Academic journal article Journal of Cultural Diversity

Differential Tuberculosis Deaths among a Late Nineteenth and Early Twentieth Century New York City Population: An Analysis of Death Certificate Data

Academic journal article Journal of Cultural Diversity

Differential Tuberculosis Deaths among a Late Nineteenth and Early Twentieth Century New York City Population: An Analysis of Death Certificate Data

Article excerpt

Abstract: Purpose: This paper explores population substructure through an analysis of 8,691 individual death certificates representing a native-born New York City (NYC) population and a European Immigrant population who died from tubercular infection in Manhattan, NYC, 1890-1930. From the death certificate data, four classes of tubercular infection were derived: pulmonary, chronic pulmonary, acute/miliary tuberculosis, and tubercular meningitis. The United Nations classification system was used to categorize the European regions of birth listed on the death certificates resulting in four international regions of birth (Western, Northern, Eastern, and Southern Europe) and NYC. Using these data, the correlation between region of birth, age, sex, and the type of tubercular infection causing death was examined. Through a chi-square analysis, the data demonstrated that region of birth influenced the type of tuberculosis (TB) from which an individual died. An ANOVA test determined there was a significant relationship between mean age and type of tubercular infection, sex, and region of birth. The results of this analysis lead to the conclusion that: (1) historical vital records, specifically death certificate data, are useful when exploring tuberculosis variability among historical populations; and (2) these data may provide useful information when designing and implementing current policy to control and prevent TB.

Key Words: Disease Variability, Immigrants, Microethnic-Substructure

Tuberculosis (TB) is a non-discriminatory infectious disease primarily caused by Mycobacterium tuberculosis. As an illness of the respiratory system, an infected person can spread the bacteria into the air when coughing or sneezing. About 1.6 million people the from tuberculosis annually and the World Health Organization (WHO) (2007) identifies TB as a global emergency. In 2005, South East Asia accounted for 34% of the global incidence cases. The estimated incidence in sub-Saharan Africa is twice the rate of South East Asia with approximately 350 cases per 100,000 individuals. The number of new cases continues to rise each year (WHO, 2007). While many may be exposed to M. tuberculosis, of those exposed, less than fifty percent develop tubercular disease. This reflects both the variation in the virulence of the tubercle bacillus (Burgos & Pym, 2002; Caws et al., 2007) and an individual's immune response (Bellemy, 2000; Vasilca et al., 2004; Van Helden, Molle, Babb, & Waren, 2006; Gagneux et al., 2006; Caws et al., 2007; Schurr, 2007; Soborg et al, 2007).

Through an analysis 8,691 individual death certificates representing European Americans and European immigrants who died from tubercular infection in Manhattan, NYC between 1890-1930, this paper provides an analysis of micro-ethnic substructure within the macro-racial category white. It is hypothesized that regionally specific historical explorations of demography and epidemiology can provide preliminary insight into population substructure. These data can ultimately be aligned with the genetic record to assist current researchers discern human variability and identify disease risk (Seldin & Price, 2008). It is further hypothesized that historical and archival data collected during an era of endemic TB may prove useful to policy makers working to control and prevent TB outbreaks.

In this study, geography is central as individuals or groups living in a specific region are often descended from specific founding populations and exposed to similar environmental constraints (Jackson, 2004). For example, contemporary populations in New York City, NY, Oklahoma City, OK, and New Orleans, LA are the descendente of a set of regionally specific founding populations. Subsequent migrations are also regionally specific further contributing to the population's heterogeneity. These three cities are also located in different geographical regions of the United States each with its own historically specific ecological, political, social, economic and cultural environment. …

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