Tuberculosis Essay Research Paper TUBERCULOSIS SummaryThis paper

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Tuberculosis Essay, Research Paper TUBERCULOSIS Summary This paper explores whether the incidence of tuberculosis (TB) is higher among low income people because they are less likely to seek medical care. It investigates two urban districts that compare in terms of race and income level, these being Harlem and West Central, USA. To determine the role of race and economic disadvantage in the incidence of tuberculosis in these geographic areas, ethnographic methods were used to analyze the information. It appears that there are significant race and class dimensions to the incidence of tuberculosis in these areas, but there are other confounding factors ? such as (human immunodeficiency virus) HIV and the times at which sufferers sought medical help. This study suggests that

there is a pressing need to improve our understanding of the socio-economic aspects of problems affecting public health, such as TB in the United States. Background i. Statement of the problem People in economically disadvantaged positions living in medically under-served communities are at an increased risk for tuberculosis. The disease does continue to be a barometer of poverty and race, but there are other significant factors associated with the incidence of TB. Studies in South Africa suggest that those qualified as black or coloured had significantly less access to health care, and thus stood less chance of being diagnosed than their white counterparts (Andersson 1990). Those in this disadvantaged condition tended to suffer disproportionately from other socio-economic

related medical factors, such as malnutrition and incidence of HIV/AIDS that are closely linked with the incidence of TB. The pattern is similar in other countries, including the USA. The problem in the United States is that there is limited population-based data on TB by social class (Lifson et al. 1999). There is even less data on the incidence of seeking 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 implications of social class and race for urban public health policy