The syndemics concept recognizes that disease epidemics cluster in vulnerable populations as a consequence of social/structural factors, and interact to generate deleterious health outcomes. Syndemics theory offers significant benefits to the field of the global health as it (1) reveals the complexity of health conditions biologically and socially; and, (2) it draws attention to systems and structures that generate vulnerable populations, thereby highlighting social inequities and the unjust distribution of power as it directly affects health.

In responding to critiques of the theory, specifically that it lacks evidence, I have presented the Synergy Factor approach as an accessible tool to confirm the presence of syndemic arrangements (biological and social elements that interact synergistically). I see this tool as a starting point for scholars to begin a comprehensive exploration of why and how the syndemic construct exists in a local context.

Select publications:

BULLED, N. (in press) A new approach to measuring the synergy in a syndemic: Revisiting the SAVA syndemic among urban MSM in the United States. Global Public Health.

Singer, M., BULLED, N., & Leatherman, T. (in press) Are there global syndemics? Medical Anthropology.

BULLED, N. & Singer, M. (2020) In the shadow of HIV & TB: A commentary on the COVID epidemic in South Africa. Global Public Health. DOI: 10.1080/17441692.2020.1775275

Singer, M., BULLED, N., & Ostrach, B. (2020). Whither Syndemics?: Trends in Syndemic Research, A Review 2015-2019. Global Public Health. DOI: 10.1080/17441692.2020.1724317

Singer, M., BULLED, N., Ostrach, B., & Mendenhall, E. (2017). Syndemics and the biosocial conception of health. Lancet. 389(10072):941-950.

BULLED, N., Singer, M. & Dillingham, R. (2014). The Syndemics of Childhood Diarrhea: a biosocial perspective on efforts to combat global inequities in diarrhea-related morbidity and mortality. Global Public Health, 9(7): 841-853, doi:10.1080/17441692.2014.924022.

Singer, M. & BULLED, N. (2012). Interlocked Infections: The Health Burdens of Syndemics of Neglected Tropical Diseases. Special Issue of Annals of Anthropological Practice, 36(2): 328-345.

BULLED, N. & Singer, M. (2011). Syringe-mediated Syndemics. AIDS and Behavior, 15(7):1539-1545.