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ANTC68H3 Chapter Notes -Medical Anthropology, Syndemic, Biological Interaction


Department
Anthropology
Course Code
ANTC68H3
Professor
Bryce

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ANTC68 WINTER 2013
Syndemics and Public Health Reconceptualizing Disease in Bio-Social Context
Introduction
Syndemic: term to label the synergistic interaction of two or more coexistent
diseases and resultant excess burden of disease
Order imposed in health sector via nosology, a classification system for grouping and
separating sickness events and labelling them according on a basis of shared and
unshared features such as the International Classification of Diseases by the WHO
Nosology’s value: provides guidance in mobilizing effective response in prevention
and treatment
Disease is an explanatory model and biomedicine has ascribed it to be discrete,
objective, clinically identifiable, disjunctive and a boundable entity
Bio cultural approach: understand the determinant interconnections among pressing
health problems, sufferer, and community understandings of illness/disease, in
question, the relevant social, political, and economic forces in play and the
environmental conditions that may have contributed to the development of ill health
Conceptualizing the Syndemic: The Population Level
Simplest population level: refers to two or more epidemics interacting synergistically
and contributing as a result of their interaction to excess burden of disease in a
population (by person, place or time)
To prevent a syndemic, you must not only prevent the individual diseases but also
the forces that bind them together
Syndemic doesn’t refer to just the temporal or locational co-occurrence of two or
more disease or health problems but also the health consequences of biological
interactions among health conditions present
Example: HIV and TB co infection accelerates the progression of both diseases and
increases pathology of HIV
o Reduces survival time of patient with just HIV or just TB
o Active and rapidly progressing TB compared to those who are HIV negative
because of the effect on immune system
Not just co infection but rather ENHANCED infection due to disease INTERACTION
Example: HPV + Herpes + HIV = way worse outcomes!
Example: Asthma
o Asthma worse in those exposed to neighbourhood violence
o Asthma + SES
o Asthma & RSV infection
Conceptualizing the Syndemic: Biological Synergism
Central point of a syndemic is that co-occurrence of two or more disease results in
actual biological interaction
Does not require direct physical interaction (like genetics) but there must be new or
amplified health consequences
Hepatitis B and HIV extensive replication of HIV when infected with Hep B as well
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