300,000 families living in US-Mexico border towns face exposure to toxic stress

The study abstract, "Assessing Health Status and Housing Quality of Families Living in Model Subdivisions (Colonias) of the Rio Grande Valley," will be presented on Sunday, Sept. 17, at the American Academy of Pediatrics 2017 National Conference & Exhibition in Chicago.

"Colonias" are unincorporated, residential model subdivisions that can be found along the U.S.-Mexico border. Researchers conducted 63 surveys of these communities and conducted home visits to understand and document the experiences and conditions of families living there. Colonia dwellers are nearly exclusively of Hispanic ethnicity, the majority of whom are U.S. citizens, though mixed status families are common. There are many children growing up in these homes with nearly half (46 percent) of families in severely overcrowded environments. The neighborhoods had poor infrastructure including lack of water, electricity, paved roads, streetlights, adequate sewage, wastewater treatment, and trash collection. Ninety percent of those surveyed did not think their home could withstand natural disasters.

"As a pediatrician, I was saddened to witness the level of toxic stress the colonia residents and children had to endure," said lead researcher Pei-Yuan Pearl Tsou, MD, a pediatric hospitalist in Hoffman Estates, Ill. "But I was also extremely moved by their inspiring resilience and their active participation in our study as well as other community organizing efforts to take on these challenges."

Dr. Tsou and her colleagues found several manifestations of the negative health consequences of substandard housing within the homes that they visited. Almost all (97 percent) reported having pest problems and 50 percent have mold issues. Many residents feel socially isolated and never invite guests into their homes.

More than 82 percent of residents reported the presence of one or more chronic diseases within their household. Almost one-third of respondents rated their personal health as either fair or poor, which is over 3 times more often than the general U.S. adult population. When self-assessing their mental health, 35 percent of respondents rated it fair or poor, nearly 5 times more often than the noninstitutionalized adult U.S. population.

"Poor housing impedes all modes of self-care that are prescribed daily by primary care physicians throughout the world. We hope to shine a light on the inhumane realities that children and their caregivers are facing in the colonias," said lead researcher Reshem Agarwal, MD, a community pediatrician in Oakland, CA. "These children need public policies and interventions that help buffer the dangerous effects of poverty, and the first step is acknowledging that these communities are too often forgotten," she said.