The face of tuberculosis looks different across metropolitan Detroit. USA born Blacks in Detroit City with tuberculosis experience greater economic disadvantage and instability than those with tuberculosis outside of the City.

For the attention of: City public health departments, mayors of major cities, urban planners constructing neighbourhood environments, housing authorities.

The problem: Inequities in socioeconomic resources across metropolitan areas give rise to inequities in tuberculosis at large. Neighbourhoods that are already disadvantaged are more likely to see epidemics of tuberculosis. However, we know very little about the neighbourhood and social context of individuals with tuberculosis in the modern-day USA.

What we did and why: We did an in-depth survey of the social experience of individuals with TB across three areas in metropolitan Detroit. Using the survey data we were able to describe the social profile of individuals with tuberculosis and how they differed across geographic space with metropolitan Detroit.

What our study adds: This is the first in-depth survey of individuals with tuberculosis in current day USA. We explored differences in patterns within metro Detroit. We found that:

  • tuberculosis in Detroit City is concentrated among non-Hispanic Blacks and U.S.-born individuals,

  • non-Hispanic Blacks/USA born individuals, had higher levels of economic disadvantage and instability than those outside of Detroit City, or their White/foreign-born counter parts.

Implications for city policy and practice: More resources are needed to address neighbourhood level factors that promote the spread of tuberculosis such as crowded housing, degraded housing, little access to green space. To tackle the disease, cities also need comprehensive promotion of programs that improve housing conditions and give access to healthy foods.

Full research article: Making the invisible visible: the current face of tuberculosis in Detroit, Michigan, USA by Grace A. Noppert & Philippa Clarke.