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Objectives. To examine linear and nonlinear associations between psychosocial syndemic factors and HIV risk and engagement in HIV prevention care among sexual and gender minority (SGM) youths. Methods. Between February and October 2022, we recruited 17 578 SGM youths aged 13 to 18 years in the United States for an online survey. We examined the relationship of syndemics (i.e., binge drinking, drug use, sexual victimization, and anti-lesbian, gay, bisexual, and transgender discrimination) with sexual behaviors (i.e., sexual initiation, condomless anal or vaginal sex, and number of sexual partners) and HIV prevention care (i.e., HIV testing, preexposure prophylaxis awareness and utilization) using regression. Results. Psychosocial syndemic burden (number of syndemic factors reported) was linearly and cubically associated with engagement in sexual behaviors. Psychosocial syndemic burden was linearly associated with higher HIV testing and preexposure prophylaxis awareness and cubically associated with higher preexposure prophylaxis utilization. Conclusions. Our findings are evidence of synergism across psychosocial syndemic factors regarding HIV risk and engagement in HIV prevention care among SGM youths in the United States. Public Health Implications. Multicomponent interventions may help reduce HIV risk and promote access to HIV prevention services among SGM individuals aged 13 to 18 years. (Am J Public Health. 2024;114(9):892-902. https://doi.org/10.2105/AJPH.2024.307753).
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Infecciones por VIH , Conducta Sexual , Minorías Sexuales y de Género , Sindémico , Humanos , Adolescente , Masculino , Minorías Sexuales y de Género/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiología , Femenino , Estados Unidos/epidemiología , Conducta Sexual/psicología , Conducta Sexual/estadística & datos numéricos , Profilaxis Pre-Exposición/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
The intricate relationship between food systems and health outcomes, known as the food-nutrition-health nexus, intersects with environmental concerns. However, there's still a literature gap in evaluating food systems alongside the global syndemic using the complex systems theory, especially concerning vulnerable populations like children. This research aimed to design a system dynamics model to advance a theoretical understanding of the connections between food systems and the global syndemic, particularly focusing on their impacts on children under five years of age. The framework was developed through a literature review and authors' insights into the relationships between the food, health, and environmental components of the global syndemic among children. The conceptual model presented 17 factors, with 26 connections and 6 feedback loops, categorized into the following 5 groups: environmental, economic, school-related, family-related, and child-related. It delineated and elucidated mechanisms among the components of the global syndemic encompassing being overweight, suffering from undernutrition, and climate change. The findings unveiled potential interactions within food systems and health outcomes. Furthermore, the model integrated elements of the socio-ecological model by incorporating an external layer representing the environment and its natural resources. Consequently, the development of public policies and interventions should encompass environmental considerations to effectively tackle the complex challenges posed by the global syndemic.
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Sindémico , Humanos , Preescolar , Lactante , Salud Global , Abastecimiento de Alimentos , Cambio Climático , Recién NacidoRESUMEN
This Medical News story discusses the multiple factors contributing to the resurgence of syphilis in the US.
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Brotes de Enfermedades , Inequidades en Salud , Determinantes Sociales de la Salud , Sífilis , Femenino , Humanos , Masculino , Antibacterianos , Brotes de Enfermedades/estadística & datos numéricos , Salud Pública , Determinantes Sociales de la Salud/etnología , Determinantes Sociales de la Salud/estadística & datos numéricos , Sindémico , Sífilis/diagnóstico , Sífilis/epidemiología , Sífilis/etnología , Sífilis/terapia , Sífilis Congénita/diagnóstico , Sífilis Congénita/epidemiología , Sífilis Congénita/prevención & control , Treponema pallidum , Estados Unidos/epidemiología , Indio Americano o Nativo de Alaska/estadística & datos numéricos , Negro o Afroamericano/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Grupos Raciales/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Blanco/estadística & datos numéricos , Asiático/estadística & datos numéricosRESUMEN
Public health, personal/community health behaviors, health care delivery, and the scientific community have all been impacted by the COVID-19 pandemic and are consequently poised to consider substantial paradigm shifts that will enhance disease prevention and public health resilience. The current analysis compares the newly developed Lifestyle Health Index (LHI) to U.S. county-level COVID-19 vaccination, infection, and mortality rates. We linked Centers of Disease Control PLACES, the U.S. Community Profile Report, and Nationhood lab databases through common zip-code identifiers to determine the association between county-level LHI scores and COVID-19 outcomes and vaccination status against the backdrop of U.S. regions with distinct cultural phenotypes. There was a statistically significant relationship between a poor LHI, lower COVID-19 vaccination rates and higher COVID-19 infection and mortality rates. There were clear differences in outcomes across the U.S. regions, suggesting distinct regional cultural characteristics may significantly influence health behaviors and outcomes. In the U.S., a syndemic comprising unhealthy lifestyle, chronic disease, and COVID-19 resulted in unnecessary hospitalizations and deaths. Politicization of the pandemic, socioeconomic inequity and regional cultural values meaningfully contributed to the uneven distribution of poor outcomes during this syndemic. Components of the syndemic were avoidable and should not be repeated. Condensed Abstract: The unhealthy lifestyle - chronic disease - COVID-19 U.S. syndemic resulted in unnecessary hospitalizations and deaths. Politicization of the pandemic, socioeconomic inequity and regional cultural values meaningfully contributed to the uneven distribution of poor outcomes during this syndemic. Components of the syndemic were avoidable and should not be repeated.
