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TB Notes 4, 2003
Consultation with African-American Organizations
The Advisory Council for the Elimination of Tuberculosis (ACET)
and CDC cosponsored a consultation with national nongovernmental,
African-American organizations and agencies whose programs could
have an impact on TB control efforts in the African-American population.
This was an initial step in addressing the disparity between the
TB case rates of African Americans and other US-born racial/ethnic
groups in the Southeastern United States. The consultation was intended
to raise awareness about the disparity, solicit support for eliminating
TB in US-born African Americans, and develop recommendations for
accelerating the decline in TB rates among US-born African Americans
in the Southeastern states.
The consultation, entitled “TB in America: Disparities in
the Southeast,” was held on May 13 and 14, 2003, at the Sheraton
Colony Square Hotel in Atlanta. Approximately 40 people attended
this consultation (not including observers from CDC). The participants
comprised a diverse group that included academicians, health care
providers, public health leaders, policy- and decision-makers, religious
and community leaders, state and local health department representatives,
and others who represent a broad spectrum of views.
Organizations Attending the ACET Consultation
Alpha Kappa Alpha Sorority, Inc.
American Medical Association
American Public Health Association
Bureau of Communicable Disease Control, Texas DOH
Chicago Department of Public Health
City of Atlanta Mayor’s Office
Denver Public Health Department
Division of Immigration Health Services, US Public Health Service
Federal Bureau of Prisons
Georgia Department of Human Resources
Georgia Division of Public Health
Georgia State Senate
HRSA/Bureau of Primary Health Care
Institute for Families in Society
Jackson (Mississippi) Medical Mall Foundation
Marion County (Indiana) Health Dept
Dept of Internal Medicine, Meharry Medical College
Metro Public Health Department of Nashville, Tennessee
N.W. Public Health District I, Mississippi
National Association of Black Social Workers
National Association of Community Health Centers
National Baptist Convention of America, Inc.
National Black Methodists for Church Renewal
NJMS National Tuberculosis Center
Office of Minority Health (DHHS)
Omega Psi Phi Fraternity, Inc.
San Francisco TB Control, SF General Hospital
South Carolina Department of Health
Substance Abuse and Mental Health Services Admin
University of Alabama-Birmingham
University of South Carolina
The first day of this consultation provided participants with an
overview of the TB problem and more specific information about TB
in African Americans. On the second day, participants were assigned
to smaller breakout groups and asked to develop specific recommendations
for accelerating the decline in TB rates among US-born African Americans
in the Southeastern states.
During the breakout sessions, the participants were asked a number
of predetermined questions that covered several major topics, including
level of community TB knowledge, how to increase awareness of the
TB problem, how to mobilize community resources, and how to enhance
relationships between TB control programs and African-American communities
in order to improve TB elimination activities.
The discussion groups identified a number of unmet needs and provided
important comments and specific recommendations for activities to
raise awareness and stimulate actions to address and reduce TB in
racial/ethnic minorities. The following is a summary of the needs
- Reframing TB disparities will be important in creating political
- Media and available technology need to be used for the dissemination
of information (realizing that some in the target population may
not use cell phones and computers).
- Communities and health departments must “come together”
to provide holistic care that addresses more than TB care.
- The private provider–public health disconnect must be
- Internal community issues that perpetuate and magnify communicable
diseases must be addressed locally.
- “Southeast” should be defined as the geographic
area where disparities are greatest and where there are enduring
historical influences of racism, discrimination, and exploitation.
- Strategies need to reflect knowledge of the environment in
which the TB patients live.
- Successful models (e.g., Mississippi) in the South exist and
key elements/best practices of those programs need to be disseminated.
- The African-American community needs to hear that TB is curable
and preventable, and not an inherited condition.
- The African-American community needs easier-to-understand educational
- Advocates for TB elimination need one-page fact sheets describing
the TB problem at the state and/or local level for presenters
of TB information and advocates to hand out to community and political
- CDC needs to do more evaluation of existing TB programs in
predominantly African-American communities.
- Notable figures are needed to advocate for TB elimination and
reduce the associated stigma.
- The community needs to become more outraged about the TB problem,
stop being so accepting.
- The consultants perceived a need to raise awareness among both
medical and legislative leaders regarding the TB problem and the
disparity among African Americans.
- A national advocacy group is needed to develop relationships
with a variety of groups.
- More publications on the disparity issue in the Southeast are
needed to help spread the word.
- Send TB experts to communities and community organizations
to speak about the problem and what we can do about it.
- Use a number of venues to get the message out, including public
service announcements, billboards, former patients, the National
Minority Health Education Network, media resources that have a
largely African-American audience, direct person-to-person (even
door-to-door) education, and local gathering points (churches,
shelters, emergency rooms, liquor stores).
- Seek out and partner with the private sector, CBOs, and other
organizations that serve the African-American community.
- Involve public school systems and form partnerships with historically
black institutions of higher learning.
- Health departments should strive to ensure that the racial/ethnic
composition of their staff is similar to that in the communities
- Place TB on the Secretary’s Health Disparities Report,
and on the agenda of the American Public Health Association conference.
- CDC should improve or establish relationships with a variety
of organizations such as the National Medical Association, the
Black Women’s Project, and African-American fraternities
- Improve the relationships between the health departments and
African-American communities. TB programs must acquire a better
understanding of black culture, maintain a level of respect for
the individual, evaluate and improve community access to TB services,
and create more community coalitions.
Since the consultation was held, work has continued on a number
of follow-up tasks. The first task was to develop and distribute
an executive summary that participants could use in their reports
back to their organizations. In addition, a final participant list
was sent to all attendees to facilitate communication between them.
On June 5, 2003, the results of the consultation were presented
to the full ACET committee. The next step was to advise ACET on
potential follow-up activities based on the recommendations made
at the consultation. An initial meeting has been held and recommendations
are currently being finalized.
In addition to these activities, many consultation participants
have been working on their own to inform others of the disparity
in TB rates. They have also asked CDC officials to report on the
disparity at their national and regional conferences. The National
Coalition for the Elimination of Tuberculosis (NCET) has invited
participants to join them. The consultants agreed to draft and co-sign
a letter to Secretary Tommy Thompson expressing their concern over
racial health disparities in TB among Americans.
—Reported by H. Dave Crowder, MPH
Div of TB Elimination