Tuberculosis in US Indigenous Communities: A Need for Public Health Prioritization

Indigenous communities continue to be confronted by health care challenges rooted in a history of colonization and forced displacement. This history is often reflected in less stable living conditions, fewer employment opportunities, lower income levels, and reduced access to food, water, and sanita...

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Bibliographic Details
Published in:American journal of public health (1971) Vol. 114; no. 2; pp. 149 - 151
Main Authors: Cilloni, Lucia, Dowdy, David W.
Format: Journal Article
Language:English
Published: United States American Public Health Association 01.02.2024
Subjects:
African Americans
American Indians
Black people
Clinical outcomes
Collaboration
Colonization
Community
Cultural competence
Cultural factors
Discrimination
Disease control
Disease prevention
Employment
Employment opportunities
Empowerment
Epidemics
Ethnic differences
Ethnic groups
Ethnicity
Food service
Health care
Health care access
Health disparities
Health services
Health Services, Indigenous
Health status
Healthy food
Hispanic Americans
Homeless people
Humans
Indigenous peoples
Living conditions
Low income groups
Marginality
Minority & ethnic groups
Minority groups
Native peoples
Pacific Islander people
Population Groups
Populations
Poverty
Public Health
Racial differences
Relocation
Sanitation
Sanitation services
Task forces
Tuberculosis
Tuberculosis - epidemiology
Tuberculosis - prevention & control
Canada
United States > US
Alaska
ISSN:0090-0036, 1541-0048, 1541-0048
Online Access:Get full text
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Summary:Indigenous communities continue to be confronted by health care challenges rooted in a history of colonization and forced displacement. This history is often reflected in less stable living conditions, fewer employment opportunities, lower income levels, and reduced access to food, water, and sanitation services. Geographic isolation, poverty, discrimination, and a lack of cultural understanding on the part of historical colonizers can create structural barriers to health care access among indigenous populations.1 Although racial and ethnic health disparities are increasingly recognized as a major contributor to poor health outcomes in the United States,2 the specific needs of indigenous communities are often underrepresented in efforts to address these disparities. As a result, members of Indigenous communities can experience health outcomes that are often worse even than those of other racial and ethnic minorities (e.g., Black and Hispanic Americans).One striking example of this structural neglect of Indigenous populations is seen in incidence rates of tuberculosis (TB).3 People Identifying as American Indian/Alaska Native (AI/AN) or Native Hawaiian/Other Pacific Islander (NH/OPI) have a TB risk that is more than twice as high as non-Hispanic Black Americans and more than 10 times higher than that of White Americans. These estimates may, in fact, underrepresent the magnitude of the underlying disparities, as multiracial and Hispanic AI/AN individuals have been systematically excluded from corresponding data sets (see Springer et al., p. 226 in this issue of (JPH).
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ISSN:0090-0036
1541-0048
1541-0048
DOI:10.2105/AJPH.2023.307544