Introduction to the Syndemic Perspective
African Americans with serious mental illness (SMI) face a unique and disproportionate burden of cardiovascular disease (CVD). This intersection of mental and physical health challenges is not merely coincidental but is deeply rooted in both biological vulnerabilities and structural inequities. This article explores how individuals living with both SMI and CVD perceive and manage these interconnected conditions in their daily lives, using insights from syndemic theory.
Research Methodology
The study was guided by grounded theory and syndemic theory, employing semi-structured interviews with 23 African American adults diagnosed with SMI who also self-reported having CVD. Participants were recruited from the Genomic Psychiatry Cohort (GPC) and its African American sub-cohort (AAGPC). The interviews focused on understanding participants’ perceptions of illness interaction, self-management strategies, and the contextual barriers they face. Data analysis was conducted using constant comparative methods to identify patterns and develop a theoretical model of syndemic interdependency.
Findings: Syndemic Interdependency
The analysis revealed a core concept of syndemic interdependency, a dynamic process where psychiatric and cardiovascular conditions interact and reinforce each other within contexts of structural deprivation. Participants described how psychiatric symptoms often disrupted their ability to adhere to CVD management plans, while cardiovascular complications exacerbated psychiatric distress, creating self-perpetuating cycles of illness.
Structural and Environmental Influences
Structural constraints, such as reliance on public assistance and food insecurity, provided minimal stability but reinforced dependency. Environmental factors, including unsafe housing and neighborhood violence, further undermined health behaviors. These conditions illustrate the broader social determinants of health that contribute to the syndemic interaction of SMI and CVD.
Healthcare Distrust and Its Impact
A significant finding was the pervasive distrust in healthcare providers, particularly in psychiatric care. This distrust emerged as a cross-cutting mechanism that deepened disengagement from healthcare services and exacerbated the trajectories of comorbid illnesses. Participants expressed concerns about the quality of care and the perceived lack of understanding from healthcare professionals, which hindered effective management of their conditions.
Conclusion and Implications for Care Models
This study extends syndemic theory by highlighting how individuals conceptualize the reciprocal entanglement of SMI and CVD within structural and environmental constraints. The findings underscore the urgent need for integrated, equity-focused care models that address both psychiatric and cardiovascular health simultaneously. Such models should incorporate trust-building measures, housing stability, and food security interventions to effectively disrupt the interdependency of SMI and CVD. Ultimately, addressing these overlapping health disparities requires confronting the structural and institutional forces that sustain them.
🔗 **Fuente:** https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1711836/full
