Public Health and Tuberculosis Mortality During the Framingham Tuberculosis Demonstration

Abstract

Between 1900 and 1940, tuberculosis moved from being the second highest cause of death in the United States to no longer being a leading cause of death. The historical causes of the decline in tuberculosis thus remain unclear. This paper examines the role of public health demonstrations in the decline in tuberculosis by studying the Framingham Community Health and Tuberculosis Demonstration, a public health demonstration conducted in Framingham, Massachusetts from 1917-1924. We measure the decreases in tuberculosis and infant mortality during the Framingham Demonstration using a linear regression model and the synthetic control model first used by Abadie and Gardeazabal (2003). The linear regression model finds that tuberculosis mortality decreased by approximately 22 deaths per 100,000 population and infant mortality decreased by approximately 11 to 14 deaths per 1,000 live births over the period of 1917-1923. The synthetic control model confirms these findings.