Confronting Structural Racism in the Prevention and Control of Tuberculosis in the United States

被引:12
作者
Asabor, Emmanuella N. [1 ,2 ]
Vermund, Sten H. [2 ,3 ]
机构
[1] Yale Sch Med, New Haven, CT USA
[2] Yale Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT USA
[3] Yale Sch Med, Dept Pediat, New Haven, CT USA
基金
美国国家卫生研究院;
关键词
structural racism; vulnerable populations; social determinants; health insurance; rural health; MASS INCARCERATION; PUBLIC-HEALTH; HOMELESSNESS; FRAMEWORK; RACE;
D O I
10.1093/cid/ciaa1763
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Tuberculosis incidence in the United States is declining, yet projections indicate that we will not eliminate tuberculosis in the 21st century. Incidence rates in regions serving the rural and urban poor, including recent immigrants, are well above the national average. People experiencing incarceration and homelessness represent additional key populations. Better engagement of marginalized populations will not succeed without first addressing the structural racism that fuels continued transmission. Examples include:(1) systematic underfunding of contact tracing in health departments serving regions where Black, Indigenous, and People of Color (BIPOC) live;(2) poor access to affordable care in state governments that refuse to expand insurance coverage to low-income workers through the Affordable Care Act;(3) disproportionate incarceration of BIPOC into crowded prisons with low tuberculosis screening rates; and(4) fear-mongering among immigrants that discourages them from accessing preventive health services. To eliminate tuberculosis, we must first eliminate racist policies that limit essential health services in vulnerable communities.
引用
收藏
页码:E3531 / E3535
页数:5
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