Syndemic thinking in large-scale studies : case studies of disability, hypertension, and diabetes across income groups in India and China

Syndemics consider where two or more conditions cluster, how they interact, and what macro-social processes have driven them together. Yet, syndemics emerge and interact differently across contexts and through time. This article considers how syndemics involving Type 2 diabetes (DM), disability, and...

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Main Authors: Saxena, Akshar, Mendenhall, Emily
Other Authors: School of Social Sciences
Format: Article
Language:English
Published: 2022
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Online Access:https://hdl.handle.net/10356/155204
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Institution: Nanyang Technological University
Language: English
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spelling sg-ntu-dr.10356-1552042022-02-15T05:44:46Z Syndemic thinking in large-scale studies : case studies of disability, hypertension, and diabetes across income groups in India and China Saxena, Akshar Mendenhall, Emily School of Social Sciences Social sciences::General Syndemics India Syndemics consider where two or more conditions cluster, how they interact, and what macro-social processes have driven them together. Yet, syndemics emerge and interact differently across contexts and through time. This article considers how syndemics involving Type 2 diabetes (DM), disability, and income differ among men and women and between India and China. We use the WHO Study on global AGEing and adult health (SAGE) data. Using multivariable logistic regression, we assess the interaction of socio-economic factors and diseases on a multiplicative scale. We found that gender and income interact significantly in China to increase the odds of reporting hypertension and diabetes, but only for reporting diabetes in India. High income interacts with metabolic conditions to increase the odds of reporting comorbidity. Hypertension and diabetes were both independently and jointly associated with increase in the odds of being disabled in both countries, but the association varies by conditions. We argue that, first, our study reveals how these syndemics differ between countries and, second, that they differ significantly between income groups. Both findings refute the idea that a "global syndemic" exists. Instead, we emphasize the need for more ethnographic work that invests in local historical, social, and political interpretations of syndemics. Furthermore, ethnographic evidence suggests that the lowest-income communities face compounded social stress, untreated depression, and poor healthcare access alongside these clustered "metabolic" conditions. This point is most notable to demonstrate the need for chronic integrated care for not only the wealthy but also poorer people with metabolic conditions. Nanyang Technological University The corresponding author would like to thank Nanyang Technological University for Startup Grant (M4082411). 2022-02-15T05:44:46Z 2022-02-15T05:44:46Z 2020 Journal Article Saxena, A. & Mendenhall, E. (2020). Syndemic thinking in large-scale studies : case studies of disability, hypertension, and diabetes across income groups in India and China. Social Science & Medicine, 113503-. https://dx.doi.org/10.1016/j.socscimed.2020.113503 0277-9536 https://hdl.handle.net/10356/155204 10.1016/j.socscimed.2020.113503 33190929 2-s2.0-85096005350 113503 en M4082411 Social Science & Medicine © 2020 Elsevier Ltd. All rights reserved.
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Social sciences::General
Syndemics
India
spellingShingle Social sciences::General
Syndemics
India
Saxena, Akshar
Mendenhall, Emily
Syndemic thinking in large-scale studies : case studies of disability, hypertension, and diabetes across income groups in India and China
description Syndemics consider where two or more conditions cluster, how they interact, and what macro-social processes have driven them together. Yet, syndemics emerge and interact differently across contexts and through time. This article considers how syndemics involving Type 2 diabetes (DM), disability, and income differ among men and women and between India and China. We use the WHO Study on global AGEing and adult health (SAGE) data. Using multivariable logistic regression, we assess the interaction of socio-economic factors and diseases on a multiplicative scale. We found that gender and income interact significantly in China to increase the odds of reporting hypertension and diabetes, but only for reporting diabetes in India. High income interacts with metabolic conditions to increase the odds of reporting comorbidity. Hypertension and diabetes were both independently and jointly associated with increase in the odds of being disabled in both countries, but the association varies by conditions. We argue that, first, our study reveals how these syndemics differ between countries and, second, that they differ significantly between income groups. Both findings refute the idea that a "global syndemic" exists. Instead, we emphasize the need for more ethnographic work that invests in local historical, social, and political interpretations of syndemics. Furthermore, ethnographic evidence suggests that the lowest-income communities face compounded social stress, untreated depression, and poor healthcare access alongside these clustered "metabolic" conditions. This point is most notable to demonstrate the need for chronic integrated care for not only the wealthy but also poorer people with metabolic conditions.
author2 School of Social Sciences
author_facet School of Social Sciences
Saxena, Akshar
Mendenhall, Emily
format Article
author Saxena, Akshar
Mendenhall, Emily
author_sort Saxena, Akshar
title Syndemic thinking in large-scale studies : case studies of disability, hypertension, and diabetes across income groups in India and China
title_short Syndemic thinking in large-scale studies : case studies of disability, hypertension, and diabetes across income groups in India and China
title_full Syndemic thinking in large-scale studies : case studies of disability, hypertension, and diabetes across income groups in India and China
title_fullStr Syndemic thinking in large-scale studies : case studies of disability, hypertension, and diabetes across income groups in India and China
title_full_unstemmed Syndemic thinking in large-scale studies : case studies of disability, hypertension, and diabetes across income groups in India and China
title_sort syndemic thinking in large-scale studies : case studies of disability, hypertension, and diabetes across income groups in india and china
publishDate 2022
url https://hdl.handle.net/10356/155204
_version_ 1725985519046754304