Analysis Essay on Prevention of Tuberculosis Among Ethnic Minority Group in the London Borough of Newham

Introduction

Tuberculosis is an infectious disease that affects mainly the lungs and other parts of the body such as the brain, kidney or spine. It is caused by a bacteria referred to as mycobacterium tuberculosis and is spread from one person to another through inhaling the tuberculosis germs. These germs are usually propelled in the air when individuals with the untreated and active form of a tuberculosis cough, spits or sneezes (World Health Organization, 2013). Under the right conditions, tuberculosis is curable and preventable. However, despite this fact, the number of cases as increased intensely. It has even become a current public health issue around the world as well. Furthermore, tuberculosis has been categorized as the second largest world killer after HIV/AIDS (World Health Organization, 2016). The paper will analyze the epidemiology, demography and ethnicity of tuberculosis among the ethnic minority in the London borough of Newham. It will further discuss the social determinants of health and interventions and strategies that have been put up to deal with the illness. In the end, recommendations for the paper will be presented.

Epidemiology, Demography and Ethnicity of Tuberculosis among Ethnic Minority Group in London Borough of Newham

The UK has been ranked as 78th out of ninety-nine nations that are included in the WHO worldwide with mortality figures for tuberculosis. The death rate in the UK as a result of tuberculosis is higher than in the US. The region has continued to experience an increase in the number of tuberculosis cases from the mid-1980s. It has been reported that it is only in the lasts four years that the UK has begun to match the global trend for the decline in the rates of tuberculosis. From 2011 to the end of 2015, the rates of tuberculosis infection decreased from 8, 919 cases to around 6,000 cases annually (Public Health England, 2016). In London, the cases of tuberculosis have been reported to be quite high with most of them occurring in the large urban areas. The rates of tuberculosis in London were further reported to be more than three times the national average. In 2015, out of 5,758 cases of tuberculosis, 39% were in London. Furthermore, there were more than 40 incidents per 100, 000 people who suffered from high rates of tuberculosis in Londons boroughs. The east and northwest of London have been reported to have the highest rates and even numbers of tuberculosis. Also, most of the people were residents of Newham where 370 cases were reported. This accounted for 117 per 100, 000 population in 2012. In 203, there were 108.3 per 100, 000 cases. Males who were 20-30 years were the most affected in the group (Floyd et al., 2015).

The population of Newham was reported to be 332, 817 in mid-2015 that depicted an increase of 2.6% or 8, 495 in mid-2014 which were 324, 322. This increase in population was reported to be quite high as compared to other London boroughs. This population has been projected to continue rising in future (Office for National Statistics, 2015). According to Millet et al., (2013), most cases of tuberculosis have been linked to malnutrition, poverty, and overcrowding. In 2010, World Health Organization conveyed 8.8 million new occurrences of tuberculosis and 1.5 million bereavements. In the major cities, having a low income and living in deprived regions have also presented the highest occurrence of tuberculosis and its mortality rates as well.

Newham has been reported to have a tuberculosis rate eight times higher than the national average. Also, the rate of tuberculosis is also three times that of London. As such, this London borough is the most affected with the rates of tuberculosis being presently advanced than in some of the impoverished countries (Rickets, Anderson, and White, 2013). In 2015, the World Health Organization reported that there were 107 cases per 100,000 individuals with tuberculosis in Newham. This depicts a slight decline from 2011 which was 108 cases per 100, 000 people (World Health Organization, 2017). With the high rates of tuberculosis in London cities and urbanization areas such as Newham, it has been purported that this disease issue is urban-related.

Amongst people who were born in the UK, the highest rates of tuberculosis have been reported among the ethnic minority groups. The largest percentage of cases were among those of the Indian origin followed by white and Pakistani. Moreover, the highest rates of tuberculosis per 100,000 of the population were among the Indian, Pakistani and black ethnic groups (Public Health England, 2014). According to Pareek et al., (2016), the new immigrants and ethnic minorities have further been indicated to be vulnerable. This has been attributed to reactivation of latent infection when they are in the country. They have also been observed to acquire new infection due to the aspect of maintaining links with countries that are highly prevalent. For instance, they may visit regions such as rural Pakistan. The likelihood of tuberculosis reactivation is also increased when one has diabetes which is common among people from South-East Asia, and this includes the ethnic groups that have been previously mentioned.

