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More than One Third of Global Human Infectious Disease Burden Is Environmentally Mediated, with Disproportionate Effects in Rural Poor Areas

31 Pages Posted: 26 Sep 2019

See all articles by Susanne Sokolow

Susanne Sokolow

Stanford University - Woods Institute for the Environment

Isabel J. Jones

Stanford University - Woods Institute for the Environment

Chelsea L. Wood

University of Washington

Kevin D. Lafferty

University of California, Santa Barbara (UCSB)

Andres Garchitorena

Institut de Recherche pour le Developpement (IRD)

Skylar R. Hopkins

University of California, Santa Barbara (UCSB)

Andrea J. Lund

Stanford University - Emmett Interdisciplinary Program in Environment and Resources

Andrew J. MacDonald

University of California, Santa Barbara (UCSB)

Nicole Nova

Stanford University - Department of Biology

Chris LeBoa

Stanford University - Department of Biology

Alison J. Peel

Griffith University

Erin A. Mordecai

Stanford University - Department of Biology

Andrew Chamberlin

Stanford University - Woods Institute for the Environment

Meghan Howard

Stanford University - Department of Biology

Julia C. Buck

University of California, Santa Barbara (UCSB)

David Lopez-Carr

University of California, Santa Barbara (UCSB) - Department of Geography

Michele Barry

Stanford University - Woods Institute for the Environment

Matthew Bonds

Harvard University - Department of Global Health and Social Medicine

Giulio A. De Leo

Stanford University - Woods Institute for the Environment

More...

Abstract

Background: Every day, billions of people - especially those living in poverty - are exposed to infectious pathogens in the environment and are at risk of contracting 'environmentally mediated' infections: those with environmental reservoirs that affect disease persistence and control. The complex ecology of environmental pathogens creates a global health problem not easily solved with medical treatment alone.

Methods: Here, we quantified the global disease burden caused by environmentally mediated infections and used a structural equation modeling approach to explore correlated factors at the global scale.

Findings: We found that 80% of pathogen species known to infect humans are environmentally mediated, causing about 40% of today's burden of infectious disease (global loss of 130 million years of healthy life annually). More than 91% of environmentally mediated burden occurs in tropical countries, and the poorest countries carry the highest burdens across all latitudes. We found weak or absent effects of biodiversity or agricultural land use at the global scale. In contrast, the strongest proximate indicator of environmentally mediated infectious disease burden is rural poor livelihoods. Political stability and wealth are associated with improved sanitation, better health care, and lower proportions of rural poor people, indirectly resulting in lower burdens of environmentally mediated infections.

Interpretation: The high and uneven burden of environmentally mediated infections highlights the need for innovative social and ecological interventions to complement biomedical advances in the pursuit of global health and sustainability goals.

Funding Statement: SHS, IJJ, and GADL received support from the Stanford Institute for Innovation in Developing Economies Global Development and Poverty Initiative. SHS and GADL also received support from the Bill & Melinda Gates Foundation (OPP1114050), National Institutes of Health (NIH) grant #1R01TW010286, National Science Foundation Coupled Natural and Human Systems grant #1414102, and the National Institute for Mathematical and Biological Synthesis through the Working Group "Optimal Control of Neglected Tropical Diseases.” IJJ was also funded by National Science Foundation Graduate Research Fellowship #1656518. SHS, SRH, CLW, KDL, MBonds, and GADL were supported by a grant from the National Center for Ecological Analysis and Synthesis through the Science for Nature and People Partnership program. AJL was supported by the Davis Family E-IPER Fellowship at Stanford and the Stanford Interdisciplinary Graduate Fellowship from the Stanford Vice Provost for Graduate Education. NN was supported by the Stanford Bing Fellowship in Honor of Paul Ehrlich. CLW was supported by a Sloan Research Fellowship from the Alfred P. Sloan Foundation and by the Michigan Society of Fellows at the University of Michigan. AJP was supported by a Queensland Government Accelerate Postdoctoral Research Fellowship and the DARPA PREEMPT program Cooperative Agreement # D18AC00031.

Declaration of Interests: The authors declare no competing interests.

Suggested Citation

Sokolow, Susanne and Jones, Isabel J. and Wood, Chelsea L. and Lafferty, Kevin D. and Garchitorena, Andres and Hopkins, Skylar R. and Lund, Andrea J. and MacDonald, Andrew J. and Nova, Nicole and LeBoa, Chris and Peel, Alison J. and Mordecai, Erin A. and Chamberlin, Andrew and Howard, Meghan and Buck, Julia C. and Lopez-Carr, David and Barry, Michele and Bonds, Matthew and De Leo, Giulio A., More than One Third of Global Human Infectious Disease Burden Is Environmentally Mediated, with Disproportionate Effects in Rural Poor Areas (09/19/2019 20:03:00). Available at SSRN: https://ssrn.com/abstract=3457412 or http://dx.doi.org/10.2139/ssrn.3457412

Susanne Sokolow (Contact Author)

Stanford University - Woods Institute for the Environment ( email )

Seattle, WA 98115
United States

Isabel J. Jones

Stanford University - Woods Institute for the Environment

Seattle, WA 98115
United States

Chelsea L. Wood

University of Washington

Seattle, WA 98195
United States

Kevin D. Lafferty

University of California, Santa Barbara (UCSB)

Santa Barbara, CA 93106
United States

Andres Garchitorena

Institut de Recherche pour le Developpement (IRD) ( email )

213, rue La Fayette
75480 Paris cedex 10, 90009
United States

Skylar R. Hopkins

University of California, Santa Barbara (UCSB)

Santa Barbara, CA 93106
United States

Andrea J. Lund

Stanford University - Emmett Interdisciplinary Program in Environment and Resources

Stanford, CA
United States

Andrew J. MacDonald

University of California, Santa Barbara (UCSB)

Santa Barbara, CA 93106
United States

Nicole Nova

Stanford University - Department of Biology

Gilbert Building, Rm 109
371 Serra Mall
Stanford, CA 94305
United States

Chris LeBoa

Stanford University - Department of Biology

Gilbert Building, Rm 109
371 Serra Mall
Stanford, CA 94305
United States

Alison J. Peel

Griffith University

170 Kessels Road
Nathan, Queensland QLD 4111
Australia

Erin A. Mordecai

Stanford University - Department of Biology

Gilbert Building, Rm 109
371 Serra Mall
Stanford, CA 94305
United States

Andrew Chamberlin

Stanford University - Woods Institute for the Environment

Seattle, WA 98115
United States

Meghan Howard

Stanford University - Department of Biology

Gilbert Building, Rm 109
371 Serra Mall
Stanford, CA 94305
United States

Julia C. Buck

University of California, Santa Barbara (UCSB)

Santa Barbara, CA 93106
United States

David Lopez-Carr

University of California, Santa Barbara (UCSB) - Department of Geography

CA 93106
United States

Michele Barry

Stanford University - Woods Institute for the Environment

Seattle, WA 98115
United States

Matthew Bonds

Harvard University - Department of Global Health and Social Medicine ( email )

Boston, MA
United States

Giulio A. De Leo

Stanford University - Woods Institute for the Environment

Seattle, WA 98115
United States

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