TY - JOUR

T1 - Can social adversity and mental, physical and oral multimorbidity form a syndemic? A concept and protocol paper

AU - Joury, Easter

AU - Nakhleh, Eliana

AU - Beveridge, Ed

AU - Tracy, Derek

AU - Heidari, Ellie

AU - Shiers, David

AU - Peckham, Emily

AU - Vereeken, Silke

AU - Gilbody, Simon

AU - Das-Munchi, Jayati

AU - Fortune, Farida

AU - Aggarwal, Vishal

AU - Mishu, Masuma Pervin

AU - Firth, Joseph

AU - Bhui, Kamaldeep

PY - 2025/1/23

Y1 - 2025/1/23

N2 - Background: Clustering mental, physical and oral conditions reduce drastically the life expectancy. These conditions are precipitated and perpetuated by adverse social, economic, environmental, political and healthcare contextual factors, and sustained through bidirectional interactions forming potentially a ‘syndemic’. No previous study has investigated such potential syndemic. Thus, the present project aimed to (i) test for syndemic interactions between social adversity (socioeconomic adversity and traumatic events) and mental, physical and oral multimorbidity using the syndemic theoretical framework; and (ii) determine whether the syndemic relationships vary by age, sex and ethnicity.Methods: Data from three large-scale population-based databases: UK BioBank, US National Health and Nutrition Examination Survey (NHANES) and the Research with East London Adolescents Community Health Survey (RELACHS) will be analysed. Structural equation modelling (SEM) will be utilised to conceptualise syndemic factors and model complex relationships between directly observed and indirectly observed (latent) variables (syndemic constructs).Discussion: the syndemic conceptualisation provides a valuable framework to understand health and illness, and hence to better design and deliver effective and cost-effective preventative and curative integrated (syndemic) care to improve patient and population health. Such syndemic care aims to address the social determinants of health, whilst simultaneously managing all interlocked conditions.

AB - Background: Clustering mental, physical and oral conditions reduce drastically the life expectancy. These conditions are precipitated and perpetuated by adverse social, economic, environmental, political and healthcare contextual factors, and sustained through bidirectional interactions forming potentially a ‘syndemic’. No previous study has investigated such potential syndemic. Thus, the present project aimed to (i) test for syndemic interactions between social adversity (socioeconomic adversity and traumatic events) and mental, physical and oral multimorbidity using the syndemic theoretical framework; and (ii) determine whether the syndemic relationships vary by age, sex and ethnicity.Methods: Data from three large-scale population-based databases: UK BioBank, US National Health and Nutrition Examination Survey (NHANES) and the Research with East London Adolescents Community Health Survey (RELACHS) will be analysed. Structural equation modelling (SEM) will be utilised to conceptualise syndemic factors and model complex relationships between directly observed and indirectly observed (latent) variables (syndemic constructs).Discussion: the syndemic conceptualisation provides a valuable framework to understand health and illness, and hence to better design and deliver effective and cost-effective preventative and curative integrated (syndemic) care to improve patient and population health. Such syndemic care aims to address the social determinants of health, whilst simultaneously managing all interlocked conditions.

U2 - 10.3389/fpsyt.2024.1426054

DO - 10.3389/fpsyt.2024.1426054

M3 - Article

VL - 15

JO - Frontiers in Psychiatry

JF - Frontiers in Psychiatry

SN - 1664-0640

ER -