2003 TB Rates Remain High for Foreign-Born, Racial and Ethnic Minority Populations in United States Despite Overall Decline

TB rates declined in the United States in 2003, but significant geographic, racial and ethnic disparities remain, and cases have increased in some parts of the country. California, New York, and Texas accounted for more than 40 percent of the 2003 national case total.

TB rates among foreign-born individuals remain disproportionately high, nearly nine times the rate of persons born in the United States. Persons born outside the United States accounted for more than half (53.3 percent) of all new TB cases in 2003.

After more than a decade of falling rates, the rate of decline for persons with active TB in the country is slowing. New surveillance data for 2003 show that 14,871 persons with active TB disease were reported in the United States, comparable to the 15,075 cases reported in 2002.

Overall, the national TB rate was 5.1 cases per 100,000 persons in 2003, a slight decline of 1.9 percent in case rate since 2002. This is the smallest one-year decline since 1992.

Blacks remain at heightened risk for TB. National rates for non-Hispanic blacks are nearly eight times higher than rates for non-Hispanic whites and two times higher than rates for Hispanics.

CDC continues to work with partners to identify contributing factors and to develop strategies to eliminate existing disparities among racial and ethnic minorities, including demonstration projects to eliminate TB in African-American communities in the United States. CDC collaborates with domestic and international partners to assist countries with a high burden of TB. In addition, CDC is working to improve TB screening among applicants for immigrant and refugee visas.

For more information about CDC's TB elimination program or World TB Day activities, visit http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5310a2.htm or www.cdc.gov/nchstp/tb/worldtb2004.

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