Racial and Ethnic Disaggregation of Tuberculosis Incidence and Risk Factors Among American Indian and Alaska Native Persons-United States, 2001-2020.

Am J Public Health

Yuri P. Springer, Thomas D. Filardo, Rachel S. Woodruff, and Julie L. Self are with the Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA. Thomas D. Filardo is also with the Epidemic Intelligence Service, Centers for Disease Control and Prevention, National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, Division of Workforce Development, Atlanta, GA.

Published: February 2024

AI Article Synopsis

  • The study investigates how breaking down racial and ethnic data impacts the understanding of tuberculosis (TB) among American Indian and Alaska Native (AI/AN) populations in the U.S.
  • Analysis of data from 2001 to 2020 showed that TB incidence was significantly higher in non-Hispanic AI/AN alone individuals compared to the overall AI/AN group.
  • Differences in health risk factors were noted between non-Hispanic AI/AN and multiracial/Hispanic AI/AN individuals, indicating that not including the latter in studies could lead to misleading conclusions about health disparities.

Article Abstract

To examine impacts of racial and ethnic disaggregation on the characterization of tuberculosis (TB) epidemiology among American Indian and Alaska Native (AI/AN) persons in the United States. Using data reported to the National Tuberculosis Surveillance System during 2001 to 2020, we compared annual age-adjusted TB incidence and the frequency of TB risk factors among 3 AI/AN analytic groups: non-Hispanic AI/AN alone persons, multiracial/Hispanic AI/AN persons, and all AI/AN persons (aggregate of the first 2 groups). During 2009 to 2020, annual TB incidence (cases per 100 000 persons) among non-Hispanic AI/AN alone persons (range = 3.87-8.56) was on average 1.9 times higher than among all AI/AN persons (range = 1.89-4.70). Compared with non-Hispanic AI/AN alone patients with TB, multiracial/Hispanic AI/AN patients were significantly more likely to be HIV positive (prevalence ratio [PR] = 2.05) and to have been diagnosed while a resident of a correctional facility (PR = 1.71), and significantly less likely to have experienced homelessness (PR = 0.53) or died during TB treatment (PR = 0.47). Racial and ethnic disaggregation revealed significant differences in TB epidemiology among AI/AN analytic groups. Exclusion of multiracial/Hispanic AI/AN persons from AI/AN analytic groups can substantively affect estimates of racial and ethnic health disparities. ( 2024;114(2):226-236. https://doi.org/10.2105/AJPH.2023.307498).

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10862211PMC
http://dx.doi.org/10.2105/AJPH.2023.307498DOI Listing

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