Health Disparities in TB
Racial and Ethnic Disparities
TB adversely affects groups that have historically experienced greater obstacles to health based on their racial or ethnic group. The percentage of TB cases that occur in Hispanic or Latino, Black or African American, and Asian persons is higher than expected based on the percentage of these minorities in the U.S. population. In 2019, about 88% of the TB cases reported in the United States occurred among racial and ethnic minority groups. The percentage of cases occurring in people born outside of the United States was 71% of the national case total in 2019.
- Table 2. Tuberculosis Cases, Percentages, and Case Rates per 100,000 Population by Hispanic Ethnicity and non-Hispanic Race: United States, 1993–2019
Certain comorbid medical conditions contribute to disparities in the rate of TB. Medical conditions such as diabetes, cancer, 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. 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.
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;
- Maintaining 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 Black or 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 Black or African American persons 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.