title: Did the 'Great Recession' produce a depression in tuberculosis incidence?
abstract: In 2009, the United States experienced a record drop in its tuberculosis (TB) case rate, coinciding with a major economic downturn. To investigate this relationship, we modeled short-term changes in gross domestic product, unemployment, and immigration as predictors of TB incidence. We also correlated each state's 2009-2010 change in unemployment with its 2008-2009 change in TB incidence. Although economic factors did not explain the decline, the 2009-2010 change in unemployment negatively correlated with incidence. We hypothesize that factors related to increased unemployment, such as diagnostic delay, may have played a role in the sudden drop in TB case rates.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina 27713, USA. david.p.holland@duke.edu
authors.forename: D P
authors.initials: DP
authors.lastname: Holland
authors.forename: A K
authors.initials: AK
authors.lastname: Person
authors.forename: J E
authors.initials: JE
authors.lastname: Stout
mesh_terms: D057210:Delayed Diagnosis; D057172:Economic Recession; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D059066:Gross Domestic Product / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D012959:Socioeconomic Factors; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*; D014478:Unemployment / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology