Article

Beyond Zoonosis: The Mental Health Impacts of Rat Exposure on Impoverished Urban Neighborhoods

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Abstract

Rats are a common problem in cities worldwide. Impoverished urban neighborhoods are disproportionately affected because factors associated with poverty promote rat infestations and rat–human contact. In public health, most studies have focused on disease transmission, but little is known about the nonphysical consequences of this environmental exposure. Mental health often is neglected but is receiving increasing attention in public health research and practice. The objective of this study was to use a systematic review and narrative synthesis of the published literature to explore the effect of rat exposure on mental health among residents in impoverished urban neighborhoods. Although the literature addressing this topic was sparse, the results of this review suggest that rat exposure consistently has a negative impact on mental health. These effects can be elicited directly (e.g., fear of rat bites) or indirectly (e.g., feeling of disempowerment from inability to tackle rat problems). By developing a better understanding of potential rat-related health risks, both mental and physical, public health officials can better evaluate, refine, and develop their policies regarding rats.

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... For example, urban rodents carry a number of zoonotic pathogens associated with significant human morbidity and mortality (Himsworth et al., 2013). Exposure to rodents may also impact mental health, particularly among marginalized populations (Lam et al., 2018). Finally, urban rodents consume and contaminate food stuffs, damage property and infrastructure, start fires and result in significant expenditures on pest control (Feng and Himsworth, 2014). ...
... Many urban rodents are inherently difficult to study as they are nocturnal, secretive, and reside in habitats not readily accessible to researchers (e.g., deep within infrastructure) (Parsons et al., 2015). They disproportionately populate impoverished neighborhoods (Himsworth et al., 2013;Feng and Himsworth, 2014) where residents are disempowered to deal with rodent-related issues compared to those living in more affluent areas (Lam et al., 2018). Many societies have negative associations with rodents (German and Latkin, 2016) and property owners may keep infestations secret because of shame, fines or possible business closures (Pimentel et al., 2005;Parsons et al., 2017). ...
... They are also able to contaminate food through their fur and excreta. It has also been reported that rodent infestation can lead to psychological trauma in the affected communities [7,8]. ...
... For example, it is common for around six family members to share one toilet. The conditions of living in underdeveloped environments and earning low or no income have previously been identified as contributory factors to rodent infestation [7,15]. Furthermore, living in a low socio-economic environment with limited resources alone invokes feelings of anger, powerlessness, and depression [16]. ...
Article
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Background: Rat infestation is a major public health issue globally, and particularly in poor urban communities in South Africa. Rats pose significant threats to residents in the form of disease spread and sustained physical injuries. The dearth of knowledge about the experiences of affected residents may curtail the initiation of rat control programs. This study aimed to explore the lived experiences of rat infestation among residents of Katlehong Township in Gauteng Province. Methods: This was a qualitative research study where data were gathered from selected community participants from Katlehong Township in Gauteng Province. A semi-structured interview guide was used to collect data through in-depth interviews. The interviews were digitally recorded and transcribed verbatim, and thematic data analysis was conducted using NVivo12 data processing software. The data were presented in themes and quotations that reflect the views of the participants. Results: Exactly 20 community members aged between 18 and 56 years participated in the study, 80% being females. Over half of the participants were unemployed (60%), inclusive of students. Majority of the participants were either Zulu or Xhosa speakers. Several themes emerged from the data, which included the residents' experiences of rat infestation, troublesome rats, dirty rats, reasons for rat infestation, and sustained physical injuries. Participants intimated that waste in the environment and overcrowding in homes contributed to rodent infestation. Conclusion: Rat infestation remains a problem that causes severe distress among the residents of Katlehong Township. The experiences reported varied from psychological trauma to bite injuries and destruction of household property. Effective rodent control strategies need to be put in place to manage both the physical and mental risks posed by rat infestation in socially underprivileged communities.
