The principle of nondiscrimination is fundamental to public health and human rights thinking and practice. Gender discrimination, for example, in addition to directly affecting vulnerability to TB and access to TB services, can deny girls and women access to education, information, and various forms of economic, social, and political participation that can increase health risk.
Limits on the authority of public health officials
The police power does not give public health officials unlimited authority. The U.S. Constitution (and state constitutions) shield individuals from excessive government intrusion. The constitutional protections most frequently invoked to limit the exercise of the public health police power are described below.7
Constitutional right to substantive due process
The Due Process Clause of the Fifth and Fourteenth Amendments to the U.S. Constitution prohibits federal and state governments from depriving individuals of ìlife, liberty, or property without due process of law. Life and liberty refer to individual self-determination, while property refers to an individualís economic interests. Due process has substantive and procedural components.
Substantive due process means an individualís right to demand that the government have an adequate justification for laws or other official actions that affect life, liberty, or property. In order to assess the adequacy of the governmentís justification, a court will evaluate the relative importance of the individual and governmental interests at stake. The criteria become more demanding as the individual interest at stake becomes more significant.
Tuberculosis (TB) is preventable and treatable but remains the world’s deadliest infectious-disease killer. Having infectious TB disease means that you can spread TB germs to others. In the last several years, the United States has reported the lowest number of TB cases on record, but too many people still suffer from TB. Even with decreasing numbers, TB continues to be a problem. While the number of TB cases in the United States has gone down, TB rates are still higher among persons in racial and ethnic minority groups compared with White persons. This is because certain racial and ethnic tuberculosisgroups are more likely to have TB risk factors that can increase the chance of developing the disease.
You should get tested for TB if:
» You have spent time with a person known or thought to have infectious TB disease.
» You were born in or frequently travel to countries where TB disease is common, including Mexico, the Philippines, Vietnam, India, China, Haiti, and Guatemala, and other countries where TB is common.
» You currently live, used to live, or are employed in a large group setting where TB is more common, such as a homeless shelter, prison, jail, or nursing home.
» You are a health care worker who cares for patients with TB disease.
» You are part of a population that is more likely to have latent TB infection (LTBI) or TB disease, including people who don’t have good access to health care, have lower income, or misuse drugs or alcohol.
In addition, children, especially those under 5, have a higher risk of developing TB disease once infected. Therefore, testing for TB infection in children who may have been exposed to a person with TB disease is important.
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