Mendenhall Emily
Science, Technology, and International Affairs Program, Edmund A. Walsh School of Foreign Service, Georgetown University.
Med Anthropol Q. 2016 Dec;30(4):462-478. doi: 10.1111/maq.12215. Epub 2015 May 15.
This article examines the comorbidity concept in medical anthropology. I argue that the dearth of articles on comorbidity in medical anthropology may result from the rise of syndemic theory. Syndemics recognize how social realities shape individual illness experiences as well as distribution of diseases across populations. I discuss synergistic interactions foundational to the syndemics construct through my research of depression and diabetes comorbidity in vulnerable populations from urban United States, India, and South Africa. I argue that social and economic factors that cluster with depression and diabetes alone and together exemplify the biosocial processes that are at the heart of syndemics. In doing so, I illustrate how social, cultural, and economic factors shape individual-level experiences of co-occurring diseases despite similar population-level trends. Finally, I discuss the relevance of syndemics for the fields of medicine and public health while cautioning what must not be lost in translation across disciplines.
本文探讨了医学人类学中的共病概念。我认为,医学人类学中关于共病的文章匮乏可能是由于综合征理论的兴起。综合征认识到社会现实如何塑造个体的疾病经历以及疾病在人群中的分布。通过对美国城市、印度和南非弱势群体中抑郁症与糖尿病共病的研究,我讨论了构成综合征概念基础的协同相互作用。我认为,单独和共同与抑郁症和糖尿病相关的社会和经济因素体现了综合征核心的生物社会过程。在此过程中,我说明了尽管在人群层面有相似趋势,但社会、文化和经济因素如何塑造个体层面共病的经历。最后,我讨论了综合征对医学和公共卫生领域的相关性,同时提醒跨学科翻译时不能遗漏的内容。