A Critical Perspective on Syndemic Theory and Social Justice

Syndemic theory proposes that social phenomena play critical roles in the production and spreading of epidemics and that a syndemic is the result of multiple, adversely interacting epidemics. As currently framed, only the co-occurrence of multiple biological epidemics constitutes a syndemic – social phenomena are treated as risk factors but not epidemics in their own right. I argue that social phenomena such as direct violence (e.g. interpersonal violence, genocide, ethnic cleansing, colonialism, and imperialism) and structural violence (e.g. poverty, racism, historical trauma, and political disenfranchisement) are widespread and adversely affect health in many Indigenous communities, thus meeting the definition of an epidemic. As such, I propose that syndemic theory must be reconceptualized to consider biological and social epidemics, with both types framed as treatable and preventable. Wider acceptance of this frame across disciplines facilitates creation of a collective action frame, which in turn allows us to demand accountability from policymakers – and to demand justice.