Race, Migration and Tuberculosis :
Which Treatment Orientations for Which Patient ? Qualitative and Quantitative Response
Diagnosing a patient suffering from TB means that healthcare professionals must act not only for and with the patient, but also with the whole social group in which they is embedded (the history of the patient and their community, their geographical itinerary, past and present living environment, professional activities, migration paths, etc.). This need to pay attention to both the individual and the social justifies the importance of the sociological approach to health.
This post-doctoral research is based on a study of public health authorities to the Centres de Lutte Antituberculose (CLATs) in Lyon, France. In high-income countries such as France, the majority of TB burden is related to displaced individuals born in high-incidence countries, or to at-risk individuals such as prison inmates or other socio-economic precarious individuals. Around a hundred cases of TB are diagnosed each year in France, over 90% of them in patients foreign-born.
The success of the public health plan depends to a large extent on the dialogue between patient and healthcare provider. In order to shed light on the major, often silent, trends in public health policy for people with migrant backgrounds, this work takes a detailed look at the interactions between medical staff and patients. Based on interviews and observations, the numerous quantitative data produced by public health agents are closely observed to shed light on the following questions:
How are patients steered towards one type of treatment or another based on how they are racially perceived by medical staff?
What is the impact of this unilateral decision on patients' access to remission?
How do public health policies organize screening of target groups, care and treatment termination?