The Field Museum of Natural History, Keller Science Action Department, Chicago, IL, USA.
Tulane University, School of Public Health and Tropical Medicine. New Orleans, LA, USA; Institute of Development Studies, University of Sussex, Brighton, United Kingdom.
Soc Sci Med. 2022 Feb;295:113037. doi: 10.1016/j.socscimed.2020.113037. Epub 2020 May 15.
Ecosyndemics refer to disease interactions that result from environmental changes commonly caused by humans. In this paper, we push scholarship on ecosyndemics into new territory by using the ecosyndemic framework to compare two case studies-the Southern Interoceanic highway in Peru and the Belo Monte hydroelectric dam in Brazil-to assess the likelihood of socio-environmental factors interacting and leading to ill health in a syndemic fashion. Assessing these two case studies using an ecosyndemic perspective, we find that the construction of dams and highways in tropical forests create the conditions for increases in vector-borne illnesses, surges in sex work and sexually-transmitted infections, and increased psychological stress resulting from violence, delinquency, and the erosion of social cohesion. We suggest that these processes could interact synergistically to increase an individual's immune burden and a population's overall morbidity. However, we find differences in the impacts of the Interoceanic highway and the Belo Monte dam on food, water, and cultural systems, and observed that community and corporate-level actions may bolster health in the face of rapid socio-ecological change. Looking at the case studies together, a complex picture of vulnerability and resilience, risk and opportunity, complicates straight-forward predictions of ecosyndemic interactions resulting from these development projects but highlights the role that the ecosyndemic concept can play in informing health impact assessments and future research. We conclude by proposing a conceptual model of the potential interactions between psychological stress, vector-borne illnesses, and sexaully-transmitted infections and suggest that future investigations of synergistic interactions among these factors draw from the biological, social, and ecological sciences.
生态综合征是指由于人类引起的环境变化而导致的疾病相互作用。在本文中，我们利用生态综合征框架将生态综合征的研究推向新的领域，通过比较秘鲁的南大洋公路和巴西的贝洛蒙特水电站这两个案例研究，来评估社会环境因素相互作用并以综合征方式导致健康不良的可能性。从生态综合征的角度评估这两个案例研究，我们发现，在热带森林中建造水坝和公路会为虫媒传染病的增加、性工作和性传播感染的激增以及暴力、犯罪和社会凝聚力侵蚀导致的心理压力增加创造条件。我们认为，这些过程可能会协同作用，增加个体的免疫负担和人群的整体发病率。然而，我们发现，南大洋公路和贝洛蒙特大坝对食物、水和文化系统的影响存在差异，并观察到社区和企业层面的行动可能会在快速的社会生态变化面前增强健康。综合来看，这些发展项目导致的生态综合征相互作用的脆弱性和弹性、风险和机遇的复杂情况，使得对生态综合征相互作用的直接预测变得复杂，但突出了生态综合征概念在健康影响评估和未来研究中的作用。最后，我们提出了一个心理压力、虫媒传染病和性传播感染之间潜在相互作用的概念模型，并建议未来对这些因素之间协同相互作用的研究应借鉴生物、社会和生态科学。
