Health and Economic Outcomes of Racial and Ethnic Tuberculosis Disparities

Significant progress has been made in reducing tuberculosis (TB) incidence in the United States, achieving one of the lowest rates globally. However, racial and ethnic disparities remain among US-born individuals, with higher TB incidence and case-fatality rates observed in marginalized communities. These disparities stem from systemic health inequities influenced by social, economic, and environmental disadvantages.[1]

Data from the National Tuberculosis Surveillance System (NTSS) from 2010 to 2019 highlight the disproportionate TB burden among racial and ethnic groups. Of the 31,811 reported TB cases in US-born persons, Black individuals accounted for 38%, followed by Hispanic (21%) and White (32%) populations. Case-fatality rates were also disproportionately high, with Black individuals experiencing 42% of TB-related deaths. Limited access to prevention services, delayed medical care, and lower quality of healthcare contribute to these disparities.[1]

Projections for 2023-2035 estimate 26,203 TB cases and 3,264 TB deaths among US-born persons, with case-fatality rates increasing by 7% due to age-related factors. Nearly half of TB cases (45%) are expected to be linked to racial and ethnic disparities, with Native Hawaiian or Other Pacific Islander persons experiencing the highest proportion of disparity-associated cases at 75%. Black and American Indian/Alaska Native individuals will bear the greatest loss in quality-adjusted life years (QALYs), reflecting the severe health burden of TB inequities.[1]

The economic impact of TB disparities is substantial, with projected costs reaching $1.397 billion between 2023 and 2035. Racial and ethnic disparities will account for up to 66% of these costs, highlighting the urgent need for targeted public health interventions. Addressing these inequities through improved access to healthcare, early detection, and prevention strategies is critical to reducing TB incidence and ensuring health equity for all US-born populations.[1] 

References:

1. Swartwood, N.A., Li, Y., Regan, M., Marks, S.M., Barham, T., Asay, G.R.B., Cohen, T., Hill, A.N., Horsburgh, C.R., Khan, A.D. and McCree, D.H., 2024. Estimated Health and Economic Outcomes of Racial and Ethnic Tuberculosis Disparities in US-Born Persons. JAMA Network Open, 7(9), pp.e2431988-e2431988.