Dwellings, crowding, and tuberculosis in Montreal

Area of Science:

• Public Health
• Epidemiology
• Urban Planning

Background:

• Tuberculosis (TB) is historically linked to poverty.
• This association may be influenced by housing and neighborhood factors promoting disease spread.

Purpose of the Study:

• To investigate if dwelling, building, and neighborhood characteristics independently predict tuberculosis occurrence.
• To examine the role of residential density and crowding in TB incidence in a low-incidence urban setting.

Main Methods:

• Geocoding of active TB cases and control dwellings in Montreal (1996-2000).
• Linking case and control dwellings to municipal and Canadian census data (1996, 2000).
• Multivariate logistic regression analysis to assess associations between dwelling/neighborhood features and TB occurrence.

Main Results:

• TB cases were more likely in taller buildings (>5 stories), newer buildings (post-1970), and properties with lower resale values.
• Higher residential density (persons per room) and recent immigration were associated with increased TB occurrence.
• Dwellings on blocks with high lot coverage also showed a higher likelihood of TB cases.

Conclusions:

• Specific dwelling and building features, such as those in tall, new buildings with lower resale values, are independently associated with TB occurrence.
• Residential density, crowding, and characteristics of the built environment are significant factors in TB epidemiology.
• Findings highlight the importance of housing and urban planning in TB control strategies.