Tuberculosis Still Hits Indian Country Harder Than Anywhere Else in America

Native populations carry a tuberculosis burden that federal data confirms is preventable with culturally competent intervention.

CDC Data Shows TB Rates Among Indigenous Americans Are 12x the National Average

Between 2009 and 2019, tuberculosis incidence among American Indian and Alaska Native persons was on average 12 times higher than among White Americans, according to CDC researchers Yuri P. Springer and colleagues published in the Journal of Racial and Ethnic Health Disparities. A 2024 geographic disaggregation study by the same CDC team found that age-adjusted TB incidence among AIAN persons in Alaska was 21 times higher than among AIAN persons in other states, with 15.9% of AIAN households in tribal areas classified as overcrowded compared to just 2.2% nationally.

Comorbidities Compound the TB Crisis for Our Relatives

AIAN TB patients were 1.91 times more likely to have end-stage renal disease and 1.33 times more likely to have diabetes mellitus than White TB patients. The Indian Health Service SDPI program now requires TB screening among Native populations with diabetes because adults with both conditions face significantly higher risk of progressing to active TB disease. Stanford Prevention Policy Modeling Lab researchers estimated 18,000 excess TB cases resulted from racial and ethnic disparities, and eliminating those disparities among AIAN persons could reduce overall U.S.-born TB incidence by more than 60%!

TB Prevention in Indian Country

The CDC recommends targeted TB testing for individuals in high-risk communities, including those served by IHS facilities and tribal health programs. Native practitioners and elders understand that effective TB screening requires culture awareness and trust built over generations, not one-size-fits-all protocols shipped in from outside Indian Country.

Know the signs: a persistent cough lasting three weeks or longer, chest pain, unexplained weight loss, night sweats, and fatigue. If you or someone in your family experiences these symptoms, consult your healthcare professional at your nearest IHS facility, tribal health program, or community clinic. Early testing saves lives, and Our Relatives deserve every opportunity to catch this disease before it spreads.