title: Aligning US health and immigration policy to reduce the incidence of tuberculosis.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Cross-sectional analysis with bivariate comparisons and multivariate logistic regression to evaluate how adults differed in reported HTB, controlling for global region of birth.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: State Health Access Data Assistance Center, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Blewett
authors.affiliation: School of Public Health, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
authors.forename: S
authors.initials: S
authors.lastname: Marmor
authors.affiliation: State Health Access Data Assistance Center, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
authors.forename: J K
authors.initials: JK
authors.lastname: Pintor
authors.affiliation: State Health Access Data Assistance Center, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
authors.forename: M
authors.initials: M
authors.lastname: Boudreaux
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004608:Eligibility Determination / Q000331:legislation & jurisprudence; D054242:Emigrants and Immigrants / Q000331:legislation & jurisprudence*; D004641:Emigration and Immigration / Q000331:legislation & jurisprudence*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000331:legislation & jurisprudence; D017057:Medically Uninsured / Q000208:ethnology / Q000331:legislation & jurisprudence; D008875:Middle Aged; D015999:Multivariate Analysis; D010353:Patient Education as Topic; D011050:Policy Making; D012111:Residence Characteristics; D014376:Tuberculosis / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control* / Q000635:transmission; D014481:United States / Q000453:epidemiology; D055815:Young Adult