A high number of people infected with tuberculosis in Newham were born outside the UK. The population has been estimated to be above 90%. 20% of this people are recent immigrants who entered the UK in a span of two years and 50% within five years (National Health Service, 2011). With these figures, the risk of tuberculosis transmission has been seen to be on the rise and in particular among the individuals from the ethnic minority group. It is also necessary to note that the country of origin where people came from recorded a rate of 96% of new tuberculosis cases. Furthermore, individuals who face social risk aspects are also at risks of being infected with tuberculosis. This entails people who are displaced, in prison or drug users. The elderly are also in this category of the ethnic minority likely to be at a high risk of being infected with tuberculosis. It is also necessary to note that the regions of Newham and Brent have been reported to have the highest rates of ethnic minorities and immigrants (Auguste et al., 2016).

According to Ricketts, Anderson, and White (2013), tuberculosis remains highly concentrated in most deprived populations in London. In 2013, 70% of the incidents were residents situated in the most disadvantaged regions. Also, nearly half of the population, around 44% were unemployed while 10% faced at least one social risk factor which was either drug or alcohol abuse, imprisonment or homelessness. The high rate of tuberculosis in Newham Borough has been seen to be higher among the ethnic minority group.

In 2013, 9% of tuberculosis patients in Newham were said to have at least one societal threat aspect. This was either mental health problems, alcohol or medication misuse and incarceration. Furthermore, one-third of this population had numerous risk factors. The patients who had social risk factors also experienced poorer forms of treatment outcomes (National Health Service, 2015). Besides Newham also records high death rates from tuberculosis than other boroughs. The rates are higher than the averages of London and England.

Social Determinants of Health

According to World Health Organization (2017), the social determinants of health are the situations where people are born, grow up or even work. It may also be their age and the broad set of forces and systems that shape their daily life. The systems and forces in place entail economic systems and policies, social norms, agendas of development and social policies as well as political organizations. The socioeconomic status has been purported to be a significant predictor of health outcome. This is, particularly at the population level. However, it does not explain the clinical results of a person exclusively.

The Index of Multiple Deprivation (IMD) has depicted Newham as being the third most disadvantaged indigenous power in London. All wards of Newham were categorized in the 20% most destitute in the country. Additionally, 8 of them were ranked in the 5% most deprived (Public Health England, 2014). On the other hand, the Office for National Statistics in the period of April-March 2011-2012 pointed out that the rate of unemployment in Newham was 14.6$. This was the highest in London as compared to other regions such as Tower Hamlets, Enfield, and London that had rates of 13%, 12.5% and 9.3% respectively (Office for National Statistics, 2015). According to Chirgwin (2013), most of the local authority homes in London have been depicted as not meeting the decent homes standards as compared to other parts of the country. Also, the share of non-decent households in Newham is advanced than the average in London. 27% of those in Newham do not meet the required standards. A large percentage of people in Newham also live in poverty. It is ranked as the 4th highest in London with poverty levels and 2nd highest in having unfit houses. In 2010, 18% of the homes in Newham were defined as being congested in comparison to 7.5 in London. Moreover, 2,710 families were living in temporary dwellings in the first quarter of 2011 which was a slight decline from 2010 which was 3,873.

The aspect of homelessness also has a significant effect on the health of the local population. However, this issue is not quite widespread in Newham. Being homeless depicts that one is more vulnerable to most of the agents that cause diseases. The number of people in temporary forms of accommodation has been reported to be quite high in Newham. It has a rate of 19.24 per 1000 households in temporary settings compared to an average of 11.05 in London (Office for National Statistics, 2015). Public Health England, (2014) has pointed out that there is a high rate of crime in the region as compared to London. 31 offenses per 1000 population have been reported in Newham which is lower than London at 23 per 1000. Besides 48% of the people in Newham have the perception that anti-social behavior is a problem. This rate is the highest of all London boroughs.

One of the major aspects that have resulted to tuberculosis being on the rise in the borough of Newham is due to poor housing conditions and meager diet as well. Living under these circumstances compromises the immune system. Furthermore, tuberculosis that was dormant in the body may also be activated causing the disease to take hold of an individual. Newham has been identified as constituting a significant percentage of individuals with tuberculosis and in particular the minority group. Regardless of the great proportion of tuberculosis at Newham borough, the incidence of the disease is greater among the minority ethnic group. It has been pointed out that approximately 90% of people suffering from tuberculosis are not born in the UK. Moreover, the occurrences of tuberculosis are ten times more among the ethnic minority as compared to the majority. Besides, most of the minority who live in Newham are in bad housing conditions hence increasing the risk of being infected (Pareek et al., 2016). As such, living in communities where people with tuberculosis live and especially in crowded housing results to increased risk regarding being exposed to Mycobacterium tuberculosis. The risk of exposure is also advanced if there is limited air movement in a space that is enclosed. On the other hand, poor access to healthcare is also another aspect observed in Newham. As such, the marginalized and most vulnerable groups of patients are at an increased risk of developing tuberculosis. Moreover, these people have...