Tuberculosis and social stratification in South Africa

Int J Health Serv. 1990;20(1):141-65. doi: 10.2190/46PA-UDCA-4VXW-M94U.


Tuberculosis (TB) continues to be a barometer of poverty, determined by racial classification, in both town and countryside in the Republic of South Africa. Despite the fact that whites with the disease stand a greater chance of being diagnosed than their black counterparts, because they have very much better access to health care, the risks of TB for people classified by the state as black and colored are 27 and 16 times, respectively, the risk for whites. Black gold miners, the nutritional elite of the workforce, have also experienced an increase in TB rates. Tuberculosis accounts for 50 percent of all black compensation cases and some 2.5 percent of white cases. The risks of TB have increased over recent years among colored and blacks. Rates of tuberculous meningitis have also increased over the past decade, and show the dramatically worse health care available to people classified as black and colored. Although about 60,000 new TB cases are reported in the country each year, there have been cutbacks in the resources available for TB control and treatment.

MeSH terms

  • Adolescent
  • Adult
  • African Americans / statistics & numerical data*
  • Aged
  • Blacks
  • Child
  • Child, Preschool
  • Health Services Accessibility
  • Humans
  • Infant
  • Infant, Newborn
  • Middle Aged
  • Poverty
  • Residence Characteristics
  • Risk Factors
  • Social Class*
  • Socioeconomic Factors
  • South Africa / epidemiology
  • Tuberculosis / epidemiology*
  • Tuberculosis / etiology
  • Tuberculosis / mortality
  • Whites / statistics & numerical data*