AUTHOR=Joury Easter , Nakhleh Eliana , Beveridge Ed , Tracy Derek , Heidari Ellie , Shiers David , Vereeken Silke , Peckham Emily , Gilbody Simon , Das-Munshi Jayati , Fortune Farida , Aggarwal Vishal R. , Mishu Masuma , Firth Joseph , Bhui Kamaldeep 

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

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 15 - 2024

YEAR=2025

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1426054

DOI=10.3389/fpsyt.2024.1426054

ISSN=1664-0640

ABSTRACT=BackgroundClustering 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.MethodsData 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).Discussionthe 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.