Bed bugs (Cimex lectularius) are making an international comeback, to the point where a global “bed bug pandemic” is being predicted.The City of Winnipeg has not been exempted from this scourge, with one local extermination company reporting 2,800 bed bug calls in 2010, compared with only a handful of calls in the previous six years.
To its credit, the Government of Manitoba has recently announced a plan for responding to the bed bug problem. The plan includes a bed bug phone line that will offer information and track infestations, grants to community-based organizations to support their education and prevention efforts, the provision of bed bug prevention materials, a public education campaign focusing on prevention and eradication, and establishing a multi-stakeholder committee.
Nevertheless, how a problem like bed bugs is framed will inform the steps taken to resolve it. Because bed bugs have not yet been proven to transmit disease, they are often classified simply as a ‘nuisance’ or a ‘pest.’ As a result, there is resistance to framing the problem of bed bugs as a public health threat. By adopting a Social Determinants of Health approach—which focuses on the social and economic conditions that contour the health of a population—we make the case that bed bugs do constitute a public health hazard and that policies and practices aimed at addressing the problem of bed bugs need to be framed within this context.
Contrary to the prevailing misconception that cleanliness and personal hygiene are the cause of infestations, bed bugs do not discriminate. They are attracted to a human host by a combination of body temperature and carbon dioxide. While anyone can be at risk of 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 vulnerable to infestations. Once infested, the costs associated with treatment (laundering, vacuuming, replacing mattresses and furniture) can be overwhelming for those with limited financial resources. When the prevailing 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.
In order to explore the social impacts of a bed bug infestation on inner-city residents, we draw upon interviews conducted with 16 residents, 5 workers at inner-city agencies, 3 landlords, and 2 public health inspectors. The stories told by residents testify to the devastating impact that dealing with a bed bug infestation has had on their daily lives, their social relationships, their identity, and their physical and mental health. Informed by the interview data as well as the approach taken by the City of Toronto in its struggle with the bed bug problem, we map out strategies that should be included in a comprehensive bed bug plan for the City of Winnipeg.
Using the Social Determinants of Health approach to frame the problem of bed bugs as a threat to public health—as opposed to simply a ‘nuisance’ or a ‘pest’—offers a holistic way of dealing with this issue. Not only are the negative health outcomes that can result from the experience of dealing with an infestation acknowledged, but so too are the social determinants of the problem.