The 1906 Annual Report of the Department of Indian Affairs, submitted by chief medical officer Peter Bryce, highlighted that the "Indian population of Canada has a mortality rate of more than double that of the whole population, and in some provinces more than three times".[4]:97–98[46]:275 Among the list of causes he noted tuberculosis and the role residential schools played in spreading the disease by way of poor ventilation and medical screening.[4]:97–98[46]:275–276