... Our results suggest that lower-income areas burdened with features related to infrastructure loss and vacancy may be more at risk of zoonotic disease transmission. Recent work has also demonstrated, however, that mental health wellness is lower in residents of areas with greater rodent abundance (German & Latkin, 2016;Lam, Byers Kaylee, & Himsworth, 2018), especially in areas that are under-resourced (German & Latkin, 2016). Evidence that vacancy is disproportionately concentrated in areas of lower income in cities across the US (Gulachenski et al., 2016) suggests that the conditions found in post-Katrina New Orleans likely occur across many other cities. ...
... Importantly, our findings point to the prospects that interventions such as land management, removal of blighted buildings and vegetation, and debris removal can be executed to address disparities. Interventions that reduce blight can also serve to reduce real and perceived risk of crime (Branas et al., 2018) and improve mental health outcomes (Lam et al., 2018). We hypothesize that comparable interventions can similarly reduce concerns associated with rodents, including the risk of pathogen transmission to humans. ...
... Despite the ubiquity of rats (Rattus spp.) in urban settings [9] their impacts on the mental health and wellbeing of urban residents has been understudied [10]. Rats are a potentially important neighbourhood stressor in communities where aging infrastructure, high human population density, and low socioeconomic status allow for rat populations to flourish [11][12][13][14][15][16] due to the availability of harbourage and food sources [17][18][19]. ...
... Despite these limitations, this exploratory study is the first to our knowledge to qualitatively describe the experiences of residents with rats and strengthens the growing body of literature suggesting that interactions with rats can negatively impact the mental health of residents [10]. Given this association, we suggest that future work build upon these findings to gather data which addresses the underlying pathways through which rats impact the health outcomes of residents, as well as how these interactions relate to other environmental hazards experienced in urban settings. ...
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Background: The presence of urban rats in the neighbourhood environment may negatively impact the physical and mental health of residents. Our study sought to describe the experiences with, perceptions of, and feelings towards rats and rat control efforts among a group of disadvantaged urban residents in Vancouver, Canada. Methods: Semi-structured interviews were held with 20 members of the Vancouver Area Network of Drug Users (VANDU) recruited by VANDU staff. Interviews were audio recorded, transcribed, and analyzed using thematic analysis. Results: Participants reported daily sightings of rats and close contact during encounters. Participants generally disliked encountering rats, raising issues of health and safety for themselves and the community due to the belief that rats carry disease. Fear of rats was common, and in some cases resulted in avoidance of rats. Effects of rats on participants were particularly pronounced for those living with rats in the home or for homeless participants who described impacts on sleep due to the sounds made by rats. Although rats were viewed as more problematic in their neighbourhood than elsewhere in Vancouver, participants believed there to be a lack of neighbourhood-level control initiatives that angered and disheartened participants. In combination with other community-level concerns (e.g., housing quality and availability), the presence of rats was viewed by some to align with a general disregard for the community and its residents. Conclusions: This study suggests that the presence of rats in urban centres may have several consequences on the physical and mental health of residents living in close contact with them. These effects may be exacerbated with continued contact with rats and when residents perceive a lack of initiative to control rats in their neighbourhood. As such, research and policies aimed at mitigating the health risks posed by rats should extend beyond disease-related risk and incorporate diverse health outcomes.
... In addition to the increase in public health risks, these urban rats are notorious for depredating of food for human consumption and compromising infrastructure [20]. However, control measures taken against persistent infestations have often led to substantial economic losses [20,21]. Given the unprecedented rates of global urbanization, it is crucial to better understand how to manage rodents in urban centres. ...
