Tuberculosis morbidity at Haskell Institute Boarding School for Native American youth, 1910–1940: Impacts of historical and existing social determinants of health

Objective To determine historical disparities in tuberculosis morbidity between Native American youth attending government boarding schools and the non-Native American population. Findings are placed within the context of documented health disparities in Native American populations, with implications for modern health. Methods Analysis performed on epidemiologic data from Haskell Institute in Kansas and corresponding statewide data for the years 1910–1940. Data on tuberculosis prevalence and enrollment for Haskell were collected via historical records. Tuberculosis morbidity rates were calculated, along with comparative tuberculosis morbidity for the state of Kansas. Results Tuberculosis rates at Haskell Institute were significantly higher than for the state of Kansas from 1910 to 1940. Conclusion Tuberculosis morbidity among Native American boarding school youth in the early 20th century was higher than among the general public. Entrenched social and historical determinants resulted in increased susceptibility to tuberculosis; these factors continue to cause increased rates of tuberculosis among Native Americans today.