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综合征与健康的生物社会概念。

Syndemics and the biosocial conception of health.

机构信息

Department of Anthropology, University of Connecticut, Storrs, CT, USA; Department of Community Medicine, University of Connecticut, Storrs, CT, USA.

Division of Interdisciplinary & Global Studies, Worcester Polytechnic Institute, Worcester, MA, USA.

出版信息

Lancet. 2017 Mar 4;389(10072):941-950. doi: 10.1016/S0140-6736(17)30003-X.

Abstract

The syndemics model of health focuses on the biosocial complex, which consists of interacting, co-present, or sequential diseases and the social and environmental factors that promote and enhance the negative effects of disease interaction. This emergent approach to health conception and clinical practice reconfigures conventional historical understanding of diseases as distinct entities in nature, separate from other diseases and independent of the social contexts in which they are found. Rather, all of these factors tend to interact synergistically in various and consequential ways, having a substantial impact on the health of individuals and whole populations. Specifically, a syndemics approach examines why certain diseases cluster (ie, multiple diseases affecting individuals and groups); the pathways through which they interact biologically in individuals and within populations, and thereby multiply their overall disease burden, and the ways in which social environments, especially conditions of social inequality and injustice, contribute to disease clustering and interaction as well as to vulnerability. In this Series, the contributions of the syndemics approach for understanding both interacting chronic diseases in social context, and the implications of a syndemics orientation to the issue of health rights, are examined.

摘要

健康的综合征模式侧重于生物社会综合体,它由相互作用、共同存在或连续发生的疾病以及促进和加剧疾病相互作用负面影响的社会和环境因素组成。这种新兴的健康概念和临床实践方法重新配置了疾病的传统历史理解,即疾病在自然界中是不同的实体,与其他疾病分开,与它们所处的社会环境无关。相反,所有这些因素往往以各种重要的方式协同相互作用,对个人和整个人口的健康产生重大影响。具体来说,综合征方法研究了为什么某些疾病会聚集(即,多种疾病影响个人和群体);它们在个体和人群中相互作用的生物学途径,从而增加了它们的总体疾病负担,以及社会环境,特别是社会不平等和不公正的条件,如何导致疾病聚集和相互作用以及易感性。在本系列中,探讨了综合征方法对理解社会背景下相互作用的慢性疾病以及综合征方向对健康权利问题的影响。

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