Tuberculosis on the move: the impact of immigration on TB rates in the counties of the Southwestern United States, 1987-1998

Abstract

What was the impact of immigration on TB prevalence rates in Southwestern US counties for the years 1987-1998, and what was the nature and degree of risk posed by infected immigrants? Research on this subject has presented immigrants as being homogenous in their demographic characteristics, although countries supplying immigrants can have very different rates of tuberculosis. Demographic factors such as immigration rates, crowded living conditions, poverty, and living in an urban environment, as well as ethnic and racial factors, are intimately linked to tuberculosis in the United States. This study used the two-factor disease ecology model and its recognition of physical and social contexts of disease, to allow a deeper investigation of the causes and manifestations of tuberculosis in the Southwest. Using a stepwise regression to fracture yearly tuberculosis rates at the county level into their component demographic characteristics allows investigation into the social factors linked to disease infection and transmission. This process revealed a strong link between net rate of immigration in a county and TB rates. Keywords: Immigration, Southwest, Tuberculosis