2003 Surveillance Slides

Slide 8: TB Case Rates by Race/Ethnicity, United States, 1993-2003.  This slide shows the declining trend in TB rates by race/ethnicity during the last 11 years.  Asians and Pacific Islanders had the highest TB rates, which declined from 44.5 per 100,000 in 1993 to 28.3 in 2003, and had the least percentage decline over the time period (36%).  Rates declined by approximately 50% or more over the time period in the other racial/ethnic groups: among non-Hispanic black or African Americans from 29.1 in 1993 to 11.6 in 2003, among Hispanics from 20.6 to 10.3, among American Indians and Alaska Natives from 14.6 to 8.1, and among non-Hispanic whites from 3.6 to 1.4.  In 2003, the Asian and Pacific Islander race category includes persons who reported race as Asian only and/or Native Hawaiian or other Pacific Islander only.  Although these categories were reported separately beginning in 2003, they were merged for this slide to allow for continuity in reporting trends.

Several important factors likely contribute to the disproportionate burden of TB in minorities.  In foreign-born persons from countries where TB is common, TB disease may result from infection acquired in the country of origin.  In racial and ethnic minorities, unequal distribution of TB risk factors, such as HIV infection, may also contribute to increased exposure to TB or to an increased risk of developing TB once infected with M. tuberculosis.  However, much of the increased risk of TB in minorities has been linked to lower socioeconomic status and the effects of crowding, particularly among U.S.-born persons.