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Vacunas contra la COVID-19 , COVID-19 , Estilo de Vida , SARS-CoV-2 , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , COVID-19/mortalidad , Estados Unidos/epidemiología , Vacunas contra la COVID-19/administración & dosificación , Sindémico , Vacunación/estadística & datos numéricos , Conductas Relacionadas con la Salud , PandemiasRESUMEN
Men who have sex with men (MSM) are at increased risk for certain types of chronic diseases and mental health problems. Despite having extended survival in the highly active antiretroviral therapy (HAART) era, MSM living with HIV contend with aging-related diseases and complications with treatment. Consequent hospitalizations incur high costs, fear, low quality of life, and frailty. Unlike heterosexual men, MSM experience more structural violence and "syndemics" of psychosocial factors that not only accelerate HIV acquisition and transmission risk but also may increase morbidity, leading to greater rates of hospitalization. We aim to examine the impact of "syndemic" psychosocial factors on the incidence of hospitalization among geographically diverse MSM in the US. Participants were 1760 MSM from the Multicenter AIDS Cohort Study (MACS) between 2004 and 2019. We examined the relationship between six psychosocial factors (depression, stimulant use, smoking, heroin use, childhood sexual abuse, and intimate partner violence) and incident hospitalization (admission to a hospital for treatment). We found a positive dose-response relationship between the number of syndemic factors and hospitalization. MSM reporting five or more syndemic factors had over twice the risk of hospitalization compared to MSM without syndemic factors [aRR = 2.14 (95% CI = 1.56, 2.94)]. Psychosocial factors synergistically increased hospitalizations over time. The positive dose-response relationship between the number of syndemic factors and hospitalization and the synergistic effects of these factors underscore the need for interventions that disentangle the syndemics to reduce hospitalization and related costs and improve the quality of life among MSM.
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Infecciones por VIH , Homosexualidad Masculina , Hospitalización , Humanos , Masculino , Homosexualidad Masculina/psicología , Homosexualidad Masculina/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Adulto , Persona de Mediana Edad , Infecciones por VIH/psicología , Infecciones por VIH/epidemiología , Estudios Longitudinales , Estados Unidos/epidemiología , Incidencia , Sindémico , Factores de Riesgo , Depresión/epidemiología , Depresión/psicología , Violencia de Pareja/psicología , Violencia de Pareja/estadística & datos numéricos , Seropositividad para VIH/psicología , Seropositividad para VIH/epidemiología , Calidad de Vida , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
INTRODUCTION: The increasing burden of non-communicable diseases, such as hypertension, diabetes and dyslipidaemia, presents key challenges to achieving optimal HIV care outcomes among ageing people living with HIV. These diseases are often comorbid and are exacerbated by psychosocial and structural inequities. This interaction among multiple health conditions and social factors is referred to as a syndemic. In the USA, there are substantial disparities by social position (ie, racial, ethnic and socioeconomic status) in the prevalence and/or control of non-communicable diseases and HIV. Intersecting stigmas, such as racism, classism and homophobia, may drive these health disparities by contributing to healthcare avoidance and by contributing to a psychosocial syndemic (stress, depression, violence victimisation and substance use), reducing success along the HIV and non-communicable disease continua of care. Our hypothesis is that marginalised populations experience disparities in non-communicable disease incidence, prevalence and control, mediated by intersectional stigma and the psychosocial syndemic. METHODS AND ANALYSIS: Collecting data over a 4 year period, we will recruit sexual minority men (planned n=1800) enrolled in the MACS/WIHS Combined Cohort Study, a long-standing mixed-serostatus observational cohort in the USA, to investigate the following specific aims: (1) assess relationships between social position, intersectional stigma and the psychosocial syndemic among middle-aged and ageing sexual minority men, (2) assess relationships between social position and non-communicable disease incidence and prevalence and (3) assess relationships between social position and HIV and non-communicable disease continua of care outcomes, mediated by intersectional stigma and the psychosocial syndemic. Analyses will be conducted using generalised structural equation models using a cross-lagged panel model design. ETHICS AND DISSEMINATION: This protocol is approved as a single-IRB study (Advarra Institutional Review Board: Protocol 00068335). We will disseminate results via peer-reviewed academic journals, scientific conferences, a dedicated website, site community advisory boards and forums hosted at participating sites.
