The COVID-19 pandemic began as an epidemic, but is it best understood as a syndemic?
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A syndemic is, simply, a synergistic epidemic. Merril Singer, an anthropologist, coined the term in the 1990s while researching HIV/AIDS and working as the Director of the Center for Community Health Research at the Hispanic Health Council in Hartford, Connecticut.
"The basic idea is that -- it was true of HIV, and it’s true of COVID -- often that people who are hit worst by these infectious diseases are already suffering from other problems that are rooted in fundamental social inequalities," Clarence Glavlee, an associate anthropology professor at the University of Florida, told KCBS Radio’s Margie Shafer in an interview on Friday.
"That makes the diseases worse, and the disease, in turn, makes the social conditions worse," he said.
Gravlee and Emily Mendenhall, a professor of global health at Georgetown University’s Walsh School of Foreign Service, authored a piece in Scientific American this week laying out how structural inequality in the U.S. left the country ripe for a syndemic.
Black, Indigenous and Latino Americans have been at higher risk of contracting COVID-19 because inequality in education, employment and housing increased their risk of exposure. Those same inequalities, the authors argued, have led to higher risks of comorbidities, like diabetes and hypertension, which in turn has led to higher risks of severe disease.
In California, Black, Indigineous and Latino residents comprise 45.4% of the state population. As of Thursday, they comprised 53.2% of official COVID-19 deaths in California.
"And then as you play it out over the last year, we see that the consequences of the pandemic have actually made many of those pre-existing social inequalities worse," Glavlee said. "You think about the Supreme Court's decision yesterday to end the (U.S. Center for Disease Control and Prevention's) moratorium on evictions. Well, here’s an example where the response to the pandemic is now gonna increase the risk that people are going to be evicted from their homes, which is gonna magnify their risk of health problems in the first place."
Neither Glavlee nor Mendenhall believe the COVID-19 pandemic is a one-off. More pandemics are likely in the future, Glavlee said on Friday, requiring social and economic inequalities to be addressed in order to make American society "more resilient."
"We need to focus on improving the health and well-being of all in the first place," he told KCBS Radio. "We need to address the social conditions that make it possible for people to live full, healthy lives."
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