期刊
SOCIAL SCIENCE & MEDICINE
卷 206, 期 -, 页码 117-122出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2018.03.040
关键词
HIV; Mixed methods; Multilevel analysis; Population health; Social determinants of health; Stigma; Syndemic; Syndemics
资金
- NATIONAL INSTITUTE OF MENTAL HEALTH [R01MH113494] Funding Source: NIH RePORTER
- NIMH NIH HHS [R01 MH113494] Funding Source: Medline
The concept of a syndemic was proposed more than two decades ago to explain how large-scale social forces might give rise to co-occurring epidemics that synergistically interact to undermine health in vulnerable populations. This conceptual instrument has the potential to help policymakers and program implementers in their endeavors to improve population health. Accordingly, it has become an increasingly popular heuristic for advocacy, most notably in the field of FIN treatment and prevention. However, most empirical studies purporting to validate the theory of syndemics actually do no such thing. Tomori et al. (2018) provide a novel case study from India illustrating how the dominant empirical approach fails to promote deeper understanding about how hazardous alcohol use, illicit drug use, depression, childhood sexual abuse, and intimate partner violence interact to worsen HIV risk among men who have sex with men. In this commentary, I relate the theory of syndemics to other established social science and public health theories of disease distribution, identify possible sources of conceptual and empirical confusion, and provide concrete suggestions for how to validate the theory using a mixed-methods approach. The hope is that more evidence can be mobilized - whether informed by the theory of syndemics or not - to improve health and psychosocial wellbeing among vulnerable populations worldwide.
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