IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v295y2022ics0277953620302501.html
   My bibliography  Save this article

Localizing syndemics: A comparative study of hunger, stigma, suffering, and crime exposure in three Haitian communities

Author

Listed:
  • Brewis, Alexandra
  • Wutich, Amber
  • Galvin, Michael
  • Lachaud, James

Abstract

Theoretically, disease syndemics are hyper-localized in the forms they take, but little empirical data show how localization manifests. We present a comparison across three sites in Haiti, from data collected in June–august 2017 testing for localizations of risks across three communities: rural farming, border town, and in a high gang-activity urban zone. First, we modeled survey responses collected from heads of 4055 geographically-sampled households via linear regression, considering additive and interaction effects of food insecurity, crime exposure, and discrimination on depression and anxiety levels. Exposure to food insecurity, crime exposure, and discrimination were each associated with more depression and anxiety symptoms. For those living in the urban zone, there was weak evidence of possible interactional risks between the three vulnerabilities, suggesting little meaningful localized syndemic patterning. Second, we conducted thematic and word-based semantic network analysis to identify if people themselves cognitively connected vulnerabilities of hunger/poverty, crime, and suffering/discrimination using 7321 text blocks from 95 semi-structured interviews/focus groups. Network visualization suggested people commonly connect these domains. While the patterns were localized, crime concerns were central to all networks. The domain connections expressed through people's own words were more complexly inter-related than was evident from the modeled survey data, and suggested counter-intuitive influences. The quantitative approach to modeling syndemic interactions suggests no apparent practical benefits to layering or combining local anticrime, anti-hunger, and anti-discrimination programming. However, the qualitative network analysis suggests that programming could none-the-less leverage the perceived connections across domains for more meaningful and effective interventions. For the broader study of syndemics, incorporating novel qualitative approaches clarifies that constituent processes are not just potentially localizing suffering, but are also extremely important in how people cognitively understand and organize their everyday lives.

