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Tuberculosis (TB) and helminth infestation are tied in multiple ways through physiological interactions both pre‐ and postnatally. In the Pacific, these interactions have occurred in the context of colonial and postcolonial changes. We argue that these biocultural interactions help to explain the historical experience of TB for people in the Pacific nations of Tuvalu and the Cook Islands. Successive campaigns against specific helminths and later efforts at TB control have led to variable outcomes. In this article, we analyze the implications of controlling syndemic conditions for health practice.

Syndemics play a substantial role in shaping the disease burdens of populations, especially in times of war. It is estimated that in the 20th century, sixty‐two million civilians suffered war‐related deaths, in addition to forty‐five million combatant deaths. Many of these casualties were due to disease rather than battlefield injuries. Through a review and analysis of interdisciplinary literature on war and health, and using case studies of several wars from different periods of history, we argue that war is a disruptive biosocial process that sets in motion interactions between diseases and other conditions that increase war‐related morbidity and mortality.

Rapid economic transformations have both positive and negative consequences for nutrition and health. This article presents data from an area of rural Costa Rica that has experienced a rapid economic shift from dairy farming and coffee production to a mixed economy based increasingly on tourism and to a lesser extent on agriculture. During a one‐year period (2004–2005), sociodemographic, employment, dietary intake, food security, anthropometric, and ethnographic (food habits) data were collected from 148 households in two rural communities. The results show that 50 percent of the households are directly involved in the tourism industry, while many others rely on economic strategies that combine involvement in tourism with agricultural activities. Overall, high rates of food insecurity were documented (with over 70 percent of the households experiencing some level of food insecurity over the previous 12 months). The data also show high rates of caregiver and child overweight and obesity and a diet that varies according to food security status. Syndemics theory, which postulates that the dynamic interaction between co‐occurring conditions magnifies the effects of each one in isolation can be used to understand how malnutrition (overnutrition) related to economic insecurity and overweight and obesity together may be contributing to the rise in chronic diet‐related diseases, such as hypertension and type‐2 diabetes, in the study area. The interactions between these comorbidities point to the need for the development of multidimensional public health interventions that couple individual behavior change and community‐driven efforts that reduce economic insecurity and ameliorate food insecurity, resulting in more balanced diets and a reduction in overweight and obesity.

Tropical disease syndemics, the adverse morbidity‐enhancing interaction of two or more neglected tropical diseases (NTDs), like the diseases that comprise them, have been largely unrecognized and generally neglected. However, their role in contributing to the health burden of the poor is significant. This paper presents syndemics as a new theoretical perspective with which to develop a comprehensive approach to understand and respond to the health consequences of adverse interactions among NTDS and between NTDs and other diseases. Specifically the paper examines local social factors and macro‐level political economic factors that are both the ultimate source and ultimate arbiter of public and medical responses to syndemics of NTDs.

The theory of syndemics has been widely applied in HIV‐prevention studies of gay, bisexual, and other MSM (men who have sex with men) over the last decade. Our investigation is the first to consider the applicability of the theory in a sample of aging (ages 50 and over) HIV‐positive MSM, which is a growing population in the United States. A sample of 199 men were actively recruited and assessed in terms of mental health and drug‐use burden, as well as sexual risk behaviors. Bivariate and multivariable analyses indicate a high level of association between psychosocial burdens (i.e., drug use and mental health) and same‐sex unprotected sexual behaviors, providing initial support for the applicability of the theory of syndemics to this population. Further support can be seen in participants' narratives. Findings suggest the mutually reinforcing nature of drug use, psychiatric disorders, and unprotected sexual behavior in older, HIV‐positive, gay, bisexual, and other MSM, highlighting the need for holistic strategies to prevention and care among this population of older and sexually active individuals. In short, the generation of gay men who came of age in the late 1970s and 1980s, "the AIDS Generation," are continuing to mature such that further efforts must be enacted to meet the multidimensional nature of these men's physical, mental, and sexual health needs.

Researchers exploring the health of Hispanics in South Florida utilizing a combination of qualitative and quantitative research methods have identified that substance abuse, violence, risky sexual behavior, and depression are not only conceptualized as tightly interrelated health and social problems, but also hold together in a measurement model to represent an underlying phenomenon (i.e., the Syndemic Factor). The purpose of this study is to test hypothesized relationships between cultural phenomena and the Syndemic Factor among community‐dwelling Hispanic women. Standardized questionnaires assessing Acculturation, Hispanic Stress, Familism, and the Syndemic Factor were administered to a cross‐sectional sample of 548 Hispanic women from South Florida. Structural equation modeling was used to analyze relationships. The model explained 61 percent of the variance in the Syndemic Factor. There was a large positive relationship between the Syndemic Factor and Hispanic Stress, and a small inverse relationship between the Syndemic Factor and Familism. Women with high Hispanic Acculturation and low U.S. Acculturation scored lower on the Syndemic Factor than Integrated/Bicultural women. Familism buffered the relationship between Hispanic Stress and the Syndemic Factor. Structural, community, family, and individual prevention strategies that address underlying conditions associated with the Syndemic Factor must be developed and formally evaluated.

