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Singer&Clair.Week3.ANTC68.docx

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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 ANTC68 WINTER 2013 Conceptualizing the Syndemic: Social Context  Syndemic points to the determinant importance of social conditions in the health of individuals and populations  Structural violence impacts health o
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