Despite an overall decline in tuberculosis (TB) cases in the United States, a recent robust analysis of national TB surveillance data has unveiled enduring disparities in TB incidence rates among U.S.-born racial and ethnic minorities. The study, published in the Annals of Internal Medicine, attributes these disparities to structural racism within the healthcare system.
Conducted by researchers from Harvard T.H. Chan School of Public Health and the Centers for Disease Control and Prevention (CDC), the analysis focused on TB incidence rates among U.S.-born individuals from 2011 to 2021. While TB cases are predominantly observed among foreign-born individuals in the U.S., the study aimed to shed light on disparities within the native-born population.
The findings revealed stark discrepancies in TB incidence ratios among various racial and ethnic groups. Individuals identifying as American Indian/Alaska Native, Asian, Black, or Hispanic experienced TB incidence rates 4.4 to 14.2 times higher than non-Hispanic white U.S.-born individuals. These disparities persisted across gender and age groups, with females exhibiting greater relative disparities.
Dr. Maria Rodriguez, lead author of the study from Harvard T.H. Chan School of Public Health, emphasized the urgent need to address these disparities to achieve health equity goals.
“Structural racism within the healthcare system continues to perpetuate disparities in TB incidence rates among U.S.-born racial and ethnic minorities,” noted Dr. Rodriguez. “Addressing these disparities is essential for advancing health equity and achieving population-level TB elimination.”
The analysis underscored the importance of reducing barriers to TB prevention activities and ensuring equitable access to affordable and effective TB services. Efforts to accelerate progress toward TB elimination must prioritize vulnerable populations disproportionately affected by TB incidence disparities.
An accompanying editorial from Emory University echoed the study’s findings, emphasizing the potential implications for targeted TB prevention and control efforts at the city and state levels. The data provide valuable insights into the deployment of culturally sensitive approaches to TB screening and early case detection among high-risk groups.
Dr. Jamal Green, co-author of the editorial from Emory University, emphasized the critical role of healthcare practitioners in promoting equitable access to TB prevention and care services.
“Healthcare practitioners play a vital role in addressing TB disparities by advocating for culturally sensitive approaches to TB screening and early case detection,” stated Dr. Green. “By prioritizing equity and inclusivity in TB prevention efforts, we can work towards eliminating TB disparities and ensuring access to quality care for all individuals.”
The study’s publication in the Annals of Internal Medicine marks a significant step toward raising awareness of TB incidence disparities and advocating for targeted interventions to address structural racism within the healthcare system.
Journal Reference: Annals of Internal Medicine (2024). DOI: 10.7326/M23-2975