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Background: Rodent population control is an important measure in reducing the risk of rodent-borne disease transmission. In this study, we examined rodent activity in the sanitary waste network around the household waste-collection bin chamber of an urban residential apartment block. Methods: We utilised infra-red camera traps to determine the pattern of rodent activity in a rodent-infested bin chamber and its associated sanitary waste network. Multivariable logistic regression was performed to assess the risk factors that were independently associated with rodent activity in the bin chambers. Result: The camera trap surveillance showed that the rodents were active in the bin chamber and sanitary network both in the day and at night. In the cross-sectional study, rodent activity in the bin chambers was independently associated with broken floor traps [Adjusted odds ratio (AOR): 36.7, CI: 21.3-66.3], calendar month [Log-likelihood ratio test (LRT) p = 0.002] and Town Council [LRT p = 0.004] variables. In restricted analysis, rodent activity in bin chambers was independently associated with defects in the wastewater pipe under the chamber [AOR: 12.3, CI: 4.3-51.7]. Conclusion: Our study suggests that urban municipal management councils should prioritize rodent control resources in areas according to the factors that increase the risk of rodent infestation.
... Each year, contamination and consumption by rodents results in billions of dollars in losses to the food supply (Pimentel et al., 2005). Furthermore, rodents are known reservoirs of human pathogens (Meerburg et al., 2009), and recent investigations demonstrate that rodents host a diversity of pathogens that impact human health (Easterbrook et al., 2007;Firth et al., 2014;Himsworth et al., 2013;Williams et al., 2018), including mental health (Lam et al., 2018). ...
Article
Rodent management programs at food distribution centers in the United States and Canada often adhere to interval-based spacing of control devices, with traps spaced 6–12 m apart on the interior perimeter, and exterior bait stations spaced 15–30 m apart. However, this design is based only on rodent foraging ranges, and does not consider the influence of rodent behavior or biology on movement patterns. Therefore, this study evaluated characteristics of food distribution centers that influence rodent behavior to determine their impact on interior trap capture and exterior bait feeding by rodents. We found that rodent interactions with control devices was not uniform in facilities, and less than half (45.2%) of all interior devices trapped at least one mouse. Rodent feeding at exterior bait stations was similarly not uniform, with 56.1% of observations representing minor feeding (one corner of bait or less consumed). Furthermore, we found that certain ecological and structural characteristics of device location were associated with higher trap capture and/or bait consumption. Results of this investigation suggest that rodent management at food distribution centers can be improved with assessment-based placement of traps and bait stations. In addition to reducing food safety threats through improved trap capture, this approach can reduce the number of devices to service and redirect service time toward pro-active inspections, rather than trap checking. Finally, device locations that are assessment-based align with the 2011 Food Safety Modernization Act that mandates preventive controls to protect human food.
... Seoul hantavirus) pathogens that can be transmitted to humans (Himsworth et al. 2013;Strand and Lundkvist 2019). Rats can also contribute to negative mental health outcomes such as symptoms of anxiety for residents facing rat infestations in their dwelling or neighbourhood (Zahner et al. 1985;Lam, Byers, and Himsworth 2018). Other harmful impacts of rats include rat bites (Childs et al. 1998;Hirschhorn and Hodge 1999), property damage (Pimentel et al. 2000;Martindale 2001;Battersby 2002) V C The Author(s) 2021. ...
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Urban rats are widely distributed pests that have negative effects on public health and property. It is crucial to understand their distribution to inform control efforts and address drivers of rat presence. Analysing public rat complaints can help assess urban rat distribution and identify factors supporting rat populations. Both social and environmental factors could promote rat complaints and must be integrated to understand rat distributions. We analysed rat complaints made between 2011 and 2017 in Chicago, a city with growing rat problems and stark wealth inequality. We examined whether rat complaints at the census tract level are associated with factors that could influence rat abundance, rats' visibility to humans, and the likelihood of people making a complaint. Complaints were significantly positively correlated with anthropogenic factors hypothesized to promote rat abundance (restaurants, older buildings, garbage complaints, and dog waste complaints) or rat visibility (building construction/demolition activity), and factors hypothesized to increase the likelihood of complaining (human population density, more owner-occupied homes); we also found that complaints were highest in the summer. Our results suggest that conflicts between residents and rats are mainly driven by seasonal variation in rat abundance and human activity and could be mitigated with strategies such as securing food waste from residential and commercial sources. Accounting for social factors such as population density, construction and demolition activity, and home ownership versus rental can also help cities more accurately predict blocks at higher risk of rat conflicts.
