Sociocultural aspects of tuberculosis: a literature review and a case study of immigrant tuberculosis.

The resurgence of tuberculosis in recent years has obliged us to reconsider the existing explanations of the disease. Whereas biomedical literature tends to explain tuberculosis in terms of biological factors (e.g., bacterial infection), social scientists have examined various cultural, environmental, and politico-economic factors. In this paper, sociocultural approaches to tuberculosis are reviewed according to their emphasis on cultural, environmental, and politico-economic factors. Then how the public health establishment considers biological, cultural, environmental and politico-economic factors will be examined through a case study of immigrant tuberculosis. While public health facilities emphasize biological factors in the control of immigrant tuberculosis, an ethnographic study of tuberculosis among Chinese immigrants in New York City provides detailed contexts that illustrate the cultural, environmental, and politico-economic forces shaping tuberculosis and supports an emerging theorization of tuberculosis that encompasses a heterogeneous collection of factors. Finally, a number of implications for public health interventions will be discussed.