Definition: Syndemic

When used as a noun, a syndemic is defined as two or more afflictions, interacting synergistically, contributing to excess burden of disease in a population. Related concepts include: linked epidemics, interacting epidemics, connected epidemics, co-occurring epidemics, co-morbidities, and clusters of health-related crises.

The word syndemic was coined by anthropologist Merrill Singer and first published in 1992 to convey what he and his colleagues saw as inextricable and mutually reinforcing connections between health problems such as substance abuse, violence, and AIDS among urban women in the US.

For additional information on this site see: Encyclopedia Entry, Overview, and Monograph.

Definition: Syndemic Orientation

When used as an adjective, a syndemic orientation is defined as a way of thinking about public health work that focuses on connections among health-related problems, considers those connections when developing health policies, and aligns with other avenues of social change to assure the conditions in which all people can be healthy.

With the Greek prefix syn, meaning together, the term syndemic strips away the ancient idea that illnesses originate from extraordinary or supernatural forces and places the responsibility for human suffering squarely within the public arena, where people come together to confront and craft a common world. The term points to the power of all relationships, raising questions about how different kinds of health problems affect each other. At the same time, it calls attention to the ways in which people and institutions relate to one another and to the physical places in which they exist. In its fullest sense, the word syndemic portrays health as a fragile, dynamic state that is imperiled when social and physical forces come together in harmful or dysfunctional ways. The word asks that all observers pay closer attention to the connections that have always existed but are often overlooked, unquestioned, or neglected in the conventional approach of epidemiology.

The notion of a syndemic does not challenge the legitimacy of epidemiology, which was invented to understand discrete, sporadically occurring problems and has proven itself to be an indispensable tool for guiding public health work. Instead, the idea invites us to develop a complementary science of relationships that is capable of understanding and more effectively governing the dynamic forces that surround multiple health problems, along with the intricate organizational systems that we as a society create to anticipate and respond to them.

For additional information on this site see: Encyclopedia Entry, Overview, and Monograph.

References

Singer M, Snipes C. Generations of suffering: experiences of a treatment program for substance abuse during pregnancy. Journal of Health Care for the Poor and Underserved 1992;3(1):222-34.
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Singer M. A dose of drugs, a touch of violence, a case of AIDS: conceptualizing the SAVA syndemic. Free Inquiry 1996;24(2):99-110.

Singer M. AIDS and the health crisis of the US urban poor: the perspective of critical medical anthropology. Social Science and Medicine 1994;39(7):931-48.
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Singer MC, Erickson PI, Badiane L, Diaz R, Ortiz D, Abraham T, Nicolaysen AM. Syndemics, sex and the city. Social Science and Medicine 2006;63(8):2010-21.
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Page last reviewed: January 30, 2008
Page last modified: January 30, 2008

Content source: Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion