Intestinal infections take a heavy toll on impoverished Black communities that have out-of-date sewage systems. These infections often spread through contaminated soil and water and are among the most common diseases worldwide.
Though national infection rates remain unclear because of the absence of large-scale studies, our preliminary work in 2019 found that 38% of children sampled in a predominantly Black Mississippi Delta community had intestinal parasitic infections.
In a landmark May 2023 court ruling, the Biden administration found that Alabama’s public health department had discriminated against Black residents by denying access to adequate sanitation systems and imposed fines for resulting sewage issues.
This decision is being hailed by environmental justice advocates as a transformative environmental justice agreement that may increase public awareness of the ongoing health crisis that results from infrastructure neglect and associated pathogen exposure.
“This country’s neglect of wastewater infrastructure in majority Black communities, both urban and rural, is resulting in a hygienic hell for far too many people, a hell that climate change is only making worse,” Flowers said in a March 2023 interview.
Why Are There Still Parasites In The U.S.?
The story of parasite infection in the U.S. is two-sided.
On one hand, the U.S. has successfully controlled many parasite infections. Malaria is one of them.
In addition, advancements in sanitation infrastructure and household construction mean that many Americans do not generally have to worry about parasite infections.
But this national success is not complete, as demonstrated by the recent findings in low-income Black communities across the country.
Limited awareness of the continued threat posed by neglected intestinal infections has made it more difficult to identify and treat these diseases in the U.S. than in lower-income nations.
For instance, in many countries the drugs needed to treat hookworm infections cost mere cents, but in the U.S., where drug prices are unregulated by the federal government, these same medications can cost hundreds of dollars.
The recent court decision in Alabama represents an important step toward increased national recognition of the role intestinal infections play in perpetuating racial health inequities.
Increased awareness will ideally result in improved access to testing and treatment in affected communities. But more work is needed to assess the full extent of these infections across the U.S.
Even if medical treatment is accessible and affordable, vulnerable individuals are often reinfected, as these pathogens continue to spread through the environment. Structural changes are needed to break the cycle of infection and poor health.
Current federal investment in community infrastructure — including water quality — is encouraging but does not go far enough. Ultimately, a concentrated nationwide effort to update and maintain sanitation systems is the best way to finally halt infection transmission and support health equity across the U.S.