Edmund A. Walsh School of Foreign Service, Georgetown University, Washington, DC, USA.
SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa.
Nat Med. 2022 Jul;28(7):1359-1362. doi: 10.1038/s41591-022-01888-y. Epub 2022 Jul 21.
The theory of syndemics has received increasing attention in clinical medicine since the onset of the COVID-19 pandemic, due to the synergistic interactions of the disease with pre-existing political, structural, social and health conditions. In simple terms, syndemics are synergistically interacting epidemics that occur in a particular context with shared drivers. When policymakers ask why some communities have higher death rates from COVID-19 compared with other communities, those working from a syndemics framework argue that multiple factors synergistically work in tandem, and populations with the highest morbidity and mortality experience the greatest impact of these interactions. In this Perspective, we use specific case examples to illustrate these concepts. We discuss the emergence of syndemics, how epidemics interact, and what scientists, clinicians and policymakers can do with this information.
自 COVID-19 大流行以来,由于疾病与先前存在的政治、结构、社会和健康状况的协同作用,综合征理论在临床医学中受到越来越多的关注。简而言之,综合征是在特定背景下发生的协同相互作用的流行病,具有共同的驱动因素。当政策制定者询问为什么某些社区的 COVID-19 死亡率高于其他社区时,从综合征理论框架出发的人认为,多种因素协同作用,发病率和死亡率最高的人群受到这些相互作用的影响最大。在本观点中,我们使用具体案例来说明这些概念。我们讨论了综合征的出现、流行病的相互作用以及科学家、临床医生和政策制定者可以用这些信息做些什么。