In more recent times, according to Dixie's Forgotten People: the South's Poor Whites, geophagia was common among poor whites in the South-eastern United States in the 19th and early 20th centuries, and was often ridiculed in popular literature. The literature also states, "Many men believed that eating clay increased sexual prowess, and some females claimed that eating clay helped pregnant women to have an easy delivery."[8] Geophagia among southerners may have been caused by the high prevalence of hookworm disease, in which the desire to consume soil is a symptom.[9]