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A national study of socioeconomic status and tuberculosis rates by country of birth, United States, 1996–2005

Authors :
Olson Nicole A
Davidow Amy L
Winston Carla A
Chen Michael P
Gazmararian Julie A
Katz Dolores J
Source :
BMC Public Health, Vol 12, Iss 1, p 365 (2012)
Publication Year :
2012
Publisher :
BMC, 2012.

Abstract

Abstract Background Tuberculosis (TB) in developed countries has historically been associated with poverty and low socioeconomic status (SES). In the past quarter century, TB in the United States has changed from primarily a disease of native-born to primarily a disease of foreign-born persons, who accounted for more than 60% of newly-diagnosed TB cases in 2010. The purpose of this study was to assess the association of SES with rates of TB in U.S.-born and foreign-born persons in the United States, overall and for the five most common foreign countries of origin. Methods National TB surveillance data for 1996–2005 was linked with ZIP Code-level measures of SES (crowding, unemployment, education, and income) from U.S. Census 2000. ZIP Codes were grouped into quartiles from low SES to high SES and TB rates were calculated for foreign-born and U.S.-born populations in each quartile. Results TB rates were highest in the quartiles with low SES for both U.S.-born and foreign-born populations. However, while TB rates increased five-fold or more from the two highest to the two lowest SES quartiles among the U.S.-born, they increased only by a factor of 1.3 among the foreign-born. Conclusions Low SES is only weakly associated with TB among foreign-born persons in the United States. The traditional associations of TB with poverty are not sufficient to explain the epidemiology of TB among foreign-born persons in this country and perhaps in other developed countries. TB outreach and research efforts that focus only on low SES will miss an important segment of the foreign-born population.

Details

Language :
English
ISSN :
14712458
Volume :
12
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Public Health
Publication Type :
Academic Journal
Accession number :
edsdoj.bed71514d53340b489a4a1c1afd28726
Document Type :
article
Full Text :
https://doi.org/10.1186/1471-2458-12-365