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. 2019 Feb;109(2):306-312.
doi: 10.2105/AJPH.2018.304816. Epub 2018 Dec 20.

Slowdown in the Decline of Tuberculosis Rates in California, 2000-2016

Alvaro Medel-Herrero  1 , Beatriz Martínez-López  1
Affiliations

Slowdown in the Decline of Tuberculosis Rates in California, 2000-2016

Alvaro Medel-Herrero et al. Am J Public Health. 2019 Feb.

Abstract

Objectives: To determine the impact of the 2007-2009 economic crisis on tuberculosis (TB) trends among California residents.

Methods: We analyzed available data from 4 different population-representative data sets. We used time charts, trend lines, and change-point detection tests during 2000 to 2016 to describe TB trends in California.

Results: We found statistically significant changes in California TB trends with the time of the onset of the economic downturn based on age-adjusted TB case rates and TB mortality rates, crude rate of TB hospitalizations, and self-reported TB. Change on TB incidence was especially apparent among racial/ethnic minority groups.

Conclusions: To our knowledge, changes in TB trends in the United States matching in time with the 2007-2009 economic crisis have not been previously reported. This study identified a slowdown in the decline of TB rates by 2007 to 2009 and provides new knowledge on TB trends that can be used to achieve California's goal of eliminating TB by 2040 and in the prevention and control of TB in the United States.

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Figures

FIGURE 1—
FIGURE 1—
Age-Adjusted Annual Rate of New Tuberculosis Cases per 100 000 Inhabitants for (a) All Residents, (b) Hispanics, (c) Asians and Pacific Islanders, (d) Whites, (e) African Americans, and (f) Native Americans: California, 2000–2016 Note. No available data for emergency department visits before 2005.
FIGURE 2—
FIGURE 2—
Tuberculosis Rates per 100 000 Inhabitants for (a) Crude Hospitalizations, (b) Crude Emergency Services, and (c) Age-Adjusted Mortality: California, 2000–2016
FIGURE 3—
FIGURE 3—
Self-Reported Tuberculosis Percentage Among California Hired Crop Workers: Fiscal Years 2000–2014
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