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 Hispanics, blacks or African Americans, and Asians is higher than expected based on the percentage of these minorities in the U.S. population. In 2015, about 87% of the TB cases reported in the United States were in racial and ethnic minorities. The percentage of cases occurring in foreign-born was 66% of the national case total in 2015.

Table 2. Tuberculosis Cases, Percentages, and Case Rates per 100,000 Population by Hispanic Ethnicity and non-Hispanic Race: United States, 1993–2015

Comorbid Conditions

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 and HIV Coinfection

Geographic Disparities

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.

Other Disparities

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 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.

Educational Resources

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, 1993-2014 (slide set)
Find TB Resources

Tuberculosis (TB)