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An ecological study of tuberculosis transmission in California

Author

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  • Myers, W.P.
  • Westenhouse, J.L.
  • Flood, J.
  • Riley, L.W.

Abstract

Objectives. We evaluated the association between ecological factors and rates of tuberculosis within California, using pediatric tuberculosis as an indicator of new transmission. Methods. Ecological variables such as racial/ethnic distribution, immigration level, education, employment, poverty, and crowding were obtained from the United States Census for each census tract in California. These data were incorporated into a negative binomial regression model with the rate of pediatric tuberculosis disease in each census tract as an outcome variable. Disease rates were obtained by geocoding reported cases. Subsections of the state (San Francisco and Los Angeles) were examined independently. Results. Census tracts with lower median incomes, more racial/ethnic minorities, and more immigrants had higher rates of pediatric tuberculosis. Other frequently cited risk factors such as overcrowding and unemployment were not associated with increased disease after adjusting for other measures. Risks were comparable across regions, but subtle differences were noted. Conclusions. The techniques used in this work provide a way to examine a disease within its social context. The results confirmed that tuberculosis in California continues to be a disease of poverty and racial/ethnic minorities.

Suggested Citation

  • Myers, W.P. & Westenhouse, J.L. & Flood, J. & Riley, L.W., 2006. "An ecological study of tuberculosis transmission in California," American Journal of Public Health, American Public Health Association, vol. 96(4), pages 685-690.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2004.048132_4
    DOI: 10.2105/AJPH.2004.048132
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    Cited by:

    1. Wenyi Sun & Jianhua Gong & Jieping Zhou & Yanlin Zhao & Junxiang Tan & Abdoul Nasser Ibrahim & Yang Zhou, 2015. "A Spatial, Social and Environmental Study of Tuberculosis in China Using Statistical and GIS Technology," IJERPH, MDPI, vol. 12(2), pages 1-24, January.
    2. Daniele Maria Pelissari & Fredi Alexander Diaz-Quijano, 2017. "Household crowding as a potential mediator of socioeconomic determinants of tuberculosis incidence in Brazil," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-13, April.
    3. Atikaimu Wubuli & Feng Xue & Daobin Jiang & Xuemei Yao & Halmurat Upur & Qimanguli Wushouer, 2015. "Socio-Demographic Predictors and Distribution of Pulmonary Tuberculosis (TB) in Xinjiang, China: A Spatial Analysis," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-22, December.
    4. Alex J Goodell & Priya B Shete & Rick Vreman & Devon McCabe & Travis C Porco & Pennan M Barry & Jennifer Flood & Suzanne M Marks & Andrew Hill & Adithya Cattamanchi & James G Kahn, 2019. "Outlook for tuberculosis elimination in California: An individual-based stochastic model," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-15, April.
    5. Maike Tahden & Juliane Manitz & Klaus Baumgardt & Gerhard Fell & Thomas Kneib & Guido Hegasy, 2016. "Epidemiological and Ecological Characterization of the EHEC O104:H4 Outbreak in Hamburg, Germany, 2011," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-19, October.
    6. Michael Greenwood & Watson Warriner, 2011. "Immigrants and the Spread of Tuberculosis in the United States: A Hidden Cost of Immigration," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 30(6), pages 839-859, December.

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