300,000 families living in US-Mexico border towns face exposure to toxic stress
CHICAGO – Roughly 300,000 Texans living in impoverished border communities known as "colonias" are facing substandard housing, lack of resources and exposure to toxic stress. New research finds these communities are also ill-equipped to face a natural disaster.
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.
Tsou and Agarwal will present the abstract, available below, on Sunday, Sept.17, from 8:00 a.m. to 9:00 a.m. CT in McCormick Place West, Room W184.
Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal.
The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit http://www.aap.org.
Abstract Title: Assessing Health Status and Housing Quality of Families Living in Model Subdivisions (Colonias) of the Rio Grande Valley
Background: "Colonias" are unincorporated, residential model subdivisions that can be found along the US-Mexico border. The majority of colonias are located in Hidalgo County, Texas. Roughly 300,000 Texans live in these impoverished communities in substandard housing structures and neighborhoods with poor infrastructure including lack of water, electricity, paved roads, streetlights, adequate sewage, wastewater treatment, and trash collection. As there is a growing body of research around social determinants of health that helps to illuminate the correlation between housing and health, this study contributes to growing interest and research on the effects of the housing in the colonias. Objective: This study aims to assess the housing conditions within the colonias of Hidalgo County and to describe the mental and physical disease burden within the colonia population. Methods/Design: This study is community-based participatory research conducted using a 53-item survey consisting of multiple-choice, close-ended, and open-ended questions as well as in-person observations of housing and health conditions by research team members. Survey data was analyzed using descriptive statistics. Direct quotations from colonia residents and observational data gathered during home visits were summarized in the form of anecdotes and personal interpretation through the lens of healthcare professionals. Results: A total of 63 surveys were conducted. In assessing housing quality, survey respondents reported that their homes have poor weatherization and 90% of respondents did not think their home could withstand natural disasters. The average household occupancy is 5.17 (SD 2.55, range 1-13), and nearly half (46%) of families live in a severely overcrowded environment. Almost all (97%) reported having pest problems and 50% have mold issues. Of those surveyed, 31.7% never invited guests over to their homes. When examining the health status of colonia residents, 82.5% reported presence of at least one or more chronic diseases within their household and 38.1% reported presence of three or more. In self-assessing personal health, 36.5% of respondents rated their health as either fair or poor, more than 3 times as often as the general U.S. adult population. When self-assessing mental health, 35% of respondents rated fair or poor, nearly 5 times more often as the non-institutionalized adult U.S. population. Almost all (92.9 %) of the colonia residents felt that improving their housing conditions would improve their personal and their family's health. Conclusion: Key findings suggest that colonia residents live in substandard housing conditions characterized by overcrowding, poor weatherization, and mold and pest infestation. Their living conditions promote social isolation and correlate with significant disease burden and high rates of perceived poor physical and mental health. This data offers insights for local community organizations, health care professionals, and state-level policy makers as they develop strategies to promote improved housing quality and healthier living for the colonia residents.