Current Trends Tuberculosis among Hispanics in the United States -- 1980

In 1980, 46 states, New York City, and Washington, D.C., reported 3,099 cases of tuberculosis among Hispanic persons; this figure represents 12.6% of the 24,662 cases in these areas that year. Four states did not submit data on Hispanic ethnicity.

Relatively more Hispanic than other patients were in younger age groups. Forty-nine percent of the Hispanic patients were 35 years of age, compared with 25% of other tuberculosis patients from these areas. The overall case rate calculated for Hispanics (23.2/100,000 population) was twice that for other persons (11.7/100,000). Among persons 35 years of age, the age-specific incidence of tuberculosis among Hispanics ranged from 2.7 to 4.2 times that for other persons (Table 1). About 62% of the Hispanic patients were males, a sex distribution comparable with that for other persons in these areas. The proportion of pulmonary cases among Hispanics and other persons did not differ significantly--85% and 86%, respectively.

Most of the Hispanic patients were concentrated in a few areas: California and Texas accounted for 42% and 26%, respectively, of the total (Table 2). Twenty-seven states and Washington, D.C., each reported 5 or fewer Hispanic patients with tuberculosis. In each of 5 southwestern states, Hispanic patients comprised over 25% of reported cases (Figure 1).

The tuberculosis case rate was higher for Hispanic persons living in cities with populations of 250,000 or more (25.4/100,000) than for Hispanic persons living elsewhere (20.6/100,000). Several cities reported a large number of cases among Hispanics (Los Angeles, 340; New York, 260; Houston, 135; Chicago, 112; San Antonio, 85; Miami, 78; El Paso, 71; San Jose, 61; and San Diego, 54). Hispanic patients accounted for almost four-fifths of the reported cases in El Paso and almost two-thirds of the reported cases in San Antonio and Albuquerque.

Additional information on Hispanic patients was available from 10 states (Connecticut, Illinois, Indiana, Maine, Mississippi, Nevada, Oklahoma, South Carolina, Washington, and Wisconsin) and 3 large cities (Miami-Dade County, New York, and St. Louis). Of the totals reported for these areas, 569 (10.1%) of the 5,635 patients were Hispanic (ranging from 19% in Dade County to 1% in Mississippi, South Carolina, St. Louis, and Washington, D.C.). The place of origin for 305 (53.6%) of the Hispanic patients from these areas was outside the 50 states and Washington, D.C. Forty-three percent of the 260 patients for whom the year of arrival in the United States was known arrived after 1975. Reported by the Tuberculosis Control Div, Center for Prevention Svcs, CDC.

Editorial Note

Editorial Note: Information about the Hispanic ethnicity of patients with tuberculosis was collected for the first time in 1980. Data on race and ethnicity were collected in separate questions so that race-specific and ethnicity-specific rates could be calculated. Alternative methods of data collection that use, among others, the categories of "white, not Hispanic," "black, not Hispanic," and "Hispanic," do not permit calculation of race-specific rates.

The categorization of persons by ethnic group or race is difficult because precise boundaries for categories are difficult to define and are cumbersome. For the tuberculosis patients reported in 1980, states were requested to use the following guidelines: Hispanics are persons of Spanish origin, descent, or culture, regardless of race. Most persons of Mexican, Puerto Rican, Cuban, and Central or South American culture or origin are Hispanic; however, persons of Portuguese culture or origin are not, and persons from Brazil, Guyana, Surinam, Trinidad and Tobago may not be. When in doubt, the category that most closely reflects the individual's recognition in his/her community should be used for counting purposes.

This definition is consistent with federal guidelines concerning the collection of data on Hispanic persons and approximates the suggested definition of "Spanish Origin" used by the Bureau of the Census (1 t).

It has been suggested that these definitions are not appropriate because they include some European groups (e.g., Spaniards) and exclude some American groups (e.g., Brazilians); a different category, such as "Latin American," might be more appropriate for epidemiologic studies and other purposes (2 t). Nevertheless, the definition above permits a reasonably accurate estimate of the rates of disease among "Hispanic" persons. The data indicate that Hispanics presently are and likely will remain, for at least several decades, at significantly higher risk of having tuberculosis than most other persons in the United States.]lf2^

References

1. United States. Bureau of the Census. 1980 census of population and housing, United States summary. Final population and housing unit counts. (Advance Reports PHC80-V-1) Washington, D.C.: Bureau of the Census, U. S. Department of Commerce, April 1981; p3.

2. Hayes-Bautista DE. Identifying "hispanic" populations: the influence of research methodology upon public policy. Am J Pubic Health 1980;70:353-6.

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