Global Health & Human Rights Faculty Publish in Top Medical Journal The Lancet
Prepared by Anne Kohler
It is uncommon for medical anthropologists to publish their work in the world’s top medical journals, but three UConn faculty members in the Human Rights Institute’s Research Program on Global Health and Human Rights (GH&HR) have done just that. Earlier this month, the British medical journal The Lancet published articles by UConn anthropologists Merrill Singer, Sarah Willen, and César Abadía-Barrero and colleagues as part of a special series on Syndemics, an interdisciplinary approach to health adversity initially developed by Singer.
Syndemics draws on medical anthropology and public health to identify, explain, and confront the synergies among co-occurring epidemics under conditions of structural and political adversity. According to the series contributors, a syndemics approach can guide strategic collaboration among clinicians, public health professionals, policy makers, civil society actors, researchers, and other stakeholders who are committed to understanding and combating health inequities. Key to such collaboration is a shared recognition that health inequities cannot be solved simply by changing people’s behavior, or giving them better medical care. Instead, syndemics researchers insist, health inequalities can best – and perhaps only – be resolved through “upstream” forms of social, political, and structural change.
Singer and colleagues developed the concept of syndemics while studying the HIV/AIDS epidemic in Hartford in the 1980s. They saw that people experiencing poverty, social exclusion, substance abuse, and the risk of violence faced not just a higher risk of getting sick, but also an increased likelihood of experiencing multiple diseases that interacted to make them sicker, faster. In their paper, “Syndemics and the Biosocial Conception of Health,” Singer and co-authors Nicola Bulled and Bayla Ostrach, both UConn alumnae, discuss why certain diseases cluster together; the biological pathways through which diseases can interact at the individual and population level; and the ways in which social, economic, political, environmental, and structural circumstances can aggravate disease clustering and heighten health vulnerability. As series editor Emily Mendenhall and colleagues contend, these patterns of clustering create significant clinical challenges, but also point to opportunities for providing “syndemic care” involving streamlined protocols for diagnosis and treatment.
The syndemics framework also has important implications for research, policy, and practice in the domain of health and human rights, as Willen and Abadía-Barrero argue in their article, “Syndemic Vulnerability and the Right to Health,” co-authored with Michael Knipper and Nadav Davidovitch. Taking the urgent matter of migrant health as focus, Willen and colleagues consider how syndemic risk and human rights violations can become entwined in ways that endanger migrants’ and refugees’ health. They offer several illustrations of the “syndemic vulnerability” migrants face, including child asylum seekers detained for prolonged periods by the Australian government; refugees living in unsafe and unsanitary open-air encampments on European soil; and farmworkers in the United States, who face heightened risk of heatstroke and kidney disease because of national, state, and industry policies that support migrant workers’ criminalization and exploitation.
A combined syndemics/human rights approach to health inequity, the authors argue, can help health professionals, researchers, activists, and policymakers advance the right to health in its fullest form: as “the opportunity for all people to develop their full range of human capabilities and have an equal chance to live a flourishing life.”
The Lancet Syndemics series is the culmination of two years of intensive collaboration among researchers at Georgetown, UConn, Harvard, Trinity, and Duke as well as other universities in the U.S. and Germany, Israel, South Africa, Kenya, India, and the United Kingdom. The project kicked off in May 2015 with a brainstorming workshop at UConn that was co-sponsored by Georgetown and the Research Program on Global Health and Human Rights at HRI, which Willen directs.