Using Geographic Disaggregation to Compare Tuberculosis Epidemiology Among American Indian and Alaska Native Persons—USA, 2010–2020

Details

• Alternative Title:
  J Racial Ethn Health Disparities
• Personal Author:
  Springer, Yuri P. ; Kammerer, J. Steve ; Felix, Derrick ; Newell, Katherine ; Tompkins, Megan L. ; Allison, Jamie ; Castrodale, Louisa J. ; Chandler, Bruce ; Helfrich, Kathryn ; Rothoff, Michelle ; McLaughlin, Joseph B. ; Silk, Benjamin J.
• Description:
  Background
  
  American Indian and Alaska Native (AIAN) populations are frequently associated with the highest rates of tuberculosis (TB) disease of any racial/ethnic group in the USA. We systematically investigated variation in patterns and potential drivers of TB epidemiology among geographically distinct AIAN subgroups.
  
  Methods
  
  Using data reported to the National Tuberculosis Surveillance System during 2010–2020, we applied a geographic method of data disaggregation to compare annual TB incidence and the frequency of TB patient characteristics among AIAN persons in Alaska with AIAN persons in other states. We used US Census data to compare the prevalence of substandard housing conditions in AIAN communities in these two geographic areas.
  
  Results
  
  The average annual age-adjusted TB incidence among AIAN persons in Alaska was 21 times higher than among AIAN persons in other states. Compared to AIAN TB patients in other states, AIAN TB patients in Alaska were associated with significantly higher frequencies of multiple epidemiologic TB risk factors (e.g., attribution of TB disease to recent transmission, previous diagnosis of TB disease) and significantly lower frequencies of multiple clinical risk factors for TB disease (e.g., diagnosis with diabetes mellitus, end-stage renal disease). Occupied housing units in AIAN communities in Alaska were associated with significantly higher frequencies of multiple measures of substandard housing conditions compared to AIAN communities in other states.
  
  Conclusions
  
  Observed differences in patient characteristics and substandard housing conditions are consistent with contrasting syndromes of TB epidemiology in geographically distinct AIAN subgroups and suggest ways that associated public health interventions could be tailored to improve efficacy.
  
  
• Keywords:
  Alaska American Indian And Alaska Native (AIAN) Persons Disaggregation Health Disparities Substandard Housing Tuberculosis
• Source:
  J Racial Ethn Health Disparities.
• Pubmed ID:
  38334874
• Pubmed Central ID:
  PMC11310363
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:c55d9a41bb6ec680a082a74f5802bc83617a7bb848730611fe58fb52c0e1dc432bb4a63026f5d201c1a208f2685ef91d257d9cee2e64c62c6ba84abff5e711ef
• Download URL:
  https://stacks.cdc.gov/view/cdc/159782/cdc_159782_DS1.pdf
• File Type:
  [PDF - 985.72 KB ]