This project documents associations between lifestyle variation, ecological factors, and community health in low-socioeconomic status (SES) regions of the United States. Our research explores the ways that lived experiences and environmental interactions become “embodied” (i.e., the process by which individuals literally incorporate their social and ecological circumstances into their biology). Embodiment may lead to long-lasting changes in immune function, growth, and development and alter human biology in ways that shape long-term health. Using this framework, the REACH study seeks to clarify how patterns of social and physical environmental interactions are embodied, resulting in health inequities.
We are especially interested in assessing the prevalence of Neglected Tropical Diseases, such soil-transmitted helminths (STH; i.e., intestinal parasitic worms found largely in low-income communities). Almost no attention has been devoted recently to STH infection in the U.S., with the last large-scale studies occurring in the 1970s/1980s. These past studies documented high STH prevalence in numerous regions of the Southern U.S. (e.g., upwards of 70% in some areas). There have been no follow-up studies to suggest that these infections have been reduced or eradicated.
This project is one of the first studies to reexamine STH infections in these regions, documenting both positive and negative health outcomes and determining specific lifestyle factors that increase likelihood of infection. This work has the potential to tremendously impact public health. In the U.S., these infections are likely to have the greatest health impact among the most vulnerable members of society, particularly those of low SES living in rural areas with limited access to medical care. Longitudinal research will also document the effects of climate change on STH exposure in the U.S.
Additionally, we are interested in the role microbiome composition and diversity plays in shaping child development and immune function. Microbes in the environment directly shape intestinal microbiome profiles, with implications for child nutrition, growth, immune regulation, and health outcomes (including potential interactions with STH species in the gut). Finally, this study also considers the prevalence of other infectious and chronic diseases, as well as childhood growth patterns and the health consequences of exposure to environmental agents (e.g., pesticides and fertilizers).