Suggested Citation

  • Brewis, Alexandra & Wutich, Amber & Galvin, Michael & Lachaud, James, 2022. "Localizing syndemics: A comparative study of hunger, stigma, suffering, and crime exposure in three Haitian communities," Social Science & Medicine, Elsevier, vol. 295(C).
  • Handle: RePEc:eee:socmed:v:295:y:2022:i:c:s0277953620302501
    DOI: 10.1016/j.socscimed.2020.113031
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953620302501
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2020.113031?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Smith Fawzi, Mary C. & Eustache, Eddy & Oswald, Catherine & Louis, Ermaze & Surkan, Pamela J. & Scanlan, Fiona & Hook, Sarah & Mancuso, Anna & Mukherjee, Joia S., 2012. "Psychosocial support intervention for HIV-affected families in Haiti: Implications for programs and policies for orphans and vulnerable children," Social Science & Medicine, Elsevier, vol. 74(10), pages 1494-1503.
    2. Tsai, Alexander C. & Burns, Bridget F.O., 2015. "Syndemics of psychosocial problems and HIV risk: A systematic review of empirical tests of the disease interaction concept," Social Science & Medicine, Elsevier, vol. 139(C), pages 26-35.
    3. Rhodes, Tim & Singer, Merrill & Bourgois, Philippe & Friedman, Samuel R. & Strathdee, Steffanie A., 2005. "The social structural production of HIV risk among injecting drug users," Social Science & Medicine, Elsevier, vol. 61(5), pages 1026-1044, September.
    4. Lund, Crick & Breen, Alison & Flisher, Alan J. & Kakuma, Ritsuko & Corrigall, Joanne & Joska, John A. & Swartz, Leslie & Patel, Vikram, 2010. "Poverty and common mental disorders in low and middle income countries: A systematic review," Social Science & Medicine, Elsevier, vol. 71(3), pages 517-528, August.
    5. Tomori, Cecilia & McFall, Allison M. & Solomon, Sunil S. & Srikrishnan, Aylur K. & Anand, Santhanam & Balakrishnan, P. & Mehta, Shruti H. & Celentano, David D., 2018. "Is there synergy in syndemics? Psychosocial conditions and sexual risk among men who have sex with men in India," Social Science & Medicine, Elsevier, vol. 206(C), pages 110-116.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Snodgrass, Jeffrey G. & Lacy, Michael G. & Cole, Steven W., 2022. "Internet gaming, embodied distress, and psychosocial well-being: A syndemic-syndaimonic continuum," Social Science & Medicine, Elsevier, vol. 295(C).
    2. Hatcher, Abigail M. & Gibbs, Andrew & McBride, Ruari-Santiago & Rebombo, Dumisani & Khumalo, Mzwakhe & Christofides, Nicola J., 2022. "Gendered syndemic of intimate partner violence, alcohol misuse, and HIV risk among peri-urban, heterosexual men in South Africa," Social Science & Medicine, Elsevier, vol. 295(C).
    3. Ouafik, Maxence R. & Buret, Laetitia & Scholtes, Beatrice, 2022. "Mapping the current knowledge in syndemic research applied to men who have sex with men: A scoping review," Social Science & Medicine, Elsevier, vol. 306(C).
    4. Danni Xia & Yingjie Chen & Ruijie Chang & Chen Xu & Xiaoyue Yu & Yujie Liu & Hui Chen & Rongxi Wang & Shangbin Liu & Xin Ge & Yuxuan Wang & Ajuan Liang & Fan Hu & Yong Cai & Ying Wang, 2022. "Psychosocial Problems and Condomless Anal Sex among Transgender Women in Two Cities of China: Study Based on the Syndemic Framework," IJERPH, MDPI, vol. 19(23), pages 1-14, December.
    5. Chakrapani, Venkatesan & Kaur, Manmeet & Tsai, Alexander C. & Newman, Peter A. & Kumar, Rajesh, 2022. "The impact of a syndemic theory-based intervention on HIV transmission risk behaviour among men who have sex with men in India: Pretest-posttest non-equivalent comparison group trial," Social Science & Medicine, Elsevier, vol. 295(C).
    6. Tsai, Alexander C. & Tomlinson, Mark & Comulada, W. Scott & Rotheram-Borus, Mary Jane, 2016. "Food insufficiency, depression, and the modifying role of social support: Evidence from a population-based, prospective cohort of pregnant women in peri-urban South Africa," Social Science & Medicine, Elsevier, vol. 151(C), pages 69-77.
    7. Eddy Eustache & Margaret E Gerbasi & Mary C Smith Fawzi & J Reginald Fils-Aimé & Jennifer Severe & Giuseppe J Raviola & Rupinder Legha & Sarah Darghouth & David J Grelotti & Tatiana Thérosmé & Erma, 2017. "High burden of mental illness and low utilization of care among school-going youth in Central Haiti: A window into the youth mental health treatment gap in a low-income country," International Journal of Social Psychiatry, , vol. 63(3), pages 261-274, May.
    8. Quinn, Katherine G., 2022. "Applying an intersectional framework to understand syndemic conditions among young Black gay, bisexual, and other men who have sex with men," Social Science & Medicine, Elsevier, vol. 295(C).
    9. Fast, Danya & Small, Will & Wood, Evan & Kerr, Thomas, 2009. "Coming 'down here': Young people's reflections on becoming entrenched in a local drug scene," Social Science & Medicine, Elsevier, vol. 69(8), pages 1204-1210, October.
    10. Lefgren, Lars J. & Stoddard, Olga B. & Stovall, John E., 2021. "Rationalizing self-defeating behaviors: Theory and evidence," Journal of Health Economics, Elsevier, vol. 76(C).
    11. Biradavolu, Monica Rao & Burris, Scott & George, Annie & Jena, Asima & Blankenship, Kim M., 2009. "Can sex workers regulate police? Learning from an HIV prevention project for sex workers in southern India," Social Science & Medicine, Elsevier, vol. 68(8), pages 1541-1547, April.
    12. Hannah L F Cooper & Sabriya Linton & Mary E Kelley & Zev Ross & Mary E Wolfe & Yen-Tyng Chen & Maria Zlotorzynska & Josalin Hunter-Jones & Samuel R Friedman & Don C Des Jarlais & Barbara Tempalski & E, 2016. "Risk Environments, Race/Ethnicity, and HIV Status in a Large Sample of People Who Inject Drugs in the United States," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-21, March.
    13. Islay Mactaggart & Lena Morgon Banks & Hannah Kuper & G V S Murthy & Jayanthi Sagar & Joseph Oye & Sarah Polack, 2018. "Livelihood opportunities amongst adults with and without disabilities in Cameroon and India: A case control study," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-17, April.
    14. Sebastian Rios & Samantha B Meyer & John Hirdes & Susan Elliott & Christopher M Perlman, 2021. "The development and validation of a marginalization index for inpatient psychiatry," International Journal of Social Psychiatry, , vol. 67(4), pages 324-334, June.
    15. Mukhopadhyay, Sankar, 2022. "The Effects of Medicaid Expansion on Job Loss Induced Mental Distress during the COVID-19 Pandemic in the US," IZA Discussion Papers 15150, Institute of Labor Economics (IZA).
    16. Cook, Jonathan E. & Purdie-Vaughns, Valerie & Meyer, Ilan H. & Busch, Justin T.A., 2014. "Intervening within and across levels: A multilevel approach to stigma and public health," Social Science & Medicine, Elsevier, vol. 103(C), pages 101-109.
    17. Bauer, Annette & Knapp, Martin & Alvi, Mohsin & Chaudhry, Nasim & Gregoire, Alain & Malik, Abid & Sikander, Siham & Tayyaba, Kiran & Wagas, Ahmed & Husain, Nusrat, 2024. "Economic costs of perinatal depression and anxiety in a lower-middle income country: Pakistan," LSE Research Online Documents on Economics 122650, London School of Economics and Political Science, LSE Library.
    18. Pronyk, Paul M. & Harpham, Trudy & Morison, Linda A. & Hargreaves, James R. & Kim, Julia C. & Phetla, Godfrey & Watts, Charlotte H. & Porter, John D., 2008. "Is social capital associated with HIV risk in rural South Africa?," Social Science & Medicine, Elsevier, vol. 66(9), pages 1999-2010, May.
    19. Naijie Guan & Alessandra Guariglia & Patrick Moore & Fangzhou Xu & Hareth Al-Janabi, 2022. "Financial stress and depression in adults: A systematic review," PLOS ONE, Public Library of Science, vol. 17(2), pages 1-20, February.
    20. Tulloch, Olivia & Taegtmeyer, Miriam & Ananworanich, Jintanat & Chasombat, Sanchai & Kosalaraksa, Pope & Theobald, Sally, 2015. "What can volunteer co-providers contribute to health systems? The role of people living with HIV in the Thai paediatric HIV programme," Social Science & Medicine, Elsevier, vol. 145(C), pages 184-192.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:295:y:2022:i:c:s0277953620302501. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.