Pellagra is a form of malnutrition caused by a severe deficiency of niacin (also known as nicotinic acid or vitamin B3) in the diet. The disease affected thousands of Arkansans and other Southerners in the late nineteenth and early twentieth centuries.

Symptoms of pellagra can include lack of energy, outbreaks of red splotches on the skin, diarrhea, and—in extreme cases—depression, dementia, and even death. Pellagra is not contagious, and the condition can be reversed. The lethargic appearance of pellagra victims was also a symptom of two other diseases widely found in the South at the time, hookworm and malaria. These three contributed to the false stereotype of Southerners at this time as lazy.

Pellagra was first recognized as a disease in 1762 in Europe. It was first reported in the United States in Alabama in 1902, but studies suggest that it most likely existed in remote areas before that time. Because of the remote locations of many victims and poor recordkeeping at the time, the number of residents suffering from pellagra has never been clear, though several historical studies suggest that perhaps tens of thousands across the South suffered from the condition at one time or another. The intense poverty and lack of access to affordable medical care allowed the ailment to continue unabated.

Dr. Joseph Goldberger of the United States Public Health Service conducted the first field studies of pellagra in the United States starting in 1914. Goldberger conducted an experiment with himself and ten other volunteers at the Rankin farm of the Mississippi State Penitentiary in 1915. Eating a diet common to Southern poor (salt meat, molasses, and corn meal), six of the eleven eventually developed pellagra, while none of the inmates, used as a control group for the experiment, developed the condition. The same experiment proved that the condition was not contagious. His later studies showed that diet could eliminate pellagra and that occurrences were related to poverty. Many officials across the South, however, refused to acknowledge the depth of the problem of hunger in the South and took no significant action for years.

The Flood of 1927, which devastated Arkansas and other portions of the lower Mississippi River Valley, heightened pellagra awareness as food availability worsened and tens of thousands of people abandoned their homes. Though the Red Cross had set up camps for the survivors, camps were segregated by race, and food supplies were slow in coming, often withheld by white landowners in order to coerce African-American sharecroppers and migrant farm workers into repairing the flood damage. As a result, cases of pellagra flared across the affected regions to more than 50,000 as malnutrition worsened. In Arkansas alone, 657 people died from pellagra in 1927.

Yeast shipments quickly cured more than 4,000 cases across the South, prompting the Red Cross to heed Goldberger’s nutritional advice. In the late 1920s, the Red Cross conducted experiments in the Marked Tree (Poinsett County) area with powdered yeast to combat the condition. By 1937, researchers identified niacin as the key to pellagra prevention.

Niacin naturally exists in a wide variety of food products, including yeast, eggs, fish, green vegetables, and cereal grains. Niacin and B vitamins were quickly added to bread and other products. The Red Cross began distributing vegetable seeds to sharecroppers and tenant farmers. This, combined with campaigns through the U.S. Department of Agriculture and the Arkansas Department of Agriculture promoting better nutrition and agricultural diversification, greatly reduced the cases of pellagra. By 1938, the number of pellagra deaths in Arkansas had dropped to 184, and it continued to drop in ensuing years.

For additional information:
Barry, John M. Rising Tide: The Great Mississippi Flood of 1927 and How It Changed America. New York: Touchstone, 1997.

Hegyi, Vladimir. “Pellagra.” (accessed August 15, 2008).

Tindall, George B. The Emergence of the New South, 1913–1945. Baton Rouge: Louisiana State University Press, 1967.

West, Elliott, ed. The WPA Guide to 1930s Arkansas. Lawrence: University of Kansas, 1987.

Kenneth Bridges
South Arkansas Community College

Last Updated: 02/07/2014