Socioeconomic Status and Tuberculosis

Socioeconomic status is responsible for the increased tuberculosis in ethnic/minority groups in the United States, according to the U.S. Centers for Disease Control and Prevention. Even after adjusting for age, sex, and country of birth, TB rates among ethnic minorities were five to ten times higher than Caucasians for the period from 1987 until 1993. According to Boyle and Key, racial and ethnic minorities have been disproportionately affected by TB since health statistics were first collected in the United States. Tuberculosis case rates among African-Americans and Asian/Pacific Islanders, for example, were approximately ten times higher, than those among whites from 1985 until 1992. Boyle and Key conclude that tuberculosis is more prevalent among ethnic populations, such as African-Americans and Asian-Asian-Americans, is due to conditions created by low socioeconomic status, rather than ethnic or racial factors.

O'Loughlin points out that a single ethnic group may demonstrate much or more variability in chronic disease than between ethnic groups. Asian and Pacific Islanders, for example, comprise as many as fifty ethnic subgroups, such as Japanese, southeast Asian, Hawaiian, Filipino, etc., with tremendous diversity in language, culture and health status. O'Loughlin believes that researchers and practitioners must be aware that categorizing such groups under a single label can mask the diversity that they should be trying to understand. She contends that "ethnic labels may provide guidance in targeting interventions or research efforts, but they do little to help us understand underlying causal mechanisms". She also suggests that labels such as white, Caucasian, black, European and Asian American have little biologic or anthropologic merit.