Prevalence of Tuberculosis Among Asians in the United States

The relationship between race, genetics, health seems to be very hard to pinpoint. As stated in the lectures, the debate is skewed by social, political, and economic biases. There are some interesting things that can be learned from race and health, but people are sometimes too caught up in the implications that might come from research in linking race, genetics, and population health. The example that was brought up in class that I thought was very interesting was the correlation between sickle cell genes and the malaria in Africa. The adaptation of the people in the area is one that shows that selective pressures are a very real determinant of who survives in parts of Africa that have a high prevalence of malaria. There is a correlation between race and health, but it seems that lifestyle is a far better indicator of how healthy a person is. The example of the Pima Indians show that they are genetically predisposed to store fat and therefore have a higher prevalence of diabetes. This is also attributed to their body’s ability to store fat and use energy more efficiently, but there was also a large correlation of where they lived and their prevalence of diabetes. This shows that although the Thrifty Genotype Hypothesis can explain predisposition, it does not necessarily address why people of the same economic status get the same disease more often than not.

 

I chose to look at the amount of tuberculosis among ethnic groups in the United States. I was surprised to find that there was actually a larger amount of Asian Americans who had tuberculosis compared to any other ethnic group that was in the study. Rates for Asians were 19.8/100,000 and were almost four times more than the next leading race (blacks at 5.7/100,000). I do believe that the prevalence was greater amongst Asians because of genetic factors, but I also believe that it is important to factor in the living situations of the people that were considered in this test. The genetic factors do play a role in how susceptible someone is to a certain disease/disorder but it is also important to note how social and economic factors are a better indicator of having these conditions. The study that this graph was taken from discussed that the largest amount of people with tuberculosis came from low socioeconomic status and it was important to address the state of people from these areas. I chose to look at TB because it is something that has a very low incidence in America, but still has a disparity amongst different races within America.

Centers for Disease Control and Prevention. “World TB Day: New U.S. Data for 2012.” Centers for Disease Control and Prevention. http://www.cdc.gov/media/dpk/2013/dpk-world-tb-day.html (accessed July 9, 2014).

 

This Post Has 2 Comments

  1. Adam Feuerstein says:

    Sultan, I think you did an excellent job at evaluating the relationship between race, genetics, and health. I agree with your stance of information being skewed by social, political, and economic bias. It seems to be easy to find contradictory evidence on just about every study of a disease when looking at in from a different perspective. I also think that you are right in stating lifestyle is a good indicator on health for a person opposed to race.
    One thing I think would be interesting to add onto your TB study is to look at the difference races from their native country. I would be curious to see if the Asian rate of TB outside the United States is still more prevalent compared to different countries around the globe. This may allow you to see if it is truly a genetic disposition for TB or if it is due to geography. TB is so contagious that it may be localized to communities of people that live with others of the same race. I think you did a good job covering the points discussed in this weeks lectures.
    I do not personally think racial categories are very important overall in health disparities. I think health has much more to do with poverty level, lifestyle, and geographic location. I believing by changing these three aspects people may improve their health in many cases. I do realize however, that DNA plays a role in health and someone may be more likely to get a disease due to his or her genetics.

  2. Albert Tamayo says:

    Sultan, I chose to comment on your post because I believe you summed up the relationship between health, genetics, and race very well. I do not think you missed anything in your analysis and, like Adam, I also agree with your belief that lifestyle plays a more significant role in overall health than any other factor.

    In terms of the tuberculosis study in Asian populations within the United States, I too would like to see the TB numbers from the native country of each group. Getting this type of data would allow us to further study the significance of genetics in the expression of the disease versus the effects of various lifestyles in different countries.

    I do not believe that racial categories should be used in clinical studies as much as they are. I do believe they are helpful in determining predisposition to a point, but I firmly believe that the world is becoming such a mixture of blended races that predisposition will become harder to figure out as time goes on. I think a better way of describing health disparities between races would be to detail specific populations. For example, instead of saying a certain amount of African-Americans are susceptible for a given disease, perhaps the researchers can do a little more digging on their sample population and be more detailed in their data. An example of this would be saying African-Americans from west Kansas are susceptible a certain amount for the disease, while African-Americans from Detroit are susceptible another amount.

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