Making morbidity multiple: History, legacies, and possibilities for global health

Multimorbidity has been framed as a pressing global health challenge that exposes the limits of systems organised around single diseases. This article seeks to expand and strengthen current thinking around multimorbidity by analysing its construction within the field of global health. We suggest tha...

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Main Authors: Justin Dixon, Emily Mendenhall, Edna N Bosire, Felix Limbani, Rashida A Ferrand, Clare I R Chandler
Format: Article
Language:English
Published: SAGE Publishing 2023-03-01
Series:Journal of Multimorbidity and Comorbidity
Online Access:https://doi.org/10.1177/26335565231164973
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author Justin Dixon
Emily Mendenhall
Edna N Bosire
Felix Limbani
Rashida A Ferrand
Clare I R Chandler
author_facet Justin Dixon
Emily Mendenhall
Edna N Bosire
Felix Limbani
Rashida A Ferrand
Clare I R Chandler
author_sort Justin Dixon
collection DOAJ
description Multimorbidity has been framed as a pressing global health challenge that exposes the limits of systems organised around single diseases. This article seeks to expand and strengthen current thinking around multimorbidity by analysing its construction within the field of global health. We suggest that the significance of multimorbidity lies not only in challenging divisions between disease categories but also in what it reveals about the culture and history of transnational biomedicine. Drawing on social research from sub-Saharan Africa to ground our arguments, we begin by describing the historical processes through which morbidity was made divisible in biomedicine and how the single disease became integral not only to disease control but to the extension of biopolitical power. Multimorbidity, we observe, is hoped to challenge single disease approaches but is assembled from the same problematic, historically-loaded categories that it exposes as breaking down. Next, we highlight the consequences of such classificatory legacies in everyday lives and suggest why frameworks and interventions to integrate care have tended to have limited traction in practice. Finally, we argue that efforts to align priorities and disciplines around a standardised biomedical definition of multimorbidity risks retracing the same steps. We call for transdisciplinary work across the field of global health around a more holistic, reflexive understanding of multimorbidity that foregrounds the culture and history of translocated biomedicine, the intractability of single disease thinking, and its often-adverse consequences in local worlds. We outline key domains within the architecture of global health where transformation is needed, including care delivery, medical training, the organisation of knowledge and expertise, global governance, and financing.
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spelling doaj-art-163dd030dfda4b9eb9099c16057bee0b2024-11-25T15:03:55ZengSAGE PublishingJournal of Multimorbidity and Comorbidity2633-55652023-03-011310.1177/26335565231164973Making morbidity multiple: History, legacies, and possibilities for global healthJustin DixonEmily MendenhallEdna N BosireFelix LimbaniRashida A FerrandClare I R ChandlerMultimorbidity has been framed as a pressing global health challenge that exposes the limits of systems organised around single diseases. This article seeks to expand and strengthen current thinking around multimorbidity by analysing its construction within the field of global health. We suggest that the significance of multimorbidity lies not only in challenging divisions between disease categories but also in what it reveals about the culture and history of transnational biomedicine. Drawing on social research from sub-Saharan Africa to ground our arguments, we begin by describing the historical processes through which morbidity was made divisible in biomedicine and how the single disease became integral not only to disease control but to the extension of biopolitical power. Multimorbidity, we observe, is hoped to challenge single disease approaches but is assembled from the same problematic, historically-loaded categories that it exposes as breaking down. Next, we highlight the consequences of such classificatory legacies in everyday lives and suggest why frameworks and interventions to integrate care have tended to have limited traction in practice. Finally, we argue that efforts to align priorities and disciplines around a standardised biomedical definition of multimorbidity risks retracing the same steps. We call for transdisciplinary work across the field of global health around a more holistic, reflexive understanding of multimorbidity that foregrounds the culture and history of translocated biomedicine, the intractability of single disease thinking, and its often-adverse consequences in local worlds. We outline key domains within the architecture of global health where transformation is needed, including care delivery, medical training, the organisation of knowledge and expertise, global governance, and financing.https://doi.org/10.1177/26335565231164973
spellingShingle Justin Dixon
Emily Mendenhall
Edna N Bosire
Felix Limbani
Rashida A Ferrand
Clare I R Chandler
Making morbidity multiple: History, legacies, and possibilities for global health
Journal of Multimorbidity and Comorbidity
title Making morbidity multiple: History, legacies, and possibilities for global health
title_full Making morbidity multiple: History, legacies, and possibilities for global health
title_fullStr Making morbidity multiple: History, legacies, and possibilities for global health
title_full_unstemmed Making morbidity multiple: History, legacies, and possibilities for global health
title_short Making morbidity multiple: History, legacies, and possibilities for global health
title_sort making morbidity multiple history legacies and possibilities for global health
url https://doi.org/10.1177/26335565231164973
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