This study analyzed demographic differences and differential mortality between the Mississippi State Asylum (MSA) and the state of Mississippi. Using census records, Biennial Reports, death certificates, and vital statistics from the Mississippi State Board of Health, statistical methods including Kaplan-Meier survival analysis and Cox proportional hazard analysis were employed to explore significant differences in population demographics, hazard of death, and survivorship in general and with tuberculosis. Key results include proportionally more females in the MSA, increased hazard of death/decreased survivorship within the MSA compared to the State, and increased hazard of death/decreased survivorship for Black/AA individuals compared to their White/EA counterparts. This study demonstrates the intersectionality of sex, race, and institutionalization on survivorship and highlights the continued relevance of such issues in modern times, particularly regarding institutional treatment.

This study investigates frailty, defined as the accumulation of deficits in physiological functioning, by applying the Skeletal Frailty Index (SFI) to a skeletal sample (N=67) recovered from the Mississippi State Asylum (MSA), and in a comparative sample, the Terry Collection. The SFI was statistically modified to increase its utility here. Variables that influence frailty, including age, sex, stress in early-life, and resilience, were assessed relative to four SFIs: Overall, Nutritional, Activity, and Infection. This study finds that the predicted relationships between the SFIs and the aforementioned variables are largely absent in the MSA sample. When compared to individuals in the Terry, MSA individuals generally manifest a lower prevalence of biomarkers but have reduced longevity, which suggests that MSA patients experienced higher frailty and lower resilience. This may be attributable to negative biosocial experiences over the life course prior to institutionalization, but primarily to often-negative environmental conditions during institutionalization.