Experiencing Syndemic

Disentangling the Biosocial Complexity of Tuberculosis Through Qualitative Research

Bibliographic Data

ID24076152
AuthorsOlga Zvonareva (0000-0001-5548-7491, National Research Tomsk State University, corresponding author), Willemien van Bergen (Maastricht University), Nadezhda Kabanets, Н Н Кабанец (0000-0001-7725-4461, Siberian State Medical University), Aleksander Alliluyev (Siberian State Medical University), Olga Filinyuk, O V Filinyuk (0000-0002-5526-2513, Siberian State Medical University)
Year2019
Volume51
Issue3
Pages403-417
Publication date2019-05-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Biosocial Science (JOURNAL)
Journal identifiersISSN: 0021-9320 • E-ISSN: 1469-7599
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s0021932018000263
PMID30296952
OpenAlexW2896086039
LanguageEN
Citations received10
References cited49

Tuberculosis (TB) remains a major global public health problem that has become a crisis fuelled by HIV and the increasing occurrence of antimicrobial resistance. What has been termed the biosocial nature of TB challenges effective control of the disease. Yet, biosocial interactions involved in the persistence of TB in diverse settings are difficult to systematically account for. The recently developed framework of syndemics provides a way to capture how complex health problems result from the interactions between diseases such as HIV and TB, and harmful social conditions such as unemployment, malnutrition and substance abuse. This article advances the syndemics scholarship by examining health conditions that cluster together with TB in the Russian Federation, by eliciting a set of social processes that precipitate this clustering and exacerbate health outcomes, and by analysing interactions between these health conditions and social processes. To provide an account of this complexity, the article takes a qualitative approach and draws on the perspectives and experiences of people with TB. The results demonstrate emergence of a syndemic of stress, substance abuse, TB and HIV that is sustained by poverty, occupational insecurity, marginalization and isolation. Frictions between the narrow focus of the health care system on TB and the wider syndemic processes in which the lives of many persons with TB are embedded, contribute to poorer health outcomes and increase the risks of developing drug resistance. Finally, the article argues that the large-scale and impersonal forces become embodied as individual pathology through the crucial interface of the ways in which persons experience and make sense of these forces and pathologies. Qualitative research is needed for the adequate analysis of this biosocial complexity in order to provide a solid basis for responses to TB-centred syndemics in various settings.

Biosocial theory · Pathology · Public health · Qualitative research · Social science · Sociology · Syndemic · Tuberculosis · Medicine · Psychology · Social Psychology · Viral Infections and Outbreaks Research · Zoonotic diseases and public health