Bed Bugs: A Public Health Problem?

Talk of a bed bug pandemic and comparisons to the common cold raise the issue of whether bed bugs constitute a public health problem. From a traditional approach to health, with its focus on biomedical and behavioural risk factors, bed bugs do not pose a health problem. Indeed, unlike other insects (such as mosquitoes), bed bugs have not yet been proven to transmit disease. Adopting a social determinants of health (SDH) approach, however, leads to a different conclusion: bed bugs do constitute a public health problem. The SDH approach focuses on “the social and economic factors that shape the health and incidence of illness among individuals and groups of individuals”.

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Key Points

• Bed bugs are making an international comeback—to the point where a global “bed bug pandemic” is predicted.
• From a social determinants of health perspective, with its focus on living condition standards, bed bugs constitute a threat to public health.
• While anyone can be at risk of experiencing a bed bug infestation, the social impacts of bed bugs can be especially devastating for people on low incomes. Reliance on second-hand furniture and clothing, lack of access to affordable, quality housing, and lack of control over the maintenance of rental units make low-income residents especially vulnerable to infestations. Once infested, the costs associated with treatment and management can be overwhelming for those with limited financial resources. When the social stigma that bed bug sufferers encounter is added into the mix, the result is stress, anxiety, sleeplessness, and social isolation—all of which compromise people’s health and well being.
• Almost all of the inner-city residents interviewed reported suffering from increased stress and sleep deprivation as a result of bed bugs. There is much well-supported research that documents the significant impacts of both stress and lack of sleep on people’s ability to undertake everyday activities, which can create further stress and health-related outcomes.
• The SDH approach offers a holistic way of dealing with the problem of bed bugs. It acknowledges the negative health outcomes that can result from the experience of dealing with an infestation and directs our attention to the social determinants that need to be addressed in developing effective policies and practices for responding to the bed bug epidemic—and providing relief and resources to those most vulnerable.

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