as a teenager, the experience only strengthened her resolve. She understood from personal experience what sick children endured, and she wanted to use that empathy to become a better physician. Her mother, Ana Delia Coello, a school principal, instilled in Antonia the values of education, service, and perseverance. Even as Antonia dealt with health challenges, her mother insisted she excel academically, preparing her for the rigorous path ahead.
Antonia attended the University of Puerto Rico, earning her bachelor's degree in 1965. She then entered the University of Puerto Rico School of Medicine, one of the few medical schools accessible to Puerto Rican students at the time. She graduated with her medical degree in 1970, ready to fulfill her childhood dream of helping sick children.
After completing her medical degree, Dr. Novello pursued pediatric residency training at the University of Michigan Medical Center in Ann Arbor. The transition from Puerto Rico to the mainland United States presented cultural and linguistic challenges, but Novello's determination and medical skill earned the respect of her colleagues and supervisors. She completed her pediatrics residency in 1973, then pursued additional fellowship training in pediatric nephrology (kidney diseases in children) at Georgetown University Hospital in Washington, D.C.
Pediatric nephrology was a natural specialization given her own childhood experiences with congenital conditions. She understood the complexities of chronic childhood illness and the long-term medical and psychological impacts on young patients and their families. This expertise would serve her well throughout her career, as she advocated for comprehensive, compassionate care for children with chronic conditions.
In 1978, Dr. Novello joined the United States Public Health Service, beginning a career that would take her from clinical medicine to public health policy and administration. She worked at the National Institutes of Health (NIH), where she conducted research on pediatric AIDS and childhood immunology. Her work focused on understanding how HIV/AIDS affected children differently than adults—a critical area of research during the early years of the AIDS epidemic.
At NIH, Novello earned a master's degree in public health from Johns Hopkins University (1982), expanding her expertise from clinical medicine to population health, epidemiology, and health policy. She understood that while treating individual patients was important, improving public health systems and policies could help millions of children simultaneously.
Her research and administrative work at NIH caught the attention of national health policy leaders. She demonstrated not only medical expertise but also the ability to communicate complex health issues to policymakers and the public. These skills would prove essential when she was appointed to the nation's highest public health position.
In 1990, President George H.W. Bush nominated Dr. Antonia Novello to serve as the 14th Surgeon General of the United States. Her confirmation made history: she became the first woman and first Latina to hold this position. The Surgeon General serves as the nation's doctor, providing Americans with the best scientific information on how to improve their health and reduce the risk of illness and injury.
Novello's appointment was groundbreaking for multiple reasons. As a Latina woman in a field dominated by white men, she represented the changing face of American medicine and the importance of diverse perspectives in public health leadership. Her personal background—having overcome childhood illness, immigrated from Puerto Rico, and worked her way through medical training—gave her credibility with communities often left out of health policy discussions.
From the start of her tenure, Dr. Novello focused on issues affecting vulnerable populations, particularly children, women, and minorities. She understood that health disparities along racial and economic lines were not inevitable but rather the result of policy choices, lack of access to care, and systemic inequalities. Her mission was to use the Surgeon General's platform to address these disparities.
As Surgeon General, Dr. Novello launched major public health campaigns targeting issues that disproportionately affected children and adolescents. One of her primary focuses was combating underage drinking and smoking. She was particularly outraged by tobacco and alcohol companies' marketing strategies that targeted young people and minorities, using cartoon characters and celebrity endorsements to make deadly products appealing to children.
Dr. Novello publicly challenged R.J. Reynolds Tobacco Company over its Joe Camel advertising campaign, which used a cartoon camel to promote cigarettes. Research showed that children recognized Joe Camel as readily as Mickey Mouse, and that the campaign led to increased smoking among minors. Her vocal criticism and advocacy contributed to increased restrictions on tobacco advertising and eventually the elimination of cartoon characters from cigarette marketing.
She also pushed for warning labels on alcoholic beverages and restrictions on alcohol advertising targeting young people and minorities. Her efforts were controversial—the tobacco and alcohol industries had powerful lobbies and fought back aggressively. But Dr. Novello persisted, understanding that protecting children's health required confronting powerful economic interests.
The AIDS epidemic was reaching its peak during Novello's tenure as Surgeon General. Drawing on her NIH research experience with pediatric AIDS, she made HIV/AIDS education and prevention a priority. She worked to destigmatize the disease, educate the public about transmission and prevention, and ensure that women and children affected by AIDS received appropriate care and support.
Dr. Novello emphasized that AIDS was not just a disease affecting gay men—a misconception that had led to inadequate attention to women and children with HIV. She advocated for comprehensive sex education in schools, distribution of information about safe practices, and funding for AIDS research and treatment. Her work helped shift public health messaging around AIDS from judgment to compassion and from ignorance to education.
After completing her term as Surgeon General in 1993, Dr. Novello continued her public health career. She served as a special representative for health and nutrition at UNICEF (United Nations Children's Fund), working on global child health initiatives. From 1999 to 2006, she served as New York State Health Commissioner, overseeing public health programs for one of the nation's most populous and diverse states.
Throughout her career, Dr. Novello has received numerous honors including the Public Health Service Distinguished Service Medal, honorary doctorate degrees from multiple universities, and the James Smithson Bicentennial Medal from the Smithsonian Institution. Her legacy continues to inspire Latina women and girls to pursue careers in medicine and public health, showing that with education and determination, any barrier can be overcome.
Dr. Novello broke barriers as the first Latina and first woman US Surgeon General, championing children's health, combating tobacco and alcohol marketing to youth, and promoting AIDS education to save countless lives.
Dr. Antonia Novello's legacy transcends her historic firsts as the first Latina and first woman Surgeon General. She fundamentally shifted how America thinks about public health, emphasizing that health is a right, not a privilege, and that protecting children's health requires confronting powerful corporate interests that profit from addiction and disease.
Her campaigns against tobacco and alcohol marketing to children were groundbreaking. Before Novello, tobacco companies used cartoon characters and celebrity endorsements to make cigarettes appealing to young people. Her vocal criticism of the Joe Camel campaign and advocacy for advertising restrictions contributed to significant changes in how addictive substances could be marketed. Today's much stronger protections for children from tobacco and alcohol advertising owe much to the foundation she laid.
During the AIDS crisis, when fear and stigma surrounded the disease, Dr. Novello brought compassion and scientific clarity to public discourse. She insisted that AIDS was not a moral judgment but a public health challenge requiring education, prevention, and treatment. Her work helped shift the national conversation from blame to understanding, from fear to compassion, ultimately saving lives by reducing stigma and promoting prevention education.
For Latinas and Puerto Ricans, Dr. Novello represents proof that cultural background is not a barrier but an asset. Her personal story—overcoming childhood illness, pursuing medical education, and rising to the nation's top public health position—inspires countless young Latinas to pursue careers in medicine and public health. She showed that empathy born from personal struggle, combined with rigorous education and determination, can equip someone to lead at the highest levels.
Dr. Novello's focus on health equity—ensuring that all people, regardless of race, ethnicity, or economic status, have access to health services and protections—anticipated contemporary public health priorities. She understood that health disparities are not natural but result from policy choices and systemic inequalities. Her work laid groundwork for ongoing efforts to address social determinants of health and ensure health justice for marginalized communities. Every child who benefits from tobacco advertising restrictions, every person who receives compassionate AIDS care, and every Latina physician who sees Dr. Novello as a role model carries forward her legacy of health equity and compassionate leadership.