Tuberculosis and syndemics: implications for Pacific health in New Zealand.

Syndemics have been conceived of as a way of approaching the multiple levels of causation and linkage between two or more health conditions and their socio-political environment. Our aim in this paper is to use the established literature on syndemic relationships to examine possible interactions involving tuberculosis. In particular, we explore the linkages between tuberculosis and diabetes mellitus which, we argue, is of particular relevance to Pacific populations resident in New Zealand. Reviewing current literature, we identify multiple synergies between these two diseases whereby their mutual presence has an amplified negative effect. Both conditions interact with other practices and aspects of the broader political economic context such as smoking, housing, and nutrition. A syndemic approach to Pacific health is argued as an effective way to address research, policy and prevention questions.