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Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations

Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations
Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations
The co-occurrence of health burdens in transitioning populations, particularly in specific socioeconomic and cultural contexts, calls for conceptual frameworks to improve understanding of risk factors, so as to better design and implement prevention and intervention programmes to address comorbidities. The concept of a syndemic, developed by medical anthropologists, provides such a framework for preventing and treating comorbidities. The term syndemic refers to synergistic health problems that affect the health of a population within the context of persistent social and economic inequalities. Until now, syndemic theory has been applied to comorbid health problems in poor immigrant communities in high-income countries with limited translation, and in low-income or middle-income countries. In this Series paper, we examine the application of syndemic theory to comorbidities and multimorbidities in low-income and middle-income countries. We employ diabetes as an exemplar and discuss its comorbidity with HIV in Kenya, tuberculosis in India, and depression in South Africa. Using a model of syndemics that addresses transactional pathophysiology, socioeconomic conditions, health system structures, and cultural context, we illustrate the different syndemics across these countries and the potential benefit of syndemic care to patients. We conclude with recommendations for research and systems of care to address syndemics in low-income and middle-income country settings.
0140-6736
951-963
Mendenhall, Emily
04022883-7dc9-4d5f-b288-e937cf07283f
Kohrt, Brandon A.
35382e2e-fb0a-4be3-b12f-ed67e50a37ba
Norris, Shane A.
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Ndetei, David
ccbe5350-759f-40e6-8cdc-938a34d9f040
Prabhakaran, Dorairaj
e994435e-230b-454a-9f31-32b12aff0cc3
Mendenhall, Emily
04022883-7dc9-4d5f-b288-e937cf07283f
Kohrt, Brandon A.
35382e2e-fb0a-4be3-b12f-ed67e50a37ba
Norris, Shane A.
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Ndetei, David
ccbe5350-759f-40e6-8cdc-938a34d9f040
Prabhakaran, Dorairaj
e994435e-230b-454a-9f31-32b12aff0cc3

Mendenhall, Emily, Kohrt, Brandon A., Norris, Shane A., Ndetei, David and Prabhakaran, Dorairaj (2017) Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations. The Lancet, 389 (10072), 951-963. (doi:10.1016/S0140-6736(17)30402-6).

Record type: Article

Abstract

The co-occurrence of health burdens in transitioning populations, particularly in specific socioeconomic and cultural contexts, calls for conceptual frameworks to improve understanding of risk factors, so as to better design and implement prevention and intervention programmes to address comorbidities. The concept of a syndemic, developed by medical anthropologists, provides such a framework for preventing and treating comorbidities. The term syndemic refers to synergistic health problems that affect the health of a population within the context of persistent social and economic inequalities. Until now, syndemic theory has been applied to comorbid health problems in poor immigrant communities in high-income countries with limited translation, and in low-income or middle-income countries. In this Series paper, we examine the application of syndemic theory to comorbidities and multimorbidities in low-income and middle-income countries. We employ diabetes as an exemplar and discuss its comorbidity with HIV in Kenya, tuberculosis in India, and depression in South Africa. Using a model of syndemics that addresses transactional pathophysiology, socioeconomic conditions, health system structures, and cultural context, we illustrate the different syndemics across these countries and the potential benefit of syndemic care to patients. We conclude with recommendations for research and systems of care to address syndemics in low-income and middle-income country settings.

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More information

Accepted/In Press date: 1 January 2017
e-pub ahead of print date: 3 March 2017
Published date: March 2017

Identifiers

Local EPrints ID: 437078
URI: http://eprints.soton.ac.uk/id/eprint/437078
ISSN: 0140-6736
PURE UUID: f9095380-67c7-4bfc-8ab5-5686afac9f49
ORCID for Shane A. Norris: ORCID iD orcid.org/0000-0001-7124-3788

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Date deposited: 16 Jan 2020 17:33
Last modified: 16 Aug 2024 01:59

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Contributors

Author: Emily Mendenhall
Author: Brandon A. Kohrt
Author: Shane A. Norris ORCID iD
Author: David Ndetei
Author: Dorairaj Prabhakaran

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