Syndemic

Definition


A syndemic typically involves one or more epidemics (diseases whose affliction rates are abnormally high for a particular community or region), or other societal problems (i.e. poverty and violence) that work together to create a more negative impact on health than there would be if the community were afflicted by simply the disease/epidemic (1; 2). By realizing that non-medically-related problems have a strong influence on current medical problems and epidemics, researchers can begin to look at disease and medicine from a broader perspective and realize how interconnected health is to society and communities in order to better understand the problems at hand and the potential for fixing th

History


The term, created by a medical anthropologist, Merrill Singer, in the mid-1990’s, is meant to bring to attention the fact that diseases and epidemics are not isolated in communities, but rather, there are often other factors that can not only help explain the contraction of such disease/epidemic, but can also negatively add to the health risks that the disease/epidemic possesses and perpetuate any attempts to fix the problems arising (3, 4). Syndemics view disease from a biocultural standpoint, which conflicts with the biomedical view that each disease is its own entity. Focusing on the "bigger picture," critical medical anthropologists recognize the fact that societal factors, such as poverty and familial environments, can play large parts in the acquisition of disease, as well as the amplication of its problems and consequences (4).

Examples


A widely recognized and heavily researched syndemic is SAVA, standing for substance abuse, violence, and AIDS (1). The SAVA syndemic is typically present in inner city and urban areas, where societal problems, such as poverty, malnutrition, lack of proper health care, and homelessness, to name a few, are often present. These societal problems and inequalities only help to cause the problems of AIDS, substance abuse, and violence to amount to a bigger threat to society (5).
Studies have shown that instances of violence, such as being sexually abused by a parent or guardian as a child, increase the occurrence of diseases/conditions later in life such as hepatitis C, STDs, drug overdoses, and mental illness (6). In addition to creating increased risks for contracting HIV/AIDS and becoming addicted to illegal or legal substances, the effects of poverty also have an effect on those afflicted. Correlated with poverty is the stigmatization that goes along with HIV/AIDS infection and substance abuse. These factors often make it difficult for the afflicted to get access to proper medical treatment to not only diagnose the conditions, but also to receive effective treatment (4).
Dr. David Malebranche, in affiliation with bbarash productions worked to create a documentary about the problems that HIV/AIDS, poverty, and substance abuse pose for a certain African American population in Atlanta, Georgia. As explained by Dr. Malebranche, syndemics cannot be treated and prevented superficially. You cannot fix a problem as large as an amputated limb with simply a band-aid, you cannot prevent the spread of HIV/AIDS by simply giving out condoms. The problems arising over syndemics become increasingly difficult when all the factors contributing to disease and its spread, contraction, and treatment are taken into account. The solution to complicated problems is a complicated answer that requires the alteration of societal views and perhaps even social and political policies. Without a concerted effort, little can be done and few know how things should be done. It is partly because of this reason why diseases are viewed from a biomedical perspective. Diseases are reduced to biochemical problems. They are reduced to be viewed as more simple problems that can be treated with simple solutions, such as medications or therapy.

References


1. http://www.cdc.gov/syndemics/ overview-principles.htm
2. http://www.medterms.com/ script/main/art.asp? articlekey=3273
3. http://www.naturalremedytips. com/index.php/464. Singer, M. and Clair S. 2003. Syndemics and Public Health: Reconceptualizing Disease in a Bio-Social Context. Med Anthropol Q. 17(4): 423-441.
5. Singer, M. Pathogen-pathogen interaction: A syndemic model of complex biosocial processes in Disease. Virulence 1(1):10-18.
6. Wallace R. 1990. Urban desertification, public health and public order: planned shrinkage, violent death, substance abuse and AIDS in the Bronx. Soc Sci Med. 31: 801-813.
7. Duke, et al. 2002. Examining the Effects of Violence on HIV Risk, Presented at the Annual Science Day Conferencem Center for Interdisciplinary Research on AIDS, Yale University. As cited in Singer & Clair 2003.
8. http://bbarash.com/bb_newrelease.htm