| An important insight about health ushered in by the | | | | individual categories, however, reduces as well our |
| emergence of HIV/AIDS and its rapid spread across | | | | ability to understand their essential interactive nature. |
| the planet is that the standard medical way of | | | | Syndemics theory brings this same understanding to |
| looking at disease is a distortion. Although medicine | | | | the study of health. A syndemic is defined as a set |
| claims to be culture free its conception of the nature | | | | of enmeshed and mutually enhancing health problems |
| of the world and of basic life processes is rooted in a | | | | that, working together in a context of adverse social |
| particular construction of reality that reflects Western | | | | and physical conditions, can significantly affect the |
| culture. In medicine, as well as in public health, the | | | | overall disease burden and health status of a |
| traditional strategy has been to narrowly focus | | | | population. From the syndemics perspective, since |
| attention on individual diseases. This orientation, | | | | many of the primary contemporary threats to the |
| derived from the Western philosophical practice | | | | health, from cancer to heart disease and from |
| known as reductionism, has been dominant since the | | | | diabetes to HIV/AIDS, often are found together |
| rise of germ theory in the mid-1800s. Reductionism | | | | rather than as independent epidemics they really are |
| asserts that complex phenomena are best | | | | not completely separable phenomena. |
| understood as a set of separable parts independent | | | | A syndemics approach, consequently, examines both |
| of other parts and of their natural context. Reflective | | | | "disease concentrations" (i.e., multiple coterminous |
| of this atomistic approach to knowledge, medicine | | | | diseases and disorders affecting individuals and |
| separates the patient from his/her social network | | | | groups) and "disease interactions" (i.e., the ways in |
| and community, diseased organ systems from the | | | | which the presence of one disease enhances the |
| whole body, a disease from other co-morbid | | | | health consequences of other co-present diseases, |
| conditions, each disease into its constituent parts, and | | | | such as paving the way for new infection as HIV |
| the treatment of disease through assignment to | | | | AIDS does with a host of opportunistic diseases but |
| narrowly focused medical specialties. | | | | with non-opportunistic diseases like kidney disease, |
| HIV/AIDS, however, has proven to be such a | | | | cancer, and malnutrition as well). Of concern to the |
| challenge, in part, because it tends to be found in | | | | syndemics approach, as a result, is the nature of the |
| close alignment with a host of other diseases, | | | | specific biological and social pathways through which |
| infectious and chronic. As a result, research on the | | | | diseases and other health conditions interact in |
| multiple diseases of people living with HIV/AIDS has | | | | individual bodies and in populations. |
| helped to foster a new conception of disease itself. | | | | Consequently, at its simplest level, the term syndemic |
| This new perspective, known as syndemics theory, | | | | labels two or more epidemics interacting |
| moves conception of health beyond the narrow | | | | synergistically and contributing, as a result of this |
| frames of customary reference. An essential feature | | | | interaction to excess disease. Importantly, the term |
| of syndemics can be grasped through a glimpse at an | | | | syndemic refers not only to the co-occurrence of |
| unexpected life form, the lichen. While in appearance | | | | two or more diseases, but also to the identifiable |
| and structure the often taken-for-granted lichen | | | | health consequences of biological interactions among |
| appears to be a simple plant; but in fact it constitutes | | | | co-present diseases. In a syndemic, interaction |
| a symbiotic community that intertwines a fungus, | | | | between diseases commonly occurs because adverse |
| most commonly a member of the family that includes | | | | social conditions (e.g., poverty, stigmatization, and |
| truffles and Baker's yeast, with an algae, usually | | | | discrimination) puts a group at heightened risk for |
| green or blue-green algae. As an interactive group of | | | | multiple health problems. It is this kind of interaction, |
| species, lichen represent a living pathway between | | | | for example, that explains both the intense HIV/AIDS |
| organisms and ecosystems. They are at once | | | | epidemic in Southern Africa as well as the |
| composed of identifiable species and of interactive | | | | disproportionate rate of HIV/AIDS among African |
| processes and relationships. Reducing them to | | | | Americans and Latinos in the United States. |