... Signs and symptoms of allergic reactions from rodents can include angioedema, asthma, bronchospasm, conjunctivitis, rhinitis, urticaria-and rarely, anaphylaxis (Hesford et al., 1995;Matsui, 2013;Rankin et al., 2007;Sheehan et al., 2010;Trummer et al., 2004). In addition, the mental health impacts of rat exposure on urban residents is underappreciated (Lam et al., 2018). ...
Article
While an increasing number of households are keeping rodents as pets, rats and mice are considered pests and efforts are undertaken to control rodent populations to avoid human–rodent encounters. Tracking the burden of rodent bite injuries can guide prevention efforts. Data for this study were from the 2001–2015 National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP), a stratified probability sample of U.S. hospitals. Records included information about age, body part affected, cause, diagnosis, case disposition, and sex. We coded narrative descriptions for the source of the bite. Every year, an estimated 12,700 injuries from rodent bites are treated in emergency departments, amounting to roughly one rodent bite injury treated every hour. Rats, mice, and squirrels were the most frequently reported rodents that bit people. The largest percentage of bites, approximately 27%, occurred in individuals <10 years and most bites occurred during the summer months. Injuries, zoonotic diseases, allergies, mental health adverse effects, and the environmental impact of rodent exposures exemplify the need for a multisectoral approach to prevention.
... In major cities, rat bites cause significant morbidity and even the presence of rats playing in your ceiling causes psychological problems. [10][11][12] Rats are everywhere, and with climate change, warming and growing populations will continue to increase in cities and in populated rural areas. 13 Public health workers, particularly, often have close encounters with rats. ...
... In a sample of public housing residents, for instance, current cockroach infestations increased the odds of experiencing high depressive symptoms by threefold and dual infestations (mouse and cockroach) led to a five-fold increase [211]. Similarly, exposure to rats can result in negative mental health consequences for residences [212,213]. ...
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... For example, rats pose a risk to public health as they are the source of a variety of zoonotic pathogens (disease-causing microbes transmissible from rats to people, e.g., Leptospira interrogans) responsible for significant human morbidity and mortality (Himsworth et al., 2013b). Infestations can also serve as a chronic stressor, impacting both the mental and physical health of residents (German and Latkin, 2016;Lam et al., 2018). Rats also damage urban infrastructure (due to chewing and burrowing activities) and contaminate foodstuffs. ...
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Public health significance of urban pests
  • S Battersby
  • R B Hirschhorn
  • B R Amman
Battersby, S., Hirschhorn, R.B., & Amman, B.R. (2008). Commensal rodents. In X. Bonnefoy, H. Kampen, & K. Sweeney (Eds.), Public health significance of urban pests (pp. 387-419). Copenhagen, Denmark: World Health Organization, Regional Office for Europe.
RAT APOCALYPSE! Toronto' s new home invaders are growing in shocking numbers
  • J Mcbride
McBride. J. (2013, December 18). RAT APOCALYPSE! Toronto' s new home invaders are growing in shocking numbers.
Vancouver rat infestation raises health concerns. The Georgia Straight
  • R Staley
Staley, R. (2014, October 15). Vancouver rat infestation raises health concerns. The Georgia Straight. Retrieved from http://www.straight. com/life/749426/vancouver-rat-infestation-raises-health-concerns World Health Organization. (1948). Constitution of WHO: Principles. Geneva, Switzerland: Author. Retrieved from http://www.who.int/ about/mission/en
Constitution of WHO: Principles
World Health Organization. (1948). Constitution of WHO: Principles. Geneva, Switzerland: Author. Retrieved from http://www.who.int/ about/mission/en