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Infecciones por VIH , Enfermedades no Transmisibles , Estigma Social , Sindémico , Humanos , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Masculino , Estados Unidos/epidemiología , Enfermedades no Transmisibles/epidemiología , Adulto , Estudios Observacionales como Asunto , Proyectos de Investigación , Persona de Mediana Edad , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Prevalencia , Disparidades en el Estado de Salud , Disparidades en Atención de SaludRESUMEN
Background: Syndemic models have been used in previous studies exploring HIV-related outcomes; however, these models do not fully consider intersecting psychosocial (e.g., substance use, depressive symptoms) and structural factors (unstable housing, concentrated housing vacancy) that influence the lived experiences of women. Therefore, there is a need to explore the syndemic effects of psychosocial and structural factors on HIV risk behaviors to better explain the multilevel factors shaping HIV disparities among black women. Methods: This analysis uses baseline data (May 2009-August 2010) from non-Hispanic black women enrolled in the HIV Prevention Trials Network 064 Women's Seroincidence Study (HPTN 064) and the American Community Survey 5-year estimates from 2007 to 2011. Three parameterizations of syndemic factors were applied in this analysis a cumulative syndemic index, three syndemic groups reflecting the level of influence (psychosocial syndemic group, participant-level structural syndemic group, and a neighborhood-level structural syndemic group), and syndemic factor groups. Clustered mixed effects log-binomial analyses measured the relationship of each syndemic parameterization on HIV risk behaviors in 1,347 black women enrolled in HPTN 064. Results: A higher syndemic score was significantly associated with increased prevalence of unknown HIV status of the last male sex partner (adjusted prevalence ratio (aPR) = 1.07, 95% confidence interval or CI 1.04-1.10), involvement in exchange sex (aPR = 1.17, 95% CI: 1.14-1.20), and multiple sex partners (aPR = 1.07, 95% CI: 1.06-1.09) in the last 6 months. A dose-response relationship was observed between the number of syndemic groups and HIV risk behaviors, therefore, being in multiple syndemic groups was significantly associated with increased prevalence of reporting HIV risk behaviors compared with being in one syndemic group. In addition, being in all three syndemic groups was associated with increased prevalence of unknown HIV status of the last male sex partner (aPR = 1.67, 95% CI: 1.43-1.95) and multiple sex partners (aPR = 1.53, 95% CI: 1.36-1.72). Conclusions: Findings highlight syndemic factors influence the lived experiences of black women.
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Negro o Afroamericano , Infecciones por VIH , Asunción de Riesgos , Conducta Sexual , Trastornos Relacionados con Sustancias , Sindémico , Humanos , Femenino , Infecciones por VIH/etnología , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Negro o Afroamericano/estadística & datos numéricos , Negro o Afroamericano/psicología , Adulto , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/etnología , Conducta Sexual/etnología , Conducta Sexual/psicología , Depresión/epidemiología , Depresión/etnología , Persona de Mediana Edad , Factores Socioeconómicos , Factores de Riesgo , Estados Unidos/epidemiología , Vivienda , Características de la Residencia , Adulto JovenRESUMEN
Psychotic conditions pose significant challenges due to their complex aetiology and impact on individuals and communities. Syndemic theory offers a promising framework to understand the interconnectedness of various health and social problems in the context of psychosis. This systematic review aims to examine existing literature on testing whether psychosis is better understood as a component of a syndemic. We conducted a systematic search of 7 databases, resulting in the inclusion of five original articles. Findings from these studies indicate a syndemic characterized by the coexistence of various health and social conditions, are associated with a greater risk of psychosis, adverse health outcomes, and disparities, especially among ethnic minorities and deprived populations. This review underscores the compelling need for a new paradigm and datasets that can investigate how psychosis emerges in the context of a syndemic, ultimately guiding more effective preventive and care interventions as well as policies to improve the health of marginalised communities living in precarity.
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Trastornos Psicóticos , Humanos , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/etiología , SindémicoRESUMEN
Digital phenotyping is a process that allows researchers to leverage smartphone and wearable data to explore how technology use relates to behavioral health outcomes. In this Research Concepts article, we provide background on prior research that has employed digital phenotyping; the fundamentals of how digital phenotyping works, using examples from participant data; the application of digital phenotyping in the context of substance use and its syndemics; and the ethical, legal and social implications of digital phenotyping. We discuss applications for digital phenotyping in medical toxicology, as well as potential uses for digital phenotyping in future research. We also highlight the importance of obtaining ground truth annotation in order to identify and establish digital phenotypes of key behaviors of interest. Finally, there are many potential roles for medical toxicologists to leverage digital phenotyping both in research and in the future as a clinical tool to better understand the contextual features associated with drug poisoning and overdose. This article demonstrates how medical toxicologists and researchers can progress through phases of a research trajectory using digital phenotyping to better understand behavior and its association with smartphone usage.
