Tuberculosis is a health equity issue in California, with disproportionate impact on people born outside the US, and racial/ethnic minorities. In California, 80% of TB cases occur in people born outside the U.S., and most of these arise from progression of latent TB infection (LTBI), which could be treated to avoid TB disease. TB rates among Asians and Pacific Islanders are 19 times higher, and rates among Black and Latinx patients four to five times higher, than among White patients. TB Free California attempts to address these disparities by: 

(1) partnering with community organizations that serve racial/ethnic groups at high risk of TB infection, 

(2) working with federally qualified health centers to measure and improve their rates of LTBI testing and treatment, 

(3) to educate physicians about evidence-supported practices related to LTBI. 

Additionally, my work includes consultation on the California multi-drug resistant (MDR) TB service, and have ongoing research work on (1) treatment of patients with drug-resistant tuberculosis and (1) the management of immunocompromised patients with tuberculosis. Finally, my branch is currently involved in discussions as to how to leverage new/repurposed resources for COVID-19, such as intensive contact tracing and improved surveillance systems, into work towards TB elimination.