Tuberculosis: an increasing problem among minorities in the United States

Although the number of tuberculosis cases reported annually in the United States has decreased markedly during the past three and a half decades, the decrease among whites has been considerably greater than among nonwhites. As a result of this widening gap, nearly two-thirds of the cases reported in 1987 occurred in minority populations and, for the first time in history, the number of cases among blacks exceeded the number of cases among non-Hispanic whites. From 1985 to 1987, tuberculosis among blacks increased 6.3 percent and among Hispanics, by 12.7 percent, but it decreased 4.8 percent among non-Hispanic whites. Much of the increase appears attributable to tuberculosis occurring among persons infected with the human immunodeficiency virus (HIV). Although there are many obstacles to the elimination of the disease in minority populations, numerous strategies have been developed and are being implemented to address this situation.