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

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

Authors

Easter Joury

Eliana Nakhleh

Ed Beveridge

Derek Tracy

Ellie Heidari

David Shiers

Silke Vereeken

Emily Peckham

Simon Gilbody

Jayati Das-Munshi

Farida Fortune

Vishal R. Aggarwal

Masuma Mishu

Joseph Firth

Kamaldeep Bhui



Abstract

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.

Citation

Joury, E., Nakhleh, E., Beveridge, E., Tracy, D., Heidari, E., Shiers, D., Vereeken, S., Peckham, E., Gilbody, S., Das-Munshi, J., Fortune, F., Aggarwal, V. R., Mishu, M., Firth, J., & Bhui, K. (in press). Can social adversity and mental, physical and oral multimorbidity form a syndemic? A concept and protocol paper. Frontiers in Psychiatry, 15, https://doi.org/10.3389/fpsyt.2024.1426054

Journal Article Type Article
Acceptance Date Dec 12, 2024
Online Publication Date Jan 23, 2025
Deposit Date Feb 10, 2025
Publicly Available Date Feb 10, 2025
Journal Frontiers in Psychiatry
Electronic ISSN 1664-0640
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Volume 15
DOI https://doi.org/10.3389/fpsyt.2024.1426054
Keywords physical conditions, syndemics, dental diseases, methodology, mental disorders, health equity, conceptualisation, integrated care
Public URL https://keele-repository.worktribe.com/output/1073343
Publisher URL https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1426054/full

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