Date of Award


Document Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Brenda Joly, Ph.D.

Second Advisor

Katherine A. Ahrens, Ph.D.


Tuberculosis Rates, Tuberculosis, New England


Purpose. The purpose of this study was to assess whether decreases in tuberculosis (TB) incidence have been followed by reductions in TB disparities in New England during 2011 and from 2014 to 2018.

Background. Tuberculosis is a potentially serious infectious disease which, without treatment, can be fatal. In the United States, 8,920 new cases were temporarily reported in 2019, showing a decrease of 1.1% from 2018. Similarly, TB incidence declined to 2.7 cases per 100,000 persons, accounting for 1.6% decrease from 2018 (CDC, 2020). Although this improvement, disparities in rates of tuberculosis disease between Whites and minority groups continue to grow (Noppert, Wilson, Clarke, Ye, Davidson & Yang, 2017). Among non-U.S.-born persons residing in the United States in 2019, the highest TB rate was observed among Asians (25.7 per 100,00), compared with 25.1 per 100,000 for Native Hawaiians/Pacific Islanders, 19.5 per 100,000 for blacks/African Americans, 10.2 per 100,000 for Hispanics/Latinos, 5.3 per 100,000 for American Indians/Alaska Natives, and 3.1 per 100,000 for whites (CDC, 2020).

Methods. To calculate TB rates, TB rates by race/ethnicity and TB rates by country of origin, we used TB case data from Centers for Disease Control and Prevention (CDC), Connecticut Department of Public Health (CDPH), Connecticut Health I-Team, Rhode Island Department of Public Health (RIDPH), and Vermont Department of Public Health (VDPH). We used rate ratios (RRs) to evaluate tuberculosis rate disparities.

Results. Although minority groups experienced decreases in TB rates, the study showed that RRs for minorities increased, compared with Whites. Similarly, RR for non-U.S.-born people increased, compared with U.S.-born individuals.

Conclusion. Overall Tuberculosis rates in New England declined during 2011 and from 2014 to 2018 while tuberculosis disparities increased at the same period. Asians experienced the greatest disparity followed by Blacks and Hispanics, compared with Whites. Non-U.S.-born people had a greater TB disparity, compared with U.S-born people.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.