| Slide 8: TB Case Rates by Race/Ethnicity,
United States, 1992-2002.
This slide shows
the declining trend in TB rates by race/ethnicity during
the last decade. Asians and Pacific Islanders had the highest
TB rates, which declined from 46 per 100,000 in 1992 to
28 in 2002, but the least percentage decline over the decade
(40%). Rates declined more than 50% over the decade in the
other racial/ethnic groups: among non-Hispanic blacks from
32 in 1992 to 13 in 2002, among Hispanics from 22 to 10,
among American Indians and Alaska Natives from 16 to 7,
and among non-Hispanic whites from 4 to 2.
Several important factors likely contribute to the disproportionate
burden of TB in minorities. In foreign-born persons from
countries where TB is common, active TB disease may result
from infection acquired in the country of origin. In racial
and ethnic minorities, unequal distribution of TB risk factors,
such as HIV infection, may also contribute to increased
exposure to TB or to an increased risk of developing active
TB once infected with M. tuberculosis. However,
much of the increased risk of TB in minorities has been
linked to lower socioeconomic status and the effects of
crowding, particularly among U.S.-born persons.