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BMC Public Health
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Tuberculosis | Research article

Understanding the intersection of race and place: the case of tuberculosis in Michigan

Authors: Grace A. Noppert, Philippa Clarke, Margaret T. Hicken, Mark L. Wilson

Published in: BMC Public Health | Issue 1/2019

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Abstract

Background

Race and place intersect to produce location-based variation in disease distributions. We analyzed the geographic distribution of tuberculosis (TB) incidence in Michigan, USA to better understand the complex interplay between race and place, comparing patterns in Detroit, Wayne County and the state of Michigan as a whole.

Methods

Using cross-sectional TB surveillance data from the Michigan Department of Health and Human Services, multivariable statistical models were developed to analyze the residence patterns of TB incidence from 2007 through 2012. Two-way interactions among the residence location and race of cases were assessed.

Results

Overall, Detroit residents experienced 58% greater TB incidence than residents of Wayne County or the state of Michigan. Racial inequalities were less pronounced in Detroit compared to both Wayne County and the state of Michigan. Blacks in Detroit had 2.01 times greater TB incidence than Whites, while this inequality was 3.62 times more in Wayne County and 8.72 greater in the state of Michigan.

Conclusion

Our results highlight how race and place interact to influence patterns of TB disease, and the ways in which this interaction is context dependent. TB elimination in the U.S. will require strategies that address the local social environment, as much as the physical environment.
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Metadata
Title
Understanding the intersection of race and place: the case of tuberculosis in Michigan
Authors
Grace A. Noppert
Philippa Clarke
Margaret T. Hicken
Mark L. Wilson
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-8036-y

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