Social Anthropology, University of Edinburgh.
Med Anthropol Q. 2020 Dec;34(4):488-503. doi: 10.1111/maq.12626. Epub 2020 Dec 4.
To date, the strongest predictor for dying with COVID-19 is suffering from several chronic disorders prior to the viral infection. Pre-existing multimorbidity is highly correlated with socioeconomic inequality. In turn, having several chronic conditions is closely linked to multiple medication intake, especially in richer countries with good access to biomedical care. Owing to its vertical structure, biomedicine often risks giving multiple treatments in an uncoordinated way. Such lack of integrated care can create complex forms of iatrogenic harm. Multimorbidity is often exacerbated by a pharmaceuticalization of social deprivation in place of integrated care. In this article, I explore the possibility that clusters of over-medication are a contributing factor to higher death rates from COVID-19, especially in poorer areas within richer countries. Anthropological perspectives on the social embeddedness of multimorbidity and multiple medication use can expand our understanding of who is most vulnerable to SARS-CoV-2.
迄今为止,COVID-19 患者死亡的最强预测因子是在病毒感染之前患有多种慢性疾病。预先存在的多种合并症与社会经济不平等高度相关。反过来,患有多种慢性疾病与多种药物的摄入密切相关,尤其是在拥有良好生物医学保健服务的富裕国家。由于生物医学的垂直结构,它往往存在多种治疗方法不协调的风险。这种缺乏综合护理的情况会导致产生复杂形式的医源性伤害。多种合并症往往因社会剥夺的药物化而恶化,而不是综合护理。在本文中,我探讨了过度用药的集群是否是导致 COVID-19 死亡率上升的一个因素,特别是在富裕国家中较贫困地区。从人类学的角度来看,多种合并症和多种药物使用的社会嵌入性可以扩大我们对谁更容易受到 SARS-CoV-2 影响的理解。