Neglected Parasitic Infections and Poverty in the United States
Dr. Peter Hotez discusses neglected tropical diseases in the United States in PLOS NTDs.
"NTDs have been shown to flourish in settings of warm climate and extreme poverty found in global subtropical regions similar to the southern US. Indeed, new information suggests that many of the world's NTDs occur predominantly among the extreme poor living in the group of 20 (G20) countries, mostly in in the subtropics, including Brazil, Indonesia, India, China, Saudi Arabia, and Mexico. It is now recognized that several neglected parasitic infections are also widespread in the southern US. This finding is consistent with new US census data indicating that 20 million Americans now live in “extreme poverty” , with 1.65 million households (with 3.55 million children) living on less than US$2 per day in a given month —a standard benchmark for global poverty. Today, the states with the highest poverty rates are all in the southern part of the country, and the nation's poorest large metropolitan area (McAllen-Edinburg-Mission, Texas) and the eight most impoverished smaller metropolitan areas are located in this region. While there are noncash safety-net programs, including food stamps and public health insurance, that blunt some of the hardship of those living in extreme poverty, there has still been a clear increase in the number of Americans living in poverty over the last 40 years. The underlying basis for why poverty promotes neglected parasitic infections in the southern US is unknown, although factors such as poor housing and sanitation and environmental contamination are likely contributors, while so far the links to ethnicity appear to be mainly socioeconomic. Through their chronic and disabling effects on worker productivity, child development, and maternal health, it is plausible that neglected parasitic infections could also help perpetuate generational poverty among people of color in the US."