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Social History of Medicine Advance Access originally published online on October 24, 2006
Social History of Medicine 2006 19(3):461-482; doi:10.1093/shm/hkl047
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© The Author 2006. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. All rights reserved

Racial Differences in Disease Susceptibilities: Intestinal Worm Infections in the Early Twentieth-Century American South

Philip R. P. Coelho* and Robert A. McGuire{dagger}

* Department of Economics, Ball State University, Muncie, IN 47306, USA. E-mail: 00prcoelho{at}bsu.edu

{dagger} Department of Economics, The University of Akron, Akron, OH 44325, USA. E-mail: rmcguire{at}uakron.edu


  Abstract

While the use of ancestry, ethnicity or race in contemporary medical and scientific research is controversial and the subject of debate in the United States, a hypothesis of ‘racial’ differentials in susceptibilities to disease has utility in the American historical context. This study employs a dataset of 542 residents of Marion County, South Carolina, collected in 1922 by medical teams to investigate the prevalence of hookworm in the American South. An examination of data for Marion County is useful because it is representative of counties in the rural agricultural South where hookworm was endemic throughout at least the early twentieth century. The results of a multivariate regression indicate a large, statistically significant difference in hookworm infection between African-Americans (blacks) and European-Americans (whites). Controlling for other demographic factors, an otherwise average white was 2.8 times more likely to be hookworm infected compared to an otherwise average black in Marion County. The predicted probability of testing positive for hookworm was 56.1 per cent for an average white and 20.3 per cent for an average black. The findings are consistent with other evidence on racial differences in hookworm infection, and have implications for understanding important historical issues concerning economic development in the American South. They also suggest that historical datasets contain important information when ancestry, ethnicity or race indentify people whose heritage is predominately from specific disease ecologies.

Keywords: race; ethnicity; disease susceptibilities; differential disease susceptibilities; racial differences; hookworm; intestinal worms; parasitic diseases; American South; 1920s


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