A Special Focus Section on Comorbidity: Preface

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The idea for this special issue arose when I was conducting my doctoral fieldwork in India in 2011. I went there to study type 2 diabetes among women, but I quickly realized that by focusing on only one disease I would be missing others. Nearly everyone I met with diabetes was also grappling with some other health problem too–among others, hypertension, cardiovascular disease, and life distress significant enough that seemed to be impacting their quality of life. Anthropological studies had told us much about multiple therapeutic choices and about how multiple symptoms could be associated with single diseases that vary cross-culturally. At the time, however, few had explicitly grappled with the problem of co-occurring diseases, or, as it is called in the medical world, comorbidity. I wanted to know what leaders in the medical social sciences were thinking about the overlaps of disease categories, and that is how this special issue came to be.

The papers collected here address a wide variety of diseases and behaviors: chronic pain, diabetes, depression, interpersonal violence, tick-borne diseases, climate change, smoking, medication side effects, risk states. In so doing, they build from the long tradition in medical anthropology of pushing the boundaries of what “counts” as a disease in the first place. But they each go beyond this to address important questions related to comorbidity that have not been directly addressed in medical anthropology before: Does it matter which disease is diagnosed first, and if so, how? Do people experience their overlapping diseases and risk states as separate entities, or as a single force in their lives? Do they prioritize one over the other(s)? How does one disease predispose someone to another, both in a biological and a social sense? Where do health-demoting factors such as violence, insects that spread disease, climate change, medications, and other risk states come into play? What territory do our existing theoretical and methodological approaches cover, and not cover?

Putting together this discussion on comorbidity in medical anthropology has helped me broaden how I think about the overlapping disease states of the people with whom I work, and I hope it will do the same for you. Happy reading.

For the peer-reviewed introduction by Lesley Jo Weaver, Ron Barrett, and Mark Nichter see the Wiley collection.

 

If you are interested in augmenting current issue article pages with an author interview or other supplementary discussions, please contact Vincanne Adams vincanne.adams@ucsf.edu

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