What to know
Consistent with previous years, in 2023, tuberculosis (TB) disease disproportionally affected non-U.S.–born persons and persons from racial and ethnic minority groups in the United States.
Introduction
Some persons have an increased risk of being exposed to TB bacteria. These groups generally have higher rates of TB disease in their communities. In the United States, TB adversely affects groups that have historically experienced greater obstacles to health care.
CDC analyzes four demographic characteristics of persons with TB disease in the United States:
- Origin of birth
- Racial/ethnic identity
- Age
- Sex
Key findings
Origin of birth
Because of the substantially greater risk of exposure to TB bacteria outside of the United States, origin of birth is a prominent risk factor for TB disease in the United States. Most TB cases (75.8%) in 2023 occurred among non-U.S.–born persons.
In 2023, among non-U.S.–born persons with TB disease:
- 1,632 (22.4%) were diagnosed within the first year after arrival in the United States.
- 1,098 (15.0%) were diagnosed 1–4 years after arrival in the United States.
- 827 (11.3%) were diagnosed 5–9 years after arrival in the United States.
- 1,062 (14.6%) were diagnosed 10–19 years after arrival in the United States.
- 2,227 (30.5%) were diagnosed 20 or more years after arrival in the United States.
Compared with 2022, the incidence rate in 2023 among non-U.S.–born persons increased from 13.1 to 15.0 cases per 100,000 persons, a 14.6% increase, while the rate for U.S.-born persons increased by 7.5% when using unrounded numbers. In 2023, the incidence rate for non-U.S.–born persons was 18.5 times higher than for U.S.-born persons.
In 2023, the five most common countries of birth among non-U.S.–born persons with TB disease were the same as in previous years. These countries of birth accounted for almost half (47.6%) of U.S. TB disease cases among non-U.S.–born persons:
- Mexico (17.3%)
- Philippines (11.5%)
- India (7.9%)
- Vietnam (6.2%)
- China (4.7%)
Racial/ethnic identity
Some population groups have higher rates of TB disease in their communities. In 2023, 90.1% of TB cases occurred among persons who identified as racial and ethnic minorities in the United States.
During 2023, persons with TB disease in the United States identified as:
- Hispanic or Latino persons (36.8%)
- Non-Hispanic Asian persons (30.0%)
- Non-Hispanic Black or African American persons (17.6%)
- Non-Hispanic White persons (9.3%)
During 2023, TB incidence rates (cases per 100,000 persons) varied by race/ethnicity:
- Non-Hispanic Native Hawaiian or Other Pacific Islander persons, 22.6
- Non-Hispanic Asian persons, 14.0
- Hispanic or Latino persons, 5.4
- Non-Hispanic American Indian or Alaska Native persons, 4.4
- Non-Hispanic Black or African American persons, 4.0
- Non-Hispanic persons who identify with more than one race, 2.4
- Non-Hispanic White persons, 0.5
Age and sex
As in prior years, in 2023, TB disease incidence rates were higher among adults than among children less than 15 years of age. The risk of developing TB disease is high in young children infected with TB bacteria because of a weak immune system. The risk of developing TB disease increases with age because of age-related changes in TB exposure and medical risk factors.
During 2023:
- Persons aged 65 years or older had the highest TB incidence rate (4.3).
- Persons aged 5–14 years had the lowest TB incidence rate (0.6).
Consistent with previous years, persons reported to be male continued to represent the majority (62.3%) of persons with TB disease in 2023.
The percentage of persons with TB disease was greater for males compared with females for all age groups. However, the differences were smaller for children less than 15 years of age.
Male persons accounted for 55.8% of TB cases among persons less than 4 years old and 50.2% of TB cases among persons aged 5–14 years old.
Among persons 45 years of age and older, male persons accounted for 67.5% of cases among U.S.-born persons compared with 61.3% among non-U.S.–born persons.