Date of Conferral

2023

Degree

Ph.D.

School

Public Health

Advisor

Tolulope Osoba

Abstract

Native Americans in the Northern Plains have a long history of tuberculosis (TB) infections. There is limited research on the causes of latent TB infections (LTBI) and TB in this population. The purpose of this quantitative study was to assess the relationship between latent TB and factors of homelessness, substance use, employment, living on a reservation, and active or latent TB among this population using the eco-social theory as the theoretical framework. Data from 146 TB cases of Native Americans living in the Northern Plains and diagnosed with TB from 1999 to 2019 were analyzed using chi-square tests that showed a relationship between LTBI and active TB disease. Binary logistic regression analyses showed no statistically significant association between the variables. Age was found to be significantly related to TB, with the odds of active TB decreasing and the odds of latent TB increasing as the study population grew older. The study outcomes could inform the development of policies, processes, and educational resources geared toward decreasing the public health burden of TB among Native American populations. This would refocus TB prevention and treatment programs on the social conditions and inform how public health programming addresses every TB case using a three-pronged approach: public health, medical, and socioeconomic. The potential positive social change that could result is due to the use of the three-pronged approach which could reduce health disparities and increase awareness of TB risks and potential strategies for risk avoidance in marginalized groups.

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