Health Disparities in TB
CDC Health Disparities and Inequalities Report – United States, 2013
The CDC Health Disparities and Inequalities Report — United States, 2013, highlights differences in mortality and disease risk for multiple conditions related to behaviors, access to health care, and social determinants of health – the conditions in which people are born, grow, live, age, and work. The report looks at disparities in deaths and illness, use of health care services, behavioral risk factors for disease, environmental hazards, and social determinants of health.
Racial and Ethnic Disparities
TB adversely affects groups that have historically experienced greater obstacles to health based on their racial or ethnic group. Since 1993, TB case rates in the United States have declined in almost all racial and ethnic groups; however, persistent disparities still exist. In other words, the percentage of TB cases that occur in Hispanics, blacks or African Americans, and Asians is higher than expected based on the percentage of these minorities in the U.S. population. In 2012, about 84% of the TB cases reported in the United States were in racial and ethnic minorities. The percentage of cases occurring in foreign-born persons increased to 63% of the national case total in 2012.
- Tuberculosis Cases, Percentages, and Case Rates per 100,000 Population by Hispanic Ethnicity and non-Hispanic Race: United States, 1993–2012
Certain comorbid medical conditions contribute to disparities in the rate of TB. Medical conditions such as diabetes, cancers, and HIV infection alter the immune system’s ability to fight TB germs. As a result, people with these medical conditions are more likely to develop TB disease if they are infected with TB germs.
TB rates vary by geographic location across the United States. While the total number of TB cases has steadily declined throughout the country, ten states and Washington D.C. accounted for more than 60% of all reported TB cases in 2012. CDC monitors these geographic differences and provides funds to support TB control efforts in all states, as well as certain metropolitan areas with high rates of TB.
- Tuberculosis Cases and Case Rates per 100,000 Population: Reporting Areas, 2012 and 2011
- Tuberculosis in the United States. National Tuberculosis Surveillance System Highlights from 2012
CDC surveillance efforts and research demonstrate TB disparities in relation to other factors such as age, housing insecurity, and incarceration.
Achieving Equity by Addressing Disparities
What CDC is Doing to Address Disparities in TB
CDC is committed to improving the health of people disproportionately affected by TB. To achieve TB elimination, ongoing efforts are needed to address the persistent disparities that exist. CDC is continuing to work on a series of projects designed to identify the underlying causes, as well as educate and raise awareness about health disparities in TB. This includes
- Collaborating with other national and international public health organizations to improve TB screening of immigrants and refugees, test recent arrivals from countries with high rates of TB, and improve TB control and prevention activities along the border between the United States and Mexico
- Launching a Spanish TB website that provides Spanish-language TB information on exposure, testing, and treatment;
- Developing culturally appropriate patient education materials in English and other languages;
- Working on projects designed to educate and raise awareness about TB in African-American communities;
- Compiling national reports of TB cases and TB case rates by gender, race and ethnicity, risk factors, and geographic location;
- Implementing a study to identify the socio-cultural, racial, and health system barriers specifically for African Americans with or at risk for TB;
- Continuing the work of two CDC research consortiums to examine more effective TB treatment options and to study the risks of TB among persons with comorbid medical conditions.
- TB in Blacks (fact sheet)
- TB in Hispanic/Latinos (fact sheet)
- Tuberculosis Facts: TB and HIV/AIDS (fact sheet)
- Epidemiology of Tuberculosis in Correctional Facilities, United States, 1993-2011 (slide set)
- Find TB Resources