Slide 8. TB Case Rates by Race/Ethnicity, United States, 1993–2008. This slide shows the declining trend in TB rates by race/ethnicity during the last 16 years. Asians and Pacific Islanders had the highest TB rates, which declined from 44.1 per 100,000 in 1993 to 25.3 in 2008, and had the smallest percentage decline over the time period (43%). Rates declined by at least 57% over the time period in the other racial/ethnic groups: among non-Hispanic blacks or African-Americans, from 28.5 in 1993 to 8.8 in 2008 (69%); among Hispanics, from 19.9 to 8.1 (59%); among American Indians and Alaska Natives, from 13.9 to 6.0 (57%); and among non-Hispanic whites, from 3.6 to 1.1 (69%). Since 2003, the Asian and Pacific Islander race category has included persons who reported race as either 1) Asian only or 2) 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 persons who were born in countries where TB is common, TB disease may result from infection acquired in the country of origin. 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.