‘Toxic Stress’ Along America’s Southern Border Heightens Chronic Health Problems

Eighty-two percent of residents living in shantytowns along the US-Mexico border reported suffering from at least one chronic illness — three times the average among American adults.

For pediatrician Reshem Agarwal, a dead dog in the middle of the road symbolized the plight of the “colonias,” or shantytowns along the United States-Mexican border where poverty is widespread and public services are scarce.

“It had been dead for a while,” said Agarwal, who practices in Oakland. “There were flies around and it was rigid. There were kids playing nearby.”

Agarwal was co-lead researcher on a study of the colonias slated for presentation in Chicago on Sunday at the national conference of the American Academy of Pediatrics.

Composed of shacks constructed from salvaged items, mobile homes, and other dwellings, colonias have been around since the 1950s to accommodate low-income Mexican workers, according to the US Department of Housing and Urban Development.

Often crowded on illegally subdivided land and lacking running water, plumbing, electricity, paved roads, street lights, trash collection, and other comforts, more than 2,400 exist today along the border. Many homeowners in the colonias purchased or inherited their properties but often lack proof of ownership.

In Texas, where most colonias are located, around 300,000 people live in them. More than a third are children born in the US, according to Proyecto Azteca, a Texas community group that helped Agarwal and her colleagues conduct the research and published a report based on their findings earlier this year. Community for Children, a Texas group that promotes pediatricians working in impoverished communities, also helped finalize the study.

‘So many people told us they cry often, they feel so overwhelmed, they’re hopeless.’

Agarwal and her colleague Pei-Yuan Pearl Tsou, an Illinois-based pediatrician, conducted in-depth surveys with 63 colonia residents in Hidalgo County, Texas where the median income was around $14,700 in 2015. They worked as volunteers.

Agarwal and Tsou found that nearly everyone in their targeted community reported pest problems. Half struggled with mold in their homes. A whopping 82 percent reported suffering from one or more chronic diseases, and 35 percent self-assessed their mental health as fair or poor, which is nearly 5 times more often than noninstitutionalized adults in the US.

“So many people told us they cry often, they feel so overwhelmed, they’re hopeless,” said Agarwal.

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For Agarwal, the reasons for the residents’ pitiable lifestyle was clear. The people were living in developing world conditions in the richest country on Earth.

“What we saw in the colonias was so much toxic stress and the sheer struggle to survive,” she said. “We saw overcrowding that facilitates the spread of infector diseases. It’s very hard to maintain a basic level of hygiene in these spaces.”

What’s more, because many of the residents were Mexican citizens who entered the US illegally or were related to someone who entered without legal permission, they usually didn’t seek help from local authorities.

“They don’t feel as if they have a voice or the tools to improve their lives,” Agarwal said. “But they still persevere.”

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She hoped the study abstract would provide data to advocates like Proyecto Azteca who might help improve the colonias, whether via legal action, public spending or private investment. She also was interested in returning to Hidalgo at some point to compare how people fared if they received funding or other help to improve their homes.

“Things should be better,” said Agarwal. “That’s really why I want to draw attention to these issues. People exist in bubbles. If you aren’t going into these communities and seeing it for yourself, it’s very easy to believe there is a certain standard of living in the US.”

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