Delay in tuberculosis care: one link in a long chain of social inequities

Abstract

In public health teaching, tuberculosis (TB) has been a traditional example of how disease occurrence is determined by the triad agent, environment, host. And it has since long been standard textbook knowledge that there are strong socioeconomic determinants behind all three components: The agent is more prevalent and is spread more easily in conditions of crowding and poor hygienic conditions, and under these conditions several host factors are also more prevalent, such as malnutrition and alcoholism. In recent years another dimension has been added to the socioeconomic patterning of TB: An already very solid mass of research has highlighted the social and economic aspects of care and follow-up of patients with TB. A recent example of this research is the paper by Wang et al .1 in this issue of the journal, on differences in both patient's delay and doctor's delay in the diagnosis of TB, when comparing residents and non-residents (rural immigrants) in Shanghai. To put the work … Correspondence: email: Peter.Allebeck{at}ki.se