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Despite prevention efforts, TB affects some groups of people more than others.
A health disparity is the occurrence of diseases at greater levels among certain population groups more than among others. Differences in rates of diseases, like TB, may occur by race or ethnicity, health conditions, and geographic location.
Social determinants of health are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. Social determinants of health like poverty, unequal access to health care, lack of education, stigma, and racism are linked to health disparities. For example, stigma around TB may deter people from seeking medical care or follow-up care if they are sick.
Some population groups have higher rates of TB disease in their communities. These groups are at higher risk of being exposed to TB germs.
In the United States, TB adversely affects groups that have historically experienced greater obstacles to health care.
Additionally, a range of social, economic, and demographic factors affect a person’s risk for TB disease.
In 2023, 90.1% of the TB cases reported in the United States occurred among persons who identified as racial and ethnic minorities.
In the United States, TB affects some racial and ethnic minority groups more than others, including:
Certain medicines or health conditions contribute to disparities in the rate of TB. Health conditions such as diabetes, cancer, or HIV infection weaken the body’s immune system. A weakened immune system lowers a person’s ability to fight TB germs. As a result, people with these health conditions are more likely to develop TB disease if they are infected with TB germs.
TB disease rates vary across the United States. Consistent with previous years, in 2023, four states accounted for half of all reported U.S. TB cases:
TB disease rates also vary around the world. Because of the substantially greater risk of exposure to TB germs outside of the United States, people who were born in or frequently travel to countries where TB is more common are more likely to be exposed to TB germs. In 2023, the TB incidence rate was 18.5 times higher among non-U.S.–born persons compared with U.S.-born persons.
People experiencing homelessness and people who live or work in correctional facilities are at increased risk for TB.
TB is a challenging disease to diagnose, treat, and control. Dwindling resources and loss of public health capacity, including access to care, and maintaining clinical and public health expertise, add to the challenge.
Communities affected by TB disparities face a number of challenges.
TB treatment takes several months to complete. Some people may not be able to, or want to take TB medicines for several months.
People with TB disease who do not take their medicine correctly could:
People with inactive TB (also called latent TB infection) do not feel sick, do not have symptoms, and cannot spread TB germs to others. People with inactive TB may not think treatment is a priority since they do not feel sick.
Without treatment, 1 in 10 people with inactive TB will get sick with TB disease. TB disease can spread to others and be deadly.
Socioeconomic factors can directly or indirectly increase a person’s risk for TB disease and make treatment difficult. These factors include:
Language barriers and cultural factors may also place certain populations at higher risk for TB. These include factors such as:
CDC is committed to improving the health of people disproportionately affected by TB by identifying the underlying causes of health disparities in TB and developing strategies to improve health equity.
Materials are available free of charge for order via CDC-Info On Demand Publications (see ordering instructions).
Tuberculosis is caused by bacteria called Mycobacterium tuberculosis. The bacteria usually attack the lungs but can attack any part of the body.
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