Emily Mendenhall

"This excellent and readily accessible study provides a compelling account of how social, psychological, and biological factors act synergistically to trigger a diabetes-depression syndemic characterized by a pernicious biosocial feedback loop. This is far more than an account of co-morbidity, which is the consequence of poverty and a difficult life. There are many trajectories leading to both diabetes and depression. One key lesson of the VIDDA Syndemic documented here is that social processes will need to be addressed in order to treat this pathogenic state, not just medicines and health education. This book is an excellent teaching resource for both undergraduate and graduate courses of anthropology and public health."--Mark Nichter, University of Arizona "By rigorously exploring how macrosocial factors shape disease and suffering, Mendenhall's book has the potential to reach well beyond the bookshelves of medical anthropologists. Indeed, it has the capacity to start new interdisciplinary conversations because of its complex methodology, theoretical grounding, and clearly argued prose. This book would make an excellent addition to undergraduate courses in medical anthropology, methods, and structural inequalities. For graduate students, this book would make an excellent addition to research design and methods courses because it demonstrates how mixed methodologies are conceived and implemented." -Jessica Hardin, Somatosphere "Syndemic Suffering employs a mixed methods approach drawn from cultural anthropology, epidemiology, and human biology to define the 'VIDDA Syndemic' (Violence, Immigration-related stress, Depression, Diabetes, Abuse). Mendenhall argues that diabetes cannot be fully separated from the structural, interpersonal and psychological factors that both lead to and flow from it. Mendenhall is explicit that her aim is not models that predict outcomes but rather to describe how components of VIDDA act synergistically. The writing, while sophisticated, is accessible, and complex concepts such as structural violence and syndemics are described clearly enough for the non-specialist to understand. In addition to its primary audience in critical medical anthropology, this book will be of considerable interest to graduate students, advanced undergraduate students, health professionals, and scholars concerned with how social forces influence immigrant health." -Jason A. DeCaro, American Journal of Human Biology "Syndemic Suffering is an admirably dense, robustly argued work of medical anthropology. Mendenhall's volume reflects the strengths of ethnography for addressing sensitive subjects and reaching isolated populations; she also reveals the capacity of mixed-methods anthropology for speaking across disciplinary divides into medicine, public health, and psychology. At the same time, the volume is a fast read and genuinely engaging for the powerful narratives of difficulty faced by these resilient survivors." -Caroline Smith-Morris, Journal of Anthropological Research

• Introduction Chapter 1: Synthesizing the Syndemic Chapter 2: Synergy of the Self: Enduring Syndemic Suffering Chapter 3: Unpacking VIDDA: An Analysis of Social Distress Chapter 4: Borderlands: Immigration, Integration, and Isolation Chapter 5: Narrative to Mechanism: Understanding Distress and Diabetes

Emily Mendenhall

"This excellent and readily accessible study provides a compelling account of how social, psychological, and biological factors act synergistically to trigger a diabetes-depression syndemic characterized by a pernicious biosocial feedback loop. This is far more than an account of co-morbidity, which is the consequence of poverty and a difficult life. There are many trajectories leading to both diabetes and depression. One key lesson of the VIDDA Syndemic documented here is that social processes will need to be addressed in order to treat this pathogenic state, not just medicines and health education. This book is an excellent teaching resource for both undergraduate and graduate courses of anthropology and public health."--Mark Nichter, University of Arizona "By rigorously exploring how macrosocial factors shape disease and suffering, Mendenhall's book has the potential to reach well beyond the bookshelves of medical anthropologists. Indeed, it has the capacity to start new interdisciplinary conversations because of its complex methodology, theoretical grounding, and clearly argued prose. This book would make an excellent addition to undergraduate courses in medical anthropology, methods, and structural inequalities. For graduate students, this book would make an excellent addition to research design and methods courses because it demonstrates how mixed methodologies are conceived and implemented." -Jessica Hardin, Somatosphere "Syndemic Suffering employs a mixed methods approach drawn from cultural anthropology, epidemiology, and human biology to define the 'VIDDA Syndemic' (Violence, Immigration-related stress, Depression, Diabetes, Abuse). Mendenhall argues that diabetes cannot be fully separated from the structural, interpersonal and psychological factors that both lead to and flow from it. Mendenhall is explicit that her aim is not models that predict outcomes but rather to describe how components of VIDDA act synergistically. The writing, while sophisticated, is accessible, and complex concepts such as structural violence and syndemics are described clearly enough for the non-specialist to understand. In addition to its primary audience in critical medical anthropology, this book will be of considerable interest to graduate students, advanced undergraduate students, health professionals, and scholars concerned with how social forces influence immigrant health." -Jason A. DeCaro, American Journal of Human Biology "Syndemic Suffering is an admirably dense, robustly argued work of medical anthropology. Mendenhall's volume reflects the strengths of ethnography for addressing sensitive subjects and reaching isolated populations; she also reveals the capacity of mixed-methods anthropology for speaking across disciplinary divides into medicine, public health, and psychology. At the same time, the volume is a fast read and genuinely engaging for the powerful narratives of difficulty faced by these resilient survivors." -Caroline Smith-Morris, Journal of Anthropological Research

