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It is encouraging that the Collaborative TB control strategy for England 20152020 34 which is currently being updated, has given more pre-eminence to addressing social determinants of TB, including for example recommendations on closer collaboration between local authorities and health services to address socio-economic risk factors of TB, dedicated TB services for homeless and those attending substance misuse services, fast-track access to social care and accommodation for homeless for the duration of their treatment, continuity of TB care between prison and the community, and the systematic monitoring of social determinants of TB 34

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If researchers and policymakers believe that life expectancy is a primary measure of a nations health, immediate gains are likely to be achieved through investments in targeted public health efforts such as access to treatment for mental health and substance use disorders, firearm safe storage laws, limitations on hours of alcohol sale, and enhancement of community programs

Brown & Bick 1987, p

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