Application of the Syndemic Theory and Analysis of Synergy

Syndemic Theory is a relatively new theory developed first within the field of medical anthropology and later adopted by social epidemiology and public health. The term “syndemic” stands for “synergistic epidemics” where two or more health (related) problems (1) co-occur and (2) synergistically interact with each other (3) within a specific socioenvironmental context which itself also interact with the health problems. These deleterious interactions result in an increased health burden. The first example in the literature was the SAVA syndemic (Substance Abuse, Violence, AIDS) identified among the urban poor. More recent studies applied the theory to the COVID-19 pandemic and the global system of Obesity-Undernutrition-Climate Change. The theory also suggests that a syndemic requires different prevention strategies than it would do if those problems were independent of each other. This theory aligns with the systems approach that we employ in the SPACE project and it has a great potential to provide actionable insights. SPACE contributes back to the theory not only by testing it on less studied cognitive and environmental health domains but also linking it with the systems approaches. This presentation provides a worked example of the application of syndemic theory to investigate air pollution, physical inactivity and cognitive decline. We will explain the use of a variety of methods to analyse synergistic interactions while recognizing the central role of the social and environmental contexts.