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syndemic
A syndemic is the aggregation of two or more diseases in a population in which there is some level of positive biological interaction that exacerbates the negative health effects of any or all of the diseases. The term was developed and introduced by Merrill Singer in several articles in the mid-1990s and has since received growing attention and use among epidemiologists and medical anthropologists concerned with community health and the effects of social conditions on health, culminating in a recent textbook.〔Merrill, S. (2009) (Introducing Syndemics: A Critical Systems Approach to Public and Community Health ) ''Wiley'' pp.304.〕 Syndemics tend to develop under conditions of health disparity, caused by poverty, stress, or structural violence, and contribute to a significant burden of disease in affected populations. The term syndemic is further reserved to label the consequential interactions between concurrent or sequential diseases in a population and in relation to the social conditions that cluster the diseases within the population.
The traditional biomedical approach to disease is characterized by an effort to diagnostically isolate, study, and treat diseases as if they were distinct entities that existed in nature separate from other diseases and independent of the social contexts in which they are found. This singular approach proved useful historically in focusing medical attention on the immediate causes and biological expressions of disease and contributed, as a result, to the emergence of targeted modern biomedical treatments for specific diseases, many of which have been successful. As knowledge about diseases has advanced, it is increasingly realized that diseases are not independent and that synergistic disease interactions are of considerable importance for prognosis. Given that social conditions can contribute to the clustering, form and progression of disease at the individual and population level, there is growing interest in the health sciences on syndemics.
==Cooccurrence versus syndemism==
Disease cooccurrence, with or without interactions, is known as comorbidity, coinfection, and associated terms. The differences between "comorbid" and "syndemic" are not merely semantic. As Mustanski et al. (2008:40) explain: "comorbidity research tends to focus on the nosological issues of boundaries and overlap of diagnoses, while syndemic research focuses on communities experiencing co-occurring epidemics that additively increase negative health consequences." Consequently, it is possible for two afflictions to be comorbid, but not be syndemic (i.e., the disorders are not epidemic in the studied population or their co-occurrence is not accompanied by worsened health). Thus, two (or more) diseases can be comorbid but no interaction occurs between them, while in other cases interaction occurs but it has beneficial rather than deleterious consequences. ''Syndemic theory'' seeks to draw attention to and provide a framework for the analysis of adverse disease interactions, including their causes and consequences for human life and well-being.
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