Below is cross-cutting theoretical work.
Beyond Comorbidity: A Critical Perspective of Syndemic Depression and Diabetes in Cross-cultural Contexts
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.
Applying syndemics and chronicity: interpretations from studies of poverty, depression, and diabetes
Medical anthropologists working with global health agendas must develop transdisciplinary frameworks to communicate their work. This article explores two similar but underutilized theoretical frameworks in medical anthropology, and discusses how they facilitate new insights about the relationships between epidemiological patterns and individual-level illness experiences. Two cases from our fieldwork in New Delhi and Chicago are presented to illustrate how syndemics and chronicity theories explain the epidemic problems of co-occurring depression and type 2 diabetes. We use these case studies to illustrate how the holistic agendas of syndemics and chronicity theories allow critical scholars to attend to the macrosocial factors contributing to the rise of noncommunicable diseases while still honoring the diversity of experiences that make individual illness experiences, and actual outcomes, unique. Such an approach not only promotes a more integrative medical anthropology, but also contributes to global health dialogues around diabetes, depression, and their overlap.
In a major contribution to the study of diabetes, this book is the first to analyze the disease through a syndemic framework. An innovative, mixed-methods study, Emily Mendenhall shows how adverse social conditions, such as poverty and oppressive relationships, disproportionately stress certain populations and expose them to disease clusters. She goes beyond epidemiological research that has linked diabetes and depression, revealing how broad structural inequalities play out in the life histories of individuals, families, and communities, and lead to higher rates of mortality and morbidity. This intimate portrait of syndemic suffering is a model study of chronic disease disparity among the poor in high income countries and will be widely read in public health, medical anthropology, and related fields.