Anuj Bhatia


An observational retrospective study was conducted for tuberculosis (TB) cases between San Bernardino County (SBC), Riverside County, and the state of California from 1996 to 2004. A univariate comparison between San Bernardino County and California indicated a higher proportion of U.S. born cases in SBC. Additionally, it was found that San Bernardino had a higher proportion of non-injection drug using TB cases, compared with California in 1996. Further comparisons were made along country of birth between TB cases in San Bernardino County from 1993 to 2004. Notable differences were observed for injection drug use, non injection drug use, alcohol abuse, homelessness, incarceration in a correctional facility, certain age groups, occupations, and type of health care provider. A multivariate logistic regression analysis for San Bernardino County indicated that several factors influenced TB cases from inside the U.S. These included correctional facility residence, age, living in the desert region of San Bernardino County, and unemployment. Several notable factors were associated with people infected with TB who were born outside the U.S. These included Hispanic or non- Latino white race and unemployment. An additional logistic regression analysis, based upon drug use, resulted in a number of significant indicators. These included homelessness, incarceration in a correctional facility, abusing alcohol, U.S. birth, and working in an occupation classified as “other.”

Although this study supported the focusing of preventive methods towards certain sections of the population in San Bernardino County, more research is still needed. This would help to better understand the risk factors related to the onset of the disease as well as the preventive care measures that could effectively limit the incidence of TB within San Bernardino County as well as the state of California. Moreover, more detailed surveillance information within the Report of a Verified Cases of Tuberculosis (RVCT) form would contribute toward more clearly determining the indicative lifestyle factors related to TB cases in San Bernardino County.


School of Public Health

First Advisor

Lee Berk

Second Advisor

Larry Beeson

Third Advisor

Susanne Montgomery

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Tuberculosis; Tuberculosis -- prevention & control; Public Health; Health Behavior; Social Environment; Socioeconomic Factors; Life Style; Cross-Cultural Studies; Analysis of Variance.



Page Count

xii; 126

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives