Blewett L A, Marmor S, Pintor J K, Boudreaux M
State Health Access Data Assistance Center, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
School of Public Health, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
Int J Tuberc Lung Dis. 2014 Apr;18(4):397-404. doi: 10.5588/ijtld.13.0279.
Tuberculosis (TB) is a significant public health issue, claiming 1.4 million lives worldwide in 2011. Using data from the 2009-2010 National Health Interview Survey, we examine variation in 'having heard of TB' (HTB) by global region of birth and health insurance status.
Cross-sectional analysis with bivariate comparisons and multivariate logistic regression to evaluate how adults differed in reported HTB, controlling for global region of birth.
HTB rates ranged from 63.4% of adults born in Asia to 88.6% born in Europe. Uninsured immigrants had the lowest rate of HTB, ranging from a low of 50.1% of uninsured adults born in Asia to 77.6% born in Europe and 90.8% of US-born uninsured adults. Longer length of time in the United States (>5 years) was significantly associated with increased likelihood of HTB, as did being of Asian race/ethnicity and being male. Those with private health insurance coverage had the highest rates of HTB.
To reduce persistent TB, public health program directors and policy makers must 1) recognize the variation in HTB by global region of birth and prioritize areas with the lowest HTB rates, and 2) reduce barriers to health insurance coverage by eliminating the 5-year ban for public program coverage for new immigrants.
结核病是一个重大的公共卫生问题，2011年在全球夺去了140万人的生命。利用2009 - 2010年美国国家健康访谈调查的数据，我们研究了按出生全球区域和健康保险状况划分的“听说过结核病”（HTB）的差异。
采用双变量比较和多变量逻辑回归进行横断面分析，以评估成年人在报告的HTB方面的差异，并控制出生全球区域。
HTB率从出生在亚洲的成年人中的63.4%到出生在欧洲的成年人中的88.6%不等。未参保移民的HTB率最低，从出生在亚洲的未参保成年人中的低至50.1%到出生在欧洲的77.6%以及在美国出生的未参保成年人中的90.8%。在美国居住时间较长（>5年）与HTB可能性增加显著相关，亚洲种族/族裔和男性也是如此。拥有私人健康保险的人群HTB率最高。
为了减少持续存在的结核病，公共卫生项目负责人和政策制定者必须：1）认识到按出生全球区域划分的HTB差异，并将HTB率最低的地区作为优先重点；2）通过取消对新移民公共项目覆盖的5年禁令来减少健康保险覆盖的障碍。
