Slide 8: TB Case Rates by Race/Ethnicity,
United States, 1993-2003. This slide shows the
declining trend in TB rates by race/ethnicity during the
last 11 years. Asians and Pacific Islanders had the
highest TB rates, which declined from 44.5 per 100,000 in
1993 to 28.3 in 2003, and had the least percentage decline
over the time period (36%). Rates declined by approximately
50% or more over the time period in the other racial/ethnic
groups: among non-Hispanic black or African Americans from
29.1 in 1993 to 11.6 in 2003, among Hispanics from 20.6
to 10.3, among American Indians and Alaska Natives from
14.6 to 8.1, and among non-Hispanic whites from 3.6 to 1.4.
In 2003, the Asian and Pacific Islander race category includes
persons who reported race as Asian only and/or Native Hawaiian
or other Pacific Islander only. Although these categories
were reported separately beginning in 2003, they were merged
for this slide to allow for continuity in reporting trends.
Several important factors likely contribute to the disproportionate
burden of TB in minorities. In foreign-born persons
from countries where TB is common, 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
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.