Parkinson’s disease is a growing public health and economic challenge in the United States. The condition is characterized by the progressive loss of the brain’s dopamine-producing nerve cells, the chemical messenger essential for muscle control. As these neurons deteriorate, individuals develop the classic triad of motor symptoms: slowed movement, resting tremor, and rigidity.
According to the Centers for Disease Control and Prevention, nearly 1.2 million Americans suffer from PD; more than 40,000 individuals over the age of 65 died from the disease in 2024 — a 57% increase from 2017.
The financial burden of Parkinson’s disease is heavy for both families and the healthcare system. According to a March 2026 report by the Michael J. Fox Foundation, the total annual cost of PD in the U.S. reached nearly $82.2 billion in 2024 — a milestone experts didn’t expect to hit for another decade. In New York state alone, the economic toll of PD — which includes direct medical costs, lost job earnings, and unpaid family caregiving — is an estimated $5 billion annually.
New York’s Parkinson’s disease rates are close to the national average, with nearly 60,000 total cases, according to the state Department of Health’s current data. But they are distributed unevenly statewide: Rural counties including Columbia and Oneida report some of the highest PD rates — driven by a higher number of senior citizens, and a higher risk of exposure to agricultural pesticides and herbicides.
The NYS Parkinson’s Disease Registry tracks statewide PD metrics and high-risk groups. Launched in December 2024, New York is one of only 14 states with such a database, which aims to promote prevention and cure research.
The Fight Against Paraquat
Paraquat dichloride is one of the most widely used herbicides in U.S. commercial agriculture, despite proof linking it directly to the development of Parkinson’s disease. Paraquat is banned in over 70 countries — including the European Union, Canada, and China — but is not prohibited federally in the U.S. In June, the Environmental Protection Agency announced it was convening a national roundtable for experts to review paraquat safety. For reasons that are unclear, the meeting never took place, and has not been rescheduled.
States are taking independent action. In July, Vermont became the first to enact a full ban on the sale and use of paraquat. New York is one of 13 states with pending legislation to ban or severely restrict the herbicide use.
Parkinson-linked chemical exposure is not limited to commercial farms. A May 2025 study published in JAMA Network Open showed that living within 1 mile of a golf course more than doubles the risk of developing Parkinson’s disease compared to living six miles away. Researchers attribute this increase to airborne and groundwater contamination from the heavy use of pesticides, herbicides, and fungicides required to maintain pristine fairways and greens.
Chronic exposure to forever chemicals like PCBs (Polychlorinated biphenyls) are also a known PD risk. Used as heavy machinery coolants and lubricants until their federal ban in 1979, PCBs persist in local soil and waterways for more than 50 years.
Idiopathic Versus Familial Causes of Parkinson’s Disease
In the vast majority of cases, the exact cause of Parkinson’s disease is unknown. It is likely triggered by a mix of cellular aging and long-term exposure to harmful chemicals. Hereditary Parkinson’s disease accounts for roughly 15% of all cases.
Regardless of the type, the destructive process in the brain is the same. In a healthy brain, a normal protein called alpha-synuclein helps nerve cells communicate. In Parkinson’s disease, this protein becomes misfolds, becomes abnormally sticky, and forms clumps called Lewy bodies. These toxic clusters target and destroy dopamine-producing neurons in the basal ganglia, which lie deep within the brain.
Without dopamine, the signs of PD emerge. Many patients develop a shuffling gait, vision changes, or cramped, tiny handwriting. Daily activities become impossible without help. Long-term complications include difficulty swallowing, fall injuries, and dementia.
Non-motor symptoms are also common, such as insomnia and mood changes. The loss of the sense of smell can surface years before the onset of physical tremors.
The primary risk factors for Parkinson’s disease include age (60 or over), male gender, and specific occupations. Chronic contact with pesticides and herbicides makes farmers vulnerable, while repeated head trauma elevates the risk for contact-sport athletes, like boxers and football players — including nonprofessionals. Chronic sleep disorders may also increase the likelihood of developing the disease.
PD is diagnosed by medical history and symptoms; blood tests and brain imaging studies can help rule out other neurologic conditions.
There is no known cure. Treatment is tailored to improve mobility and quality of life: Medications like carbidopa-levodopa (Sinemet) and ropinirole (Requip) restore dopamine activity in the brain, reducing stiffness and tremors. Physical, occupational, and speech therapies can also help. Adaptive Deep Brain Stimulation, FDA-approved in 2025, is a pacemaker-like medical device that blocks abnormal brain activity and can stop tremors and stiffness.
Medical research is pivoting from symptom management to early intervention, with treatments that target alpha-synuclein and Lewy bodies. A new vaccine may prevent destructive protein clumps from forming. The injectable anti-inflammatory drug adalimumab (Humira) — commonly prescribed for rheumatoid arthritis — is being studied to see if it can prevent Parkinson’s disease before it begins. Stem cells may offer a way to repair and replace the brain’s damaged dopamine-producing neurons.
See your primary care provider if you notice persistent resting tremors, noticeably slow movement, or muscle tightness that interferes with routine tasks — like writing, walking, or buttoning your shirt.
Dr. Mary Jenkins, a contributor to the Herald and member of its board of directors, retired after nearly 40 years as a family practice physician in New York state.