What Comes After a Pandemic? Syndemics

The global pandemic is in the spotlight, but experts at the School are already raising concerns about its downstream effect on other public health crises.

November 10, 2020

The economic downturn and high unemployment are driving concerning trends in suicide and an increase in opioid-related fatalities. Symptoms of anxiety disorder and depressive disorder increased considerably in the United States between April and June of this year, according to Morbidity and Mortality Weekly Report. And spikes in gun purchases beginning in March were followed by significant increases in firearm fatalities in April and May when compared to the same months in 2019.

Charles Branas, PhD, Gelman Professor of Epidemiology and chair, Department of Epidemiology, believes these trends are best examined through a syndemic lens. His focus is on gun violence. “Equity and social justice issues are longstanding and an epidemic unto themselves, and when you mix them with COVID-19 you get a syndemic. The two feed on each other and make the outcome much worse.” Fixing syndemic problems requires a multifocal approach. Branas points to a program called Operation Peacemaker Fellowship in Richmond, California, as an example. Young people who have been involved in gun violence are given stipends, mentorship, job training, and other benefits. This has been shown to significantly reduce the likelihood of future gun crimes. Faculty Kara Rudolph, MPH, PhD, and Katherine M. Keyes, MPH, PhD, did research that supports this and similar violence interruption programs.

Branas hopes that future solutions to gun violence will arise out of the SURGE program (Scientific Union for the Reduction of Gun Violence), which he and others launched in February with a consortium from across Columbia University to make gun violence a top focus for Columbia and promote scientifically supported solutions. The group has already logged one success: Earlier this year, SURGE led universities to petition legislators to provide CDC and NIH grants for gun violence research, the first such grants from these agencies in decades.