• Introduction Chapter 1: Synthesizing the Syndemic Chapter 2: Synergy of the Self: Enduring Syndemic Suffering Chapter 3: Unpacking VIDDA: An Analysis of Social Distress Chapter 4: Borderlands: Immigration, Integration, and Isolation Chapter 5: Narrative to Mechanism: Understanding Distress and Diabetes

Emily Mendenhall

"This excellent and readily accessible study provides a compelling account of how social, psychological, and biological factors act synergistically to trigger a diabetes-depression syndemic characterized by a pernicious biosocial feedback loop. This is far more than an account of co-morbidity, which is the consequence of poverty and a difficult life. There are many trajectories leading to both diabetes and depression. One key lesson of the VIDDA Syndemic documented here is that social processes will need to be addressed in order to treat this pathogenic state, not just medicines and health education. This book is an excellent teaching resource for both undergraduate and graduate courses of anthropology and public health."--Mark Nichter, University of Arizona "By rigorously exploring how macrosocial factors shape disease and suffering, Mendenhall's book has the potential to reach well beyond the bookshelves of medical anthropologists. Indeed, it has the capacity to start new interdisciplinary conversations because of its complex methodology, theoretical grounding, and clearly argued prose. This book would make an excellent addition to undergraduate courses in medical anthropology, methods, and structural inequalities. For graduate students, this book would make an excellent addition to research design and methods courses because it demonstrates how mixed methodologies are conceived and implemented." -Jessica Hardin, Somatosphere "Syndemic Suffering employs a mixed methods approach drawn from cultural anthropology, epidemiology, and human biology to define the 'VIDDA Syndemic' (Violence, Immigration-related stress, Depression, Diabetes, Abuse). Mendenhall argues that diabetes cannot be fully separated from the structural, interpersonal and psychological factors that both lead to and flow from it. Mendenhall is explicit that her aim is not models that predict outcomes but rather to describe how components of VIDDA act synergistically. The writing, while sophisticated, is accessible, and complex concepts such as structural violence and syndemics are described clearly enough for the non-specialist to understand. In addition to its primary audience in critical medical anthropology, this book will be of considerable interest to graduate students, advanced undergraduate students, health professionals, and scholars concerned with how social forces influence immigrant health." -Jason A. DeCaro, American Journal of Human Biology "Syndemic Suffering is an admirably dense, robustly argued work of medical anthropology. Mendenhall's volume reflects the strengths of ethnography for addressing sensitive subjects and reaching isolated populations; she also reveals the capacity of mixed-methods anthropology for speaking across disciplinary divides into medicine, public health, and psychology. At the same time, the volume is a fast read and genuinely engaging for the powerful narratives of difficulty faced by these resilient survivors." -Caroline Smith-Morris, Journal of Anthropological Research

• Introduction Chapter 1: Synthesizing the Syndemic Chapter 2: Synergy of the Self: Enduring Syndemic Suffering Chapter 3: Unpacking VIDDA: An Analysis of Social Distress Chapter 4: Borderlands: Immigration, Integration, and Isolation Chapter 5: Narrative to Mechanism: Understanding Distress and Diabetes