Tuberculosis in African-American and minority populations: historic epidemiology of a nonclassic contagious process.

This article analyzes recent medical research and health data on persistent and resurgent tuberculosis within America's African-American population and other racial minorities. Case studies and epidemiologic data suggest that the African-American and minority-American community's experience with tuberculosis control problems has diverged markedly from the nation's as a whole. The key variations include: (1) the historically higher tuberculosis incidence and mortality in African-American and other minority populations compared with whites, and (2) an emerging epidemiologic pattern of interaction between human immunodeficiency virus (HIV) and tuberculosis generally limited to African-American and minority populations. This trend results from the disproportionate spread of HIV disease in minority communities. There are new research needs in the fields of health policy theory, microbiology, molecular genetics, and behavioral sciences.