Neglected Diseases and Poverty in “The Other America” The Greatest Health Disparity in the United States 英文参考文献.docVIP

Editorial NeglectedDiseasesandPovertyin‘‘TheOtherAmerica’’: TheGreatestHealthDisparityintheUnitedStates? PeterJ.Hotez* SabinVaccineInstituteandDepartmentofMicrobiology,Immunology,andTropicalMedicine,GeorgeWashingtonUniversityMedicalCenter,Washington,D.C.,United StatesofAmerica To be sure, the other America is not impoverished in the same sense as those poornationswheremillionsclingtohunger as a defense against starvation. This country has escaped such extremes. That doesnotchangethefactthattensofmillions of Americans are, at this very moment, maimed in body and spirit, existing at levels beneath those necessary for human decency…Theyarewithoutadequatehous- ingandeducationandmedicalcare. South,andamajorcauseofsevereanemia and malnutrition in the region [1]. To- gether with malaria, niacin deficiency (pellagra),typhoidfever,ascariasis,trichu- riasis, and other conditions common to areas of tropical and subtropical poverty, hookwormhelpedtofostertheconceptof the ‘‘sick man of the South’’ or the ‘‘lazy Southerner’’ [2]. The poverty-promoting aspects of these diseases are powerfully illustrated by the recent work of the economist Hoyt Bleakley, who has esti- matedthatbecauseofitsimpactonchild growth and development, school perfor- mance, and school attendance, chronic hookworm infection in the American Southwasresponsiblefora43%reduction in future wage-earning [3]. Hookworm is still one of the most important parasitic infections of humans in developing coun- tries, although it is no longer a serious public health problem in the US [1]. A dramatic decline in the prevalence of NTDs in the American South, including hookworm, began in the 1930s when several New Deal programs transformed the region from an economy based on subsistence agriculture into an urbanized one with higher wage earning and im- provedqualitydwellings[2]. ofAmericanschoolchildrenlivinginpoor areasoftheAmericanSouthwereinfected with the large common roundworm, Ascaris lumbricoides [7–10], includ