Pellagra, a nutritional disease with no known diagnostic skeletal indicators, affected patients in the Mississippi State Insane Asylum (MSA) between 1909 and 1936. The current study employed a sample of the MSA’s death-by-discharge records (N=3445) and a skeletal sample (N=19) from the MSA cemetery to test whether co-occurring alveolar bone loss and reduced bone remodeling in the skeletons can be associated with pellagra mortality in the records. Results of the study were inconclusive as to whether the co-occurring markers are associated with pellagra, but suggest that poor dietary conditions within the MSA, conditions prior to institutionalization, and age, sex, and duration in the asylum affected patients’ pellagra mortality outcomes. Future studies should employ larger skeletal samples to better understand pellagra’s effect on the skeleton. This study and the results of future studies may aid in relief efforts for refugee populations, who are at a heightened risk of developing pellagra.

This project employs a modified version of the Bioarchaeology of Care (BoC) in an analysis of Burial 1 from the Mississippi State Asylum, Jackson, MS. Burial 1 is a skeletal individual recovered from the historic MSA cemetery. Notably, Burial 1 exhibits recidivistic cranial trauma in the form of cranial depression fractures (CDFs) and significant entheseal changes in the upper extremities. However, because there is no identifying information associated with Burial 1, interpretations of the caretaking they may have received, both prior to and after institutionalization, include short- and long-term outcomes from their community and the MSA. Additionally, Burial 1’s CDFs and subsequent traumatic brain injury likely increased their risk of being institutionalized and created complications for them in the MSA. Despite the limitations of this study, future research applying a modified BoC could lead to otherwise unknown information about the lived experiences of institutionalized patients in historic institutions of care.