3178.0: Monday, November 13, 2000 - 4:54 PM

Abstract #6736

Cultural and Structural Barriers in Tuberculosis Control with Immigrant Groups in Santa Clara, CA

Karen L. Smith, MD, MPH, Department of Public Health, TB Control Program, Santa Clara County, CA, Disease Control and Prevention, 2220 Moorpark Ave, San Jose, CA 95128, (408)885-4219, karen.smith@hhs.CO.Santa-Clara.CA.US and Diane A. Melendez, PhD, MPH, Consultant, 114 Tulare Street, Brisbane, CA 94005.

In Santa Clara County, CA, approximately 90% of TB cases occur in foreign-born individuals. Immigrants from Vietnam, the Philippines, and Mexico comprise the three largest patient groups. This paper will present the results of an anthropological study aimed at identifying cultural and structural factors that impact patient reactions to TB treatment programs. We will discuss how the challenges of the immigration/assimilation process form the context in which TB disease is experienced by the patient. In addition to ethnicity, other factors found to be important in influencing patient reactions to TB diagnosis and treatment include age, employment status, English-language proficiency, educational level, economic status, length of residence in U.S., living situation, and family support. Data will be presented from interviews with patients and physicians, and discussion groups with community members, and consider implications for providing culturally responsive care. We will discuss features of a “best practices” case management system that addresses the range of structural and cultural barriers faced by immigrants. We will describe public health outreach efforts to increase awareness of TB among high-risk immigrant groups and educational activities with community physicians to decrease delays in diagnosing TB.

Learning Objectives: At the conclusion of the presentation, the attendee for this paper will: 1. Know five cultural barriers experienced by immigrants with TB. 2. Know two structural barriers experienced by immigrants with TB. 3. Be familiar with one community education outreach method for TB. 4. Be familiar with one eduational outreach method with community physicians regarding the prompt diagnosis of TB. 5. Be familiar with one model of "best practices" for case management for patients with TB

Keywords: Tuberculosis, Immigrants

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA