HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Barr, R. G. Articles by Pablos-Méndez, A. Search for Related Content PubMed PubMed Citation Articles by Barr, R. G. Articles by Pablos-Méndez, A. Related Collections Community Health Tuberculosis Other Race/Ethnicity Socioeconomic Factors Immigration

R. Graham Barr, MD, MPH, Ana V. Diez-Roux, MD, PhD, Charles A. Knirsch, MD, MPH and Ariel Pablos-Méndez, MD, MPH

R. Graham Barr, Ana V. Diez-Roux, and Ariel Pablos-Méndez are with the Division of General Medicine, College of Physicians and Surgeons, Columbia University, New York, NY. Dr Barr is also with the General Medicine Division, Massachusetts General Hospital, Harvard Medical School, Boston, Mass. Dr Diez-Roux and Dr Pablos-Méndez are also with the Division of Epidemiology, School of Public Health, Columbia University, New York, NY. Charles A. Knirsch is with the Division of Infectious Disease, College of Physicians and Surgeons, Columbia University, New York, NY. Dr Pablos-Méndez is also with the Rockefeller Foundation, New York, NY.

Correspondence: Requests for reprints should be sent to R. Graham Barr, MD, MPH, Division of General Medicine, PH-9 East, Columbia-Presbyterian Medical Center, 622 W 168th St, New York, NY 10032 (e-mail: rgb9{at}columbia.edu).

Objectives. The resurgence of tuberculosis (TB) in New York City has been attributed to AIDS and immigration; however, the role of poverty in the epidemic is unclear. We assessed the relation between neighborhood poverty and TB at the height of the epidemic and longitudinally from 1984 through 1992.

Methods. Census block groups were used as proxies for neighborhoods. For each neighborhood, we calculated TB and AIDS incidence in 1984 and 1992 with data from the Bureaus of Tuberculosis Control and AIDS Surveillance and obtained poverty rates from the census.

Results. For 1992, 3343 TB cases were mapped to 5482 neighborhoods, yielding a mean incidence of 46.5 per 100 000. Neighborhood poverty was associated with TB (relative risk = 1.33; 95% confidence interval = 1.30, 1.36 per 10% increase in poverty). This association persisted after adjustment for AIDS, proportion foreign-born, and race/ethnicity. Neighborhoods with declining income from 1980 to 1990 had larger increases in TB incidence than did neighborhoods with increasing income.

Conclusions. Leading up to and at the height of the TB epidemic in New York City, neighborhood poverty was strongly associated with TB incidence. Public health interventions should target impoverished areas.

This article has been cited by other articles:

				M Baker, D Das, K Venugopal, and P Howden-Chapman Tuberculosis associated with household crowding in a developed country J. Epidemiol. Community Health, August 1, 2008; 62(8): 715 - 721. [Abstract] [Full Text] [PDF]

				S. Shin, M. Munoz, B. Espiritu, J. Zeladita, E. Sanchez, M. Callacna, C. Rojas, J. Arevalo, Ying Wu, A. Caldas, et al. Psychosocial Impact of Poverty on Antiretroviral Nonadherence Among HIV-TB Coinfected Patients in Lima, Peru J Int Assoc Physicians AIDS Care (Chic Ill), April 1, 2008; 7(2): 74 - 81. [Abstract] [PDF]

				Ming Wen, C. R. Browning, and K. A. Cagney Neighbourhood Deprivation, Social Capital and Regular Exercise during Adulthood: A Multilevel Study in Chicago Urban Stud, December 1, 2007; 44(13): 2651 - 2671. [Abstract] [PDF]

				C. C. Leung, T. H. Lam, W. M. Chan, W. W. Yew, K. S. Ho, G. Leung, W. S. Law, C. M. Tam, C. K. Chan, and K. C. Chang Lower Risk of Tuberculosis in Obesity Arch Intern Med, June 25, 2007; 167(12): 1297 - 1304. [Abstract] [Full Text] [PDF]

				E. J. Mueller and J. R. Tighe Making the Case for Affordable Housing: Connecting Housing with Health and Education Outcomes Journal of Planning Literature, May 1, 2007; 21(4): 371 - 385. [Abstract] [PDF]

				W. P. Myers, J. L. Westenhouse, J. Flood, and L. W. Riley An Ecological Study of Tuberculosis Transmission in California Am J Public Health, April 1, 2006; 96(4): 685 - 690. [Abstract] [Full Text] [PDF]

				K. E. Poundstone, S. A. Strathdee, and D. D. Celentano The Social Epidemiology of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Epidemiol. Rev., July 1, 2004; 26(1): 22 - 35. [Full Text] [PDF]

				A. L. Davidow, B. T. Mangura, E. C. Napolitano, and L. B. Reichman Rethinking the Socioeconomics and Geography of Tuberculosis Among Foreign-Born Residents of New Jersey, 1994-1999 Am J Public Health, June 1, 2003; 93(6): 1007 - 1012. [Abstract] [Full Text] [PDF]

				M. Clark, P. Riben, and E. Nowgesic The association of housing density, isolation and tuberculosis in Canadian First Nations communities Int. J. Epidemiol., October 1, 2002; 31(5): 940 - 945. [Abstract] [Full Text] [PDF]

				J. Krieger and D. L. Higgins Housing and Health: Time Again for Public Health Action Am J Public Health, May 1, 2002; 92(5): 758 - 768. [Abstract] [Full Text] [PDF]