An ecological view of the risk factors for tuberculosis in the United States

Abstract


David Young* and Sheryl Strasser

There is scientific evidence of socio-demographic, behavioral and health risk factors associated with tuberculosis (TB) infection and TB disease. The primary objective of the study was to examine the correlation of TB risk factors at the state level in the United States (US) to obtain insights specific to the state of TB in the US. Secondary data from the centers for disease control and prevention (CDC) and US Census Bureau on line databases were used. Simple and multiple linear regressions were carried out. The model created to represent the TB rate by state included the percent of the population which was non-Hispanic white (p < 0.001), the AIDS diagnosis rate/100,000 (p = 0.067) and the percentage of the population which is foreign born. Per capita income, GINI, diabetes rates, smoking rates and alcohol abuse rates were excluded from the final model. Race/ethnicity acts as a marker for a number of risk factors, and the focus of the fight against TB in the US should be on minority communities, those populated by the foreign-born and those with high rates of AIDS particularly where a large degree of income inequality is present.

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