THE EFFECT OF DEVELOPMENT OF GEOGRAPHY, VITAMIN D, WEALTH, AND AGRICULTURAL PRODUCTIVITY ON TUBERCULOSIS MORTALITY: THE CASE OF THE 19TH CENTURY US

Tuberculosis remains a major cause of international mortality, and researchers and policy advocates continue to seek a cost effective prevention and treatment. To better understand the current dilemma, this paper considers the physical and material environments associated with 19th century US tuberculosis mortality. Vitamin D was an historical remedy for tuberculosis, and sunlight-the primary source of vitamin D production and time of year-are documented here to have been associated with lower tuberculosis mortality rates. Occupations were also related with the physical environment and tuberculosis mortality, and workers in outdoor occupations, such as farmers and unskilled workers, were less likely than workers in other occupations to die from tuberculosis. Absolute wealth and agricultural productivity were associated with the likelihood of dying from tuberculosis, and people who lived in high wealth and low agriculturally productive states were less likely to die from tuberculosis.