Decline in tuberculosis among Mexico-born persons in the United States, 2000-2010.

BACKGROUND: In 2010, Mexico was the most common (22.9%) country of origin for foreign-born persons with tuberculosis in the United States, and overall trends in tuberculosis morbidity are substantially influenced by the Mexico-born population. OBJECTIVES: To determine the risk of tuberculosis disease among Mexico-born persons living in the United States. METHODS: Using data from the U.S. National Tuberculosis Surveillance System and the American Community Survey, we examined tuberculosis case counts and case rates stratified by years since entry into the United States and geographic proximity to the United States-Mexico border. We calculated trends in case rates over time measured by average annual percent change. RESULTS: The total tuberculosis case count (-14.5%) and annual tuberculosis case rate (average annual percent change -5.1%) declined among Mexico-born persons. Among those diagnosed with tuberculosis less than 1 year since entry into the United States (newly arrived persons), there was a decrease in tuberculosis cases (-60.4%), no change in tuberculosis case rate (average annual percent change of 0.0%), and a decrease in population (-60.7%). Among those living in the United States for more than 5 years (non-recently arrived persons), there was an increase in tuberculosis cases (+3.4%), a decrease in tuberculosis case rate (average annual percent change of -4.9%), and an increase in population (+62.7%). In 2010, 66.7% of Mexico-born cases were among non-recently arrived persons, compared with 51.1% in 2000. Although border states reported the highest proportions (>15%) of tuberculosis cases that were Mexico-born, the highest Mexico-born-specific tuberculosis case rates (>20/100,000 population) were in states in the eastern and southeastern regions of the United States. CONCLUSIONS: The decline in tuberculosis morbidity among Mexico-born persons may be attributed to fewer newly arrived persons from Mexico and lower tuberculosis case rates among non-recently arrived Mexico-born persons. The extent of the decline was dampened by an unchanged tuberculosis case rate among newly arrived persons from Mexico and a large increase in the non-recently arrived Mexico-born population. If current trends continue, tuberculosis morbidity among Mexico-born persons will be increasingly driven by those who have been living in the United States for more than 5 years.

Community built environment factors and mobility around senior wellness centers: the concept of "safe senior zones".

The authors investigated built environment (BE) factors in urban neighborhoods in DeKalb County, Georgia. Each volunteering, consenting senior was placed into one of two groups: walking tours outside, then discussions (n=37); and focus group discussions indoors about photographs of BE conditions potentially influencing mobility (n=43). The authors sought to identify BE factors-both real and perceived by participating seniors-related to their ability to walk around senior wellness centers in a healthy and safe manner. The authors focused specifically on available literature and pilot study data for their concept of "safe senior zones" around senior wellness centers serving urban communities in this article. They also characterized their study population regarding sociodemographic variables and doctor-diagnosed chronic diseases, and types of walking aids reported used to help prevent falls. Their results can inform future applied practice and research on traffic-related exposures and BE factors concerning seniors, and support policy and planning to benefit community environmental public health.