In her 2010 book, Third World America, Ariana Huffington wrote presciently about the erosion and abandonment of the Middle Class and their descent into poverty.

Aside from emerging as an important driver in this Presidential Election, ‘Third World America’ has also now become a dominant theme of our new National School of Tropical Medicine at Baylor College of Medicine in Houston, Texas. While we initially focused on neglected tropical diseases affecting the poor in tropical regions of Latin America and the Caribbean, Africa, and Asia, our latest findings on the geography of these diseases recently uncovered them in places that previously we never imagined.

Indeed, in a new book just released (Blue Marble Health: An Innovative Plan to Fight Diseases of the Poor amid Wealth https://jhupbooks.press.jhu.edu/content/blue-marble-health) I find poverty-related neglected diseases are now mostly affecting the poor who live in wealthy G20 countries. I argue that the traditional concept of global health — developing versus developed nations — has morphed and given way to hidden pockets of intense poverty and poverty-related diseases in expanding economies.

One of the more astonishing findings is that neglected tropical diseases are widespread among the poor living in Texas, Florida, and the US Gulf Coast.

I estimate that one half-dozen poverty-related neglected diseases are threats to the health and wellness of the American poor. They are mostly chronic and debilitating conditions that are not well known, even to people in the health professions. For example, toxocariasis is caused by parasitic worms migrating through the brains and lungs and socioeconomically disadvantaged children, resulting in developmental delays and other adverse health consequences. Cysticercosis is another parasitic worm infection that causes epilepsy, while toxoplasmosis has been linked to serious mental illness. Chagas disease is a chronic heart infection transmitted by kissing bugs found widely in Texas. Zika virus infection also falls into this category — not many realize that poverty is an important risk factor. In all, I estimate there are at least 10 million Americans who live with a neglected tropical disease, many held back in poverty because of the long-term effects of their illnesses!

We need a national effort to address these very unique and important poverty-related neglected diseases as a means to both improve the health of Americans and possibly lift them out of poverty. They include efforts to determine the numbers of Americans actually infected, where and how they are becoming infected, and disease treatment and prevention efforts. We also need research to develop improved and easy accessible diagnostics, as well as new medicines and vaccines. We’ve worked with the US Congress to enact legislation but so far it has not gone very far.

Neglected these diseases are not rare in the United States. Instead they represent some of the most common conditions of the poor, especially in the American South. A new Presidential Administration committed to the concerns initially highlighted by Ms Huffington now has an opportunity to treat and prevent Third World America’s hidden and neglected diseases. In so doing the Trump Administration can reaffirm its commitment to a disappearing Middle Class and to people who find themselves in trapped in poverty due to illness.

Originally published at medium.com