A mixed-methods, population-based study of a syndemic in Soweto, South Africa
A mixed-methods, population-based study of a syndemic in Soweto, South Africa
A syndemic has been theorized as a cluster of epidemics driven by harmful social and structural conditions wherein the interactions between the constitutive epidemics drive excess morbidity and mortality. We conducted a mixed-methods study to investigate a syndemic in Soweto, South Africa, consisting of a population-based quantitative survey (N = 783) and in-depth, qualitative interviews (N = 88). We used ethnographic methods to design a locally relevant measure of stress. Here we show that multimorbidity and stress interacted with each other to reduce quality of life. The paired qualitative analysis further explored how the quality-of-life impacts of multimorbidity were conditioned by study participants' illness experiences. Together, these findings underscore the importance of recognizing the social and structural drivers of stress and how they affect the experience of chronic illness and well-being.
Adult, Diabetes Mellitus/epidemiology, Female, HIV Infections/epidemiology, Humans, Hypertension/epidemiology, Male, Middle Aged, Multimorbidity, Neoplasms/epidemiology, Quality of Life, Social Cohesion, South Africa/epidemiology, Stress, Psychological/epidemiology, Syndemic
64-73
Mendenhall, Emily
04022883-7dc9-4d5f-b288-e937cf07283f
Kim, Andrew Wooyoung
baef02e6-b25d-42a5-89e6-1907d35aad0a
Panasci, Anthony
14b40cdd-5fb2-45f3-9008-c17a3dde66e6
Cele, Lindile
84803a47-1968-459b-9138-3cb0a15c92d3
Mpondo, Feziwe
aa646c71-ab88-4d96-9f15-c9351ec6ed44
Bosire, Edna N
043436e9-f457-4ef9-a1a5-a1179db63f2f
Norris, Shane A
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Tsai, Alexander C
8edc0030-cdb6-408f-8f5d-653ada933085
23 December 2021
Mendenhall, Emily
04022883-7dc9-4d5f-b288-e937cf07283f
Kim, Andrew Wooyoung
baef02e6-b25d-42a5-89e6-1907d35aad0a
Panasci, Anthony
14b40cdd-5fb2-45f3-9008-c17a3dde66e6
Cele, Lindile
84803a47-1968-459b-9138-3cb0a15c92d3
Mpondo, Feziwe
aa646c71-ab88-4d96-9f15-c9351ec6ed44
Bosire, Edna N
043436e9-f457-4ef9-a1a5-a1179db63f2f
Norris, Shane A
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Tsai, Alexander C
8edc0030-cdb6-408f-8f5d-653ada933085
Mendenhall, Emily, Kim, Andrew Wooyoung, Panasci, Anthony, Cele, Lindile, Mpondo, Feziwe, Bosire, Edna N, Norris, Shane A and Tsai, Alexander C
(2021)
A mixed-methods, population-based study of a syndemic in Soweto, South Africa.
Nature Human Behaviour, 6 (1), .
(doi:10.1038/s41562-021-01242-1).
Abstract
A syndemic has been theorized as a cluster of epidemics driven by harmful social and structural conditions wherein the interactions between the constitutive epidemics drive excess morbidity and mortality. We conducted a mixed-methods study to investigate a syndemic in Soweto, South Africa, consisting of a population-based quantitative survey (N = 783) and in-depth, qualitative interviews (N = 88). We used ethnographic methods to design a locally relevant measure of stress. Here we show that multimorbidity and stress interacted with each other to reduce quality of life. The paired qualitative analysis further explored how the quality-of-life impacts of multimorbidity were conditioned by study participants' illness experiences. Together, these findings underscore the importance of recognizing the social and structural drivers of stress and how they affect the experience of chronic illness and well-being.
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More information
Accepted/In Press date: 22 October 2021
Published date: 23 December 2021
Additional Information:
We are greatly indebted to the participants, their families and our research assistants, as this study would not have existed without them. We thank X. Potelwa, S. Kunene, J. Mabasa, S. Mavi, G. Morsi, Z. Mpanza and S. Sihlangu for their collaborative work on the study. We also thank the front-line and community health workers who are working endlessly to keep Soweto and the rest of South Africa healthy and safe during this challenging time. The project benefited substantially from the support of M. Beery. The research was funded by US National Institutes of Health (NIH) grant nos R21TW010789 (E.M., S.A.N. and A.C.T.) and D43TW010543 (A.W.K.), the South African Medical Research Council (S.A.N.) and the Department of Science and Innovation–National Research Foundation Centre of Excellence in Human Development (S.A.N.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Keywords:
Adult, Diabetes Mellitus/epidemiology, Female, HIV Infections/epidemiology, Humans, Hypertension/epidemiology, Male, Middle Aged, Multimorbidity, Neoplasms/epidemiology, Quality of Life, Social Cohesion, South Africa/epidemiology, Stress, Psychological/epidemiology, Syndemic
Identifiers
Local EPrints ID: 456302
URI: http://eprints.soton.ac.uk/id/eprint/456302
ISSN: 2397-3374
PURE UUID: a50d58ed-3b00-4a9b-8bb8-f631834be1ac
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Date deposited: 27 Apr 2022 02:09
Last modified: 17 Mar 2024 03:57
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Contributors
Author:
Emily Mendenhall
Author:
Andrew Wooyoung Kim
Author:
Anthony Panasci
Author:
Lindile Cele
Author:
Feziwe Mpondo
Author:
Edna N Bosire
Author:
Alexander C Tsai
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