Exploring biocultural determinants of intestinal health: Do resource access and parasite exposure contribute to intestinal inflammation among a preliminary sample of children in rural Mississippi?

Abstract

ObjectivesBiocultural perspectives combining methods and theories from biological and cultural anthropology are needed to better understand socioeconomic and race‐based health inequities in the United States. For example, the developmental trajectories of gastrointestinal health disparities based on embodied (i.e., internalized) inequities in resource access and environmental pathogen exposure are poorly understood. Here, we present a preliminary exploration of these relationships among 20 children (aged 3–14 years) from 12 families living in a low‐resource, predominantly Black, rural Mississippi community.MethodsRelationships between fecal calprotectin levels (FC; biomarker of intestinal inflammation measured from stool samples), BMI‐for‐age/Height‐for‐age z‐scores (calculated from standard anthropometric measures), household income/size (from parent interviews), and parasitic worm (helminth) infection status (detected in stool samples by 18 s rRNA gene amplification/sequencing) were tested using bootstrap linear regression and ANOVA/ANCOVA tests.ResultsAbout 80% of sampled children had clinically elevated FC (> 50 μg/g). BMI z‐scores (95%CI = −154.63; −7.34) and household income (95%CI = −135.90; −16.44) were negatively associated with FC levels. Household size was positively associated with FC levels (95%CI = 4.65, 101.61). Helminth infections were detected (n = 6), with positive associations between infection and the FC level (p < 0.05) that were likely driven by two infected children with very high FC levels.ConclusionThe high levels of intestinal inflammation in this small sample of children suggest that gastrointestinal health disparities may appear in childhood. We explore how these disparities may be related to inequities in environmental exposures, nutritional and socioeconomic status, and barriers to medical care and resource access.

Evidence and potential drivers of neglected parasitic helminth and protist infections among a small preliminary sample of children from rural Mississippi

“…However, recent soil analyses from public parks and private residences in the same Mississippi county sampled here found evidence of several more concerning nematode species, including Strongyloides stercoralis and both hookworm species (Blackburn et al, 2023), suggesting these are likely candidates for the nematode infections seen here (Blackburn et al, 2023); The study did not analyze potential platyhelminth presence. We also cannot speak to infection intensity, though very few parasite eggs were observed microscopically, suggesting low‐intensity infections (Cepon‐Robins et al, 2022).…”

“…Stool samples were collected, stored, shipped, and analyzed using 18s rRNA gene amplification and sequencing following previously documented methods (Cepon‐Robins et al, 2022).…”

From ancient pathogens to modern pandemics: Integrating evolutionary, ecological, and sociopolitical dynamics of infectious disease and pandemics through biological anthropology

“…Biocultural perspectives are needed to better understand how socially produced conditions of structural violence affect human development and disease risk and to identity new threats to public health in marginalized communities. Cepon‐Robins et al (2023) evaluate the physical health effects of helminth infections and gastrointestinal disease risk in a sample of Black American children and raises these threats to health as an under‐recognized public health concern in the US South. While gastrointestinal diseases are not considered to exist at pandemic levels, the systemic impacts of societal marginalization and government divestment in rural and lower income Black American communities raise concerns about the embodied consequences of poverty and long‐term exposures to polluted environments.…”

Dispensing with reductionism and dualism: Biological anthropological perspectives towards understanding disease, epidemics, and pandemics

“…The age of onset of respiratory disease, environmental contexts such as urban and rural settings, and varying nutrition, were key factors associated with mortality prior to, during, and after the 1918 flu epidemic in Newfoundland. Lastly, Cepon‐Robins et al (2023) show in their modern sample of 20 children that health outcomes, such as intestinal inflammation, helminth infection, and immune response, are strongly linked to complex environmental conditions—conditions brought on by systemic inequality that influence exposure to stressors and the body's response.…”