PTTC Post Article - October 2023

The Role of Prevention in Syndemic Solutions

Author: Cele Fichter-DeSando, MPM

The Syndemic Model

The Centers for Disease Control and Prevention (CDC) defines a syndemic as “epidemics—of diseases or health conditions, such as viral hepatitis, sexually transmitted infections (STI), substance use, and behavioral health issues—that interact with each other and by that interaction increase their adverse effects on the health of communities that face systematic, structural, and other inequities. In addition, social determinants of health (SDOH) (racism, homophobia, poverty) interact with syndemic conditions/diseases to elevate them to a syndemic level” (CDC/DHP. 2022). 


Syndemic Solutions Decorative Banner

Syndemic Solutions Summit

The Collaborative to Advance Health Sciences at the University of Missouri Kansas City designed the nation’s first known public health summit focused on discussing and generating solutions for syndemic approaches to end the intertwined health conditions of 5 epidemics: HIV; STIs; Viral Hepatitis; Substance Use Disorders and Mental health; and Reproductive and Sexual Health. The PTTC and ATTC Network’s National Coordinating Offices contributed to the facilitation of the 2023 Syndemic Solutions Summit held on July 26 and 27 in Kansas City, MO. More than 200 public health professionals and leaders from government, community, and research participated, amplifying the importance of inclusive, equitable, systems-level approaches to ending these epidemics. The inaugural Summit was a neutral space for the public health workforce across the 5 epidemics, including federal and state government, health departments, researchers, community organizations, and people with lived experience to gather for a collaborative approach to creating syndemic solutions. The objectives of the Syndemic Solutions Summit were to:

  • Define the key elements of a syndemic framework.
  • Discuss the benefits of applying the framework to prioritize health equity among populations impacted by health disparities.
  • Describe existing solution-focused initiatives across disciplines that successfully synchronize strategies of a syndemic approach.
  • Identify at least three ways that researchers, funders, policymakers, service providers, and people with lived experience can collaborate to advance the health needs of all communities using a syndemic framework.


Prevention and Syndemic Solutions

The concept of a syndemic approach as a biosocial conception of health was proposed in the 1990s by anthropologist Merrill Singer to explain how pervasive and widespread social forces contribute to co-occurring epidemics that work together to undermine public health, particularly in vulnerable populations. A syndemic solutions model can help policymakers, researchers, and public health organizations collaborate to improve population health (TSAI, 2018). 

Prevention Professionals are instrumental in syndemic solutions with their focus and experience on risk and protective factors and in designing trauma-informed programs, aligned with health equity and social determinants of health for vulnerable populations. According to Singer, “a syndemics approach examines why certain diseases cluster (i.e., multiple diseases affecting individuals and groups); the pathways through which they interact biologically in individuals and within populations, and thereby multiply their overall disease burden, and the ways in which social environments, especially conditions of social inequality and injustice, contribute to disease clustering and interaction as well as to vulnerability” (Singer et al, 2017).

Northwest PTTC Project Co-Director, Michele Frye-Spray attended the Summit and shared her thoughts on the role of primary prevention in syndemic solutions. “The syndemics solution involves a comprehensive and integrated approach to health issues that are interconnected, primary substance misuse prevention is one component of this approach. Prevention can help address the root causes associated with substance misuse, reduce risky behaviors, promote integrated approaches, provide empowerment and education opportunities, facilitate community engagement, and create long-term impact and positive outcomes by preventing substance use initiation and substance misuse.” 

The summit was one step in collaborating and generating solutions for syndemic approaches to end the intertwined health conditions of 5 epidemics: HIV; STIs; Viral Hepatitis; Substance Use Disorders and Mental health; and Reproductive and Sexual Health. The goals of the summit point to the ongoing nature of the syndemic solutions process.

  • To create a neutral space for government, the workforce, and people with lived experience to learn and listen, and collaboratively chart the path forward.
  • To step away from focusing on each of the health conditions as their own “vertical” and focus more broadly on solutions such as braided funding, standardized language, streamlined data gathering, and program best practices

To support the continued work of the summit, the materials, presentations, and videos from the Syndemic Solutions Summit will be made available for continued collaboration and program development. “The PTTCs are experts in creating intentional partnerships, collaborating with others, and knowing how to engage key stakeholders,” said Rori Douros, Project Coordinator for the Mountain Plains PTTC, “It’s my hope that all the partners involved in creating syndemic solutions turn to prevention to utilize our expertise in these areas.”


Centers for Disease Control and Prevention, CDC. (2022). DHP’s Cross-Cutting Focus and Strategic Framework.
Source: Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention.  Last Reviewed: September 30, 2022

Singer, M.; Bulled, N.; Ostrach, B.; & Mendenhall, E. (2017). Syndemics and the biosocial conception of health. Published: March 04, 2017 DOI:

Tsai A. C. (2018). Syndemics: A theory in search of data or data in search of a theory?. Social science & medicine (1982), 206, 117–122.

Copyright © 2024 Prevention Technology Transfer Center (PTTC) Network