Climate as a resource, disease as a device: the failure of public tuberculosis sanatoria in Colorado

Colorado was one of the few states to never create a state-funded tuberculosis (TB) sanatorium despite having among the highest TB mortality and incidence rates in the nation in the first decades of the twentieth century.This thesis explores two proposals for public sanatoria in Colorado: a municipal sanatorium in Denver in 1919, and a state sanatorium between 1931 and 1935.Both proposals failed.The prevailing ideology of environmental exceptionalism allowed government officials and residents alike to show disinterest in a public health response.The widespread belief that Colorado's climate was inherently curative attracted hundreds of thousands of consumptives to the state.Resultantly, residents and government officials attempted to reconcile paradoxical interests in promoting growth and preserving Colorado's image of health.These conflicting goals ultimately justified and sustained government inaction during the state's most significant contagious disease crisis to date.v Rsum: Malgr des taux de mortalit de tuberculose parmi les plus levs du pays au dbut du XXme sicle, le Colorado fut l'un des rares tats ne jamais tablir de sanatorium financ par des fonds publics.Cette thse explore deux propositions avortes de sanatorium publics dans le Colorado : un sanatorium municipal Denver en 1919, et un sanatorium d'tat entre 1931 et 1935.L'idologie dominante de l'exceptionnalisme environnemental permit aux reprsentants gouvernementaux et aux rsidents de se dsintresser d'une action de sant publique.La croyance rpandue selon laquelle le climat du Colorado tait curatif attira des centaines de milliers de tuberculeux dans l'tat.Rsidents et responsables politiques tentrent alors de concilier des intrts opposs : promouvoir la croissance tout en prservant l'image de sant du Colorado.Ces objectifs contradictoires ont finalement justifi et prolong l'inaction du gouvernement face la plus importante crise de maladies contagieuses de son histoire.New York City in 1889, the same year that circulars about the prevention of consumption began to be published.By 1897, twenty-four state health departments were distributing their own literature, and, following the inaugural International Congress on Tuberculosis in 1899, the first American Congress on Tuberculosis transpired in 1900. 2 Anti-tuberculosis initiatives, which primarily took place in the Northeast and Midwest, advocated for regulations like mandatory case reporting, municipal disinfection laws, and common cup bans in the late nineteenth and early twentieth centuries. 3 Yet to many, it was apparent that legislation alone was not enough.For those suffering from the disease, laws preventing the spread of tuberculosis did not offer relief from their condition, opportunities for employment, or financial aid.Therefore, in addition to general public health laws, states began to seek opportunities to treat citizens infected with TB directly. 4 The impetus to create institutions for tuberculosis treatment had begun in Europe decades earlier in the form of health resorts.At the beginning of the nineteenth century, wealthy consumptives travelled to places such as Nice and Egypt for respite from the disease. 5 It was believed that these mild climates were healthier due to extensive sunlight and more neutral weather, which were drawn in contrast to the tropics, perceived as deeply insalubrious.However, by the mid-century, experts had coupled these previous beliefs with the conviction that high-altitude places, such as the Swiss Alps, were the most advantageous locations for recovery.