The White Plague Returns · Episode 6 of 12 · 23 min
The U-Shaped Curve
In 1959 the United States declared it would finish tuberculosis off; then, as numbers fell, it stopped paying for the work. The sanatoria emptied, dedicated federal money vanished into broader grants, and after a national low in 1985 cases turned upward. A Newark physician named the pattern the U-shaped curve of concern, and the episode weighs whether shifting money away was neglect or sound stewardship.
Who's who
- Lee Reichman+1 more episodeNewark TB physician who named the U-shaped curve of concern
- Gordon MeadeDirector who announced the Trudeau Sanatorium's closing in 1954
- D. J. Burns AmbersonSanatorium board president who explained the decision to close
- James E. PerkinsNational Tuberculosis Association director who described choosing elimination over eradication
Where it happens
- Saranac Lake, New York+2 more episodesHome of the Trudeau Sanatorium, closed in 1954
- Arden House, New YorkSite of the 1959 conference setting the elimination goal
- Newark, New Jersey+1 more episodeBase of Reichman's TB work
- Harlem Hospital Center, New York+1 more episodeSetting of a 1988 TB patient study
Timeline
- December 1, 1954The Trudeau Sanatorium closes after seventy years
- 1959Arden House Conference on Tuberculosis adopts elimination as the goal
- 1985The national count reaches its low of 22,201 cases
- April 21, 1989Strategic Plan for the Elimination of Tuberculosis is published
- October 1991Reichman's U-shaped curve of concern editorial appears
- 1992National peak of 26,673 cases, about twenty percent above 1985
Still debated
Historians dispute when dedicated federal TB money ended and returned, and the 1981 block grants are better seen as part of the financing climate than as the act that defunded TB. How much of the rebound came from neglect versus HIV, immigration and social change remains a judgment.
