Using Syndemic Theory and the Societal Lens to Inform Resilient Recovery from COVID-19 Toward a Post-Pandemic World: Proceedings of a Workshop–in Brief (2021) / Chapter Skim
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Using Syndemic Theory and the Societal Lens to Inform Resilient Recovery from COVID-19: Toward a Post-Pandemic World: Proceedings of a Workshop - in Brief
Using Syndemic Theory and the Societal Lens to Inform Resilient Recovery from COVID-19: Toward a Post-Pandemic World: Proceedings of a Workshop - in Brief
Pages 1-11
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the biological and social determinants of health that are involved in identifying and describing syndemics; (2) the reasons for and implications of using the syndemic framing for COVID-19, based on the influence of particular geographic and community contexts on localized disease impacts; and (3)
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Mendenhall stated that a syndemic lens is a way to translate principles from anthropology across disciplines and operationalize them to create and implement effective public health interventions -- at not just the clinical level but the policy level, and perhaps even farther upstream. One of the critiques of syndemic theory, Mendenhall explained, is that identifying and measuring social-level interactions can be complicated compared to more familiar public health research models.
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Mendenhall laid out several possible social remedies for drivers of worsened disease states in the United States: better nutritional labeling and education; improved school lunch options and access; and expanding access to affordable housing, health care, and legal counsel, especially in a clinical setting. She also proposed ways to rethink clinical care, such as person-centered medical homes, which can better coordinate treatment for co-occurring conditions; offering incentives for general practitioners to keep their patients healthy and comprehensively consider their well-being; expanding clinical care teams to include not only more nurses and technicians but also social workers, lawyers, mental health experts, and team coordinators; and improving home visits to treat "super-utilizers"3 who are underserved by fragmented specialty health care.
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The syndemic model, Duchin explained, applies strongly to Seattle and King County, with regard to both its baseline health disparities and the overlay of the local COVID-19 epidemic. One of the main challenges in applying the syndemic model, however, lies in the currently poor understanding of the pathophysiology and biological sequelae of COVID-19.
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He emphasized that combating misinformation regarding health is a critical responsibility for national and local authorities, because in a vacuum of effective public messaging during a crisis, falsehoods fill the gap. This problem, Espinal explained, is not just affecting the United States; nations in Latin America (especially those with low literacy rates)
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Duchin added to Mendenhall's point, acknowledging how the 2019 Global Health Security Index found that, while top ranked for preparedness overall, the United States scored near the bottom of its economic peer group in categories such as access to health care, social support, and public confidence in government leadership (Nuzzo et al., 2020) .12 He added that Seattle and King County's relatively low morbidity and mortality rates compared to other U.S.
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Additionally, Duchin explained, it is difficult for states to enforce the recommended stay-at-home orders if they cannot also provide emergency income assistance to those unable to work, which indicates that the problem is twofold -- lack of both cooperative initiative and the needed facilitating resources. Occupational Health Considerations Helmuth posed a question from the audience about occupation and type of work as contributing social syndemic factors related to COVID-19 and whether solutions might exist to mitigate their effects.
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Securitizing public health, she added, also tempts narrowing it to focus primarily on biological threats and pandemic preparedness, which would detract from the horizontal health integration and community-based approaches propounded by the syndemic philosophy. Espinal expanded on Mendenhall's answer by offering an international perspective on IHR core capacity building, where funds are often allocated vertically to national-level health security issues instead of to community-level health systems.
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Additionally, he argued that the "panic-then-forget" attitude toward public health crises must be broken, and resources and political will can be leveraged to transform the current tendency toward episodic interest in certain emergent diseases into lasting, forward-looking, and comprehensive improvements that account for broad social determinants of health. In conclusion, Obregón shared some insights into the forum's planning for a future workshop titled Toward a Post-Pandemic Future: Lessons from COVID-19 for Now and the Future.16 Topics under consideration include the impact of COVID-19 on other health issues; what can be learned from organizational successes and failures worldwide; the implications of the pandemic for public health messaging and communications; how to build pandemic resilience in all sectors of society; ways to better unite science and politics in public health; and how to break the "panic-thenforget" cycle of public health disaster response.
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2020. WHO to review International Health Regulations during pandemic.
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2021. Using syndemic theory and the societal lens to inform resilient recovery from COVID-19: Toward a post-pandemic world: Proceedings of a workshop -- in brief.
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