Though indigenous communities have undergone rapid economic integration in the last few decades as a result of neoliberal reforms and increased migration, these communities experience a complex epidemiological profile that includes fetal and childhood undernutrition and adult obesity and diabetes. We argue here that the interaction of these burdens and the social conditions that have dismantled local food systems and propelled out‐migration best explain the growing rate of diabetes in this region. We contrast this syndemic approach with the Thrifty Genotype Hypothesis, which attributes the high rate of diabetes among Native American populations to presumed genetic predisposition, triggered by lifestyle changes. We find the Thrifty Phenotype Hypothesis useful for explaining links between fetal and postnatal nutrition interruptions and chronic diseases in later life in certain populations and that a syndemics framework is useful for modeling the complex social causes of this pattern. While the syndemics model has largely been used to understand infectious diseases and addiction, social scientists have yet to use the framework to investigate the complex interactions between chronic malnutrition, metabolic syndrome, and political economy in rural Oaxacan communities. The most effective efforts to reduce diabetes will be those that address the social determinants of diabetes in this and other similar populations, rather than programs that address individual behaviors and lifestyle.

Analyses of mortality in Alaska and Labrador during the 1918 influenza pandemic indicate that influenza itself was only one of several factors influencing mortality in different communities. We discuss the added impact of exposure to influenza prior to the major waves of the pandemic in 1918 and cocirculation of other acute infectious diseases, including pneumonia, smallpox, and measles; chronic conditions such as nutritional deficiencies and tuberculosis; and social and cultural factors such as the economic climate, ethnicity, official responses, and access to health care. The emphasis is on potential explanations for differential mortality in these regions and on how the experiences of Labradoreans and Alaskans can help to inform us about the multitude of interrelated factors influencing modern health issues.

This article explores the syndemic interaction between poverty, food insecurity, and limited access to dental care among migrant farm laborers in Central Florida. Although a great deal of syndemic research examines the role of pathogen–pathogen interaction (PPI; Singer ; Ventura and Mehra ), social factors, such as poverty, may be of greater importance than the pathogens that infect the body (Singer and Clair ) and demand increased research and policy attention. The data presented in this article show how poverty, food insecurity, and limited access to dental care work synergistically to exacerbate poor health conditions, presenting a syndemic that necessitates increased attention to mitigate poverty circumstances and promote what I call "oral health security" in an effort to advocate for vulnerable populations.

Syndemic Theory posits that an understanding of the HIV/AIDS pandemic can only be gained by examining the dynamic interaction of the disease with other health problems (e.g., tuberculosis, sexually transmitted infections, malnutrition, substance abuse), in the context of social and structural conditions such as poverty, unequal access to resources, violence, stigma, etc. While the theory has been extensively used to guide research, it has not been widely utilized as a training tool. This article presents a model for the use of Syndemic Theory as a framework for the training and mentorship of researchers and practitioners, particularly from underrepresented groups interested in HIV/AIDS prevention and treatment among ethnic minorities.

Post‐traumatic stress disorder (PTSD) is a problem that affects many combatants in war, including a high percentage of military personnel serving in Iraq and Afghanistan. The high rates of PTSD among veterans has pushed research and intervention to address the serious mental and behavioral health problems associated with wartime trauma. However, these efforts have largely proceeded using biomedical and psychological approaches, without recognizing the institutional and social contexts of trauma, adaptation, and recovery. Moreover, biomedical and psychological approaches have serious shortcomings in recognizing how individual–environment interactions, meaningful interpretations, and sense of identity play a key role in the impact of trauma and development (or not) of PTSD. A neuroanthropological approach can use ideas of neural plasticity and the encultured brain to link culture, interpretation and identity, and the impact of trauma. This synthetic approach then permits a critique of present efforts in the U.S. military to increase resilience and prevent PTSD, and propose alternative strategies and research approaches to more effectively understand and address PTSD.

The concept of "poverty poisons the brain" has become a major area of research in neuroscience and the health sciences, and an increasingly utilized metaphor to argue for the importance of addressing inequality and poverty in the United States. This article systematically presents the research behind poverty poisons the brain, which includes the impact of socioeconomic status on human development, the developmental models used to understand how poverty impacts children, and the proximate social factors and brain mechanisms that represent the core causal model behind this research. This overview examines the uses of this research for neuroanthropology, highlighting the impact of inequality and how experience becomes embodied. Nevertheless, a simplistic cause–effect approach and the reduction of the social to the biological often hamper this type of research. A critical approach to how poverty poisons the brain provides the basis for making the shift to a more robust neuroanthropological approach to poverty. Neuroanthropology can utilize social embodiment, the dynamics of stress, and the production of inequality to transform research on poverty and children, and to make policy recommendations, do applied research, and craft and test interventions to deal with the pernicious impact of poverty.

Synthetic opiates (opioids) have created among the most profitable markets worldwide. Two decades ago, FDA approval of Oxycontin® as a "minimally addictive" opioid pain reliever fueled an unprecedented rise in prescription opioid abuse. This was followed by a little known act of U.S. Congress enabling general physicians to use an opioid maintenance medication, buprenorphine, for addiction treatment in their private practices, leading to enormous growth in the U.S. addiction treatment market. Based on participant‐observation and interviews among pharmaceutical executives, policy makers, patients and prescribers, this article describes the neuroeconomics and neuropolitics of new opioid maintenance treatments. This article contrasts the historical emergence of methadone clinics from the 1960s to the 1980s as a treatment for the Black and Latino urban poor, with the current emergence of buprenorphine, a maintenance opioid approved for prescription on doctor's offices, as a treatment for white, middle‐class prescription opioid abusers. The article then traces the counterintuitive result of bringing addiction pharmaceuticals into the medical mainstream in an effort to reduce the stigma of addiction: a two tiered system of addiction treatment that reinforces stigma among the urban poor, and enhances the biological, political, and economic dependence of all classes on opioid markets, both legal and illegal.