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Trastornos Relacionados con Sustancias , Dispositivos Electrónicos Vestibles , Humanos , Teléfono Inteligente , Sindémico , Fenotipo , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
OBJECTIVE: To explore the syndemic interaction between social, environmental, and structural contexts and HIV infection in peri-mining areas in South Africa. DESIGN: Mixed qualitative methods consisting of in-depth interviews (IDIs) and focus group discussions (FGDs) exploring the interaction between HIV infection and the social, environmental and structural factors affecting people living in the peri-mining areas of South Africa. Themes were analysed following the syndemic theoretical framework. SETTING: Participants were recruited from three mining companies and locations in the peri-mining communities surrounding the mining companies in Limpopo, Mpumalanga, and Northern Cape provinces. PARTICIPANTS: Inclusion criteria included mineworkers, healthcare workers, female sex workers (FSWs), injection drug users (IDUs), and other community members, ≥18 years, living in the peri-mining area at the time of participation. Three FGDs were conducted (n=30): 13 men and 17 women aged 18-55 years. IDIs were conducted with 45 participants: mineworkers (n=10), healthcare workers (n=11), FSWs (n=15), truck drivers (n=4) and IDUs (n=5). RESULTS: The findings from this study indicate that a syndemic of four socio-behavioural factors is associated with HIV acquisition in peri-mining areas. These are migrancy, accessibility to alcohol and substance use, commercial and transactional sex, and uptake of HIV prevention services. CONCLUSIONS: Our findings have implications for HIV prevention programmes in mining companies, which rely on male condom usage promotion. More emphasis on better education about HIV prevalence, transmission and up-to-date prevention alternatives, such as pre-exposure prophylaxis for mineworkers is recommended. Furthermore, collaboration with community-based organisations is recommended to wholly address the syndemic factors influencing HIV transmission in peri-mining communities.
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Infecciones por VIH , Trabajadores Sexuales , Femenino , Masculino , Humanos , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Sudáfrica/epidemiología , Conducta Sexual , SindémicoRESUMEN
INTRODUCTION: Given the absence of international guidelines on the joint management and control of tuberculosis (TB) and type 2 diabetes mellitus (T2D), the World Health Organization (WHO) and the International Union Against Tuberculosis and Lung Disease (The Union) launched in 2011 a policy framework to address the growing syndemic burden of TB-T2D. This review aimed at mapping the available evidence on the implementation of the Union-WHO Framework, explicitly, or bi-directional TB-T2D health programs as an initiative for co-management in patients in low- and middle-income countries (LMIC). METHODS: A rapid review was performed based on a systematic search in PubMed and Web of Science electronic databases for peer-reviewed articles on The Union-WHO Framework and bi-directional interventions of TB and T2D in LMIC. The search was restricted to English language articles and from 01/08/2011 to 20/05/2022. RESULTS: A total of 24 articles from 16 LMIC met the inclusion criteria. Four described the implementation of The Union-WHO Framework and 20 on the bi-directional interventions of TB and T2D. Bi-directional activities were found valuable, feasible and effective following the Union-WHO recommendations. Limited knowledge and awareness on TB-T2D comorbidity was identified as one of the barriers to ensure a functional and effective integration of services. CONCLUSIONS: This review revealed that it is valuable, feasible and effective to implement bi-directional TB and T2D activities (screening and management) according to the Union-WHO Framework recommendations, especially in countries that face TB-T2D syndemic. Additionally, it was apparent that gaps still exist in research aimed at providing evidence of costs to implement collaborative activities. There is need for TB and T2D services integration that should be done through the well-stablished TB programme. This integration of two vertical programmes, could ensure patient-centeredness, continuum of care and ultimately contribute for health systems strengthening.
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Diabetes Mellitus Tipo 2 , Tuberculosis , Humanos , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/terapia , Países en Desarrollo , Sindémico , Tuberculosis/epidemiología , Tuberculosis/terapia , Tuberculosis/diagnóstico , ComorbilidadRESUMEN
Quilombola communities have felt the effects of racism deepened by COVID-19, whose repercussions are amplified in contexts of racial inequalities, characterizing it as a syndemic. The term refers to the synergy of biological, economic, environmental, political, and social elements that enhance coexisting conditions and states, impacting life and affecting health. Thus, our study seeks to analyze the repercussions of the COVID-19 syndemic based on the perceptions of quilombola community leaders in Mato Grosso, Brazil. In a qualitative study, three leaders were interviewed in May 2022, using a semi-structured script and treating the data through thematic analysis. The COVID-19 syndemic highlighted the structural precariousness of transport, roads, sanitation, and access to water, food, and health services. Isolation, deaths, and fