Exploring biocultural determinants of intestinal health: Do resource access and parasite exposure contribute to intestinal inflammation among a preliminary sample of children in rural Mississippi?

Objectives: Biocultural perspectives combining methods and theories from biological and cultural anthropology are needed to better understand socioeconomic and race-based health inequities in the United States. For example, the developmental trajectories of gastrointestinal health disparities based on embodied (i.e., internalized) inequities in resource access and environmental pathogen exposure are poorly understood. Here, we present a preliminary exploration of these relationships among 20 children (aged 3–14 years) from 12 families living in a low-resource, predominantly Black, rural Mississippi community. Methods: Relationships between fecal calprotectin levels (FC; biomarker of intestinal inflammation measured from stool samples), BMI-for-age/Height-for-age z-scores (calculated from standard anthropometric measures), household income/size (from parent interviews), and parasitic worm (helminth) infection status (detected in stool samples by 18 s rRNA gene amplification/sequencing) were tested using bootstrap linear regression and ANOVA/ANCOVA tests. Results: About 80% of sampled children had clinically elevated FC (> 50 μg/g). BMI z-scores (95%CI = −154.63; −7.34) and household income (95%CI = −135.90; −16.44) were negatively associated with FC levels. Household size was positively associated with FC levels (95%CI = 4.65, 101.61). Helminth infections were detected (n = 6), with positive associations between infection and the FC level (p < 0.05) that were likely driven by two infected children with very high FC levels. Conclusion: The high levels of intestinal inflammation in this small sample of children suggest that gastrointestinal health disparities may appear in childhood. We explore how these disparities may be related to inequities in environmental exposures, nutritional and socioeconomic status, and barriers to medical care and resource access.