Piedmont Sanatorium was a rest home for tubercular African Americans in Burkeville, Virginia from 1917 to 1965. It was the first facility of its kind ever to be established in the United States. The Sanatorium later became the site of Piedmont Geriatric Hospital. Influence of Tuberculosis Tuberculosis was the leading cause of death in the early twentieth century, accounting for one out of every 10 deaths. Those infected with the disease were isolated from society in sanatoriums. These self-contained communities became known as "waiting rooms for death." Piedmont Sanatorium was established circa 1917 in Burkeville, Virginia as a rest home for blacks suffering from tuberculosis. Concerns about the health of whites were what led to its construction. Segregation In the 1910s, as increasing urbanization began bringing whites and blacks into closer contact, Virginia health officials started compiling evidence of the "Negro Health Problem" - high disease, death, and maternal and infant mortality rates among blacks. Hard physical labor along with poor diet and sanitation contributed to the problem. Disease flourished in the crowded black neighborhoods, where garbage piled up, sewage went untreated, and running water was often nonexistent. Fearing that black child-care nurses, cooks, and laundresses might spread tuberculosis to white neighborhoods, the government began looking for ways to stamp out TB and other contagious diseases. At the time, the only treatment facilities for blacks were the Central State Hospital for Mental Diseases and the State Penitentiary. The Negro Organization Society, a grassroots advocacy association in Virginia, initiated discussions with the State Board of Health, and particularly Agnes Randolph. Agnes Dillon Randolph, a lifelong political activist and charter member of the Virginia State Association of Nurses, became concerned about the situation. To strengthen her political influence, Randolph rose to the position of Executive Secretary of the Virginia Anti-Tuberculosis Association. She lobbied the General Assembly to establish a sanatorium for Negro tuberculosis patients - the first ever in the United States. Although some legislators were reluctant to try such an unprecedented idea, in 1916, the legislature granted her request. The all-white Blue Ridge Sanatorium was established in 1920. The City of Charlottesville, Virginia actively sought to locate Blue Ridge within their community. Charlottesville paid $15,000 of the $32,000 required for the procurement of the property and funded Blue Ridge's water supply. Piedmont, in contrast, had to hire contractors to dig its well. Blue Ridge patients enjoyed access to University of Virginia