The Incidence of Tuberculosis Among Low Income People

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ing medical care between the onset of symptoms and the visit to a medical center. The incidence of TB is indeed higher among low income people because they are less likely to seek medical care. But the objective of this study is to suggest that there are other critical factors in the complex social dimension of public health problems associated with TB. These will be discussed in parts iii and iv of this section.

ii. Literature review

During the 1980s and 1990s, there have been dramatic transformations in the epidemiology of tuberculosis in the United States (Bloch et al. 1996). As TB morbidity began to increase in 1985, after an all-time U.S. low, a significant number of studies were begun to explain the phenomenon. Some of the conclusions of this study will be based on the extensive current literature attempting to explain this recent increase in TB morbidity. Two of the most important factors have been the available evidence on HIV co-infection, and the incidence of TB among the foreign-born. Alan Block et al. (1996) have done an excellent exploratory study of this theme, entitled ‘The need for epidemic intelligence’. The study sends the powerful message to a U.S. audience of the importance of further research into the implications of race and social class in areas like urban health policy. This is particularly true in cases of the emergence of a multidrug-resistant tuberculosis (MDR TB).
Some work has also been done on the regional variations of TB in the United States that is of great value for studies like this one. For instance, Subroto Baerji et al. (1996) have researched and written a study entitled ‘Tuberculosis in San Diego County: a border community perspective’, which takes into consideration a population in transition and the effects on the incidence of TB in that district. Pappas Dievler (1999) has done a similar investigation of Washington D.C., specializing in the HIV/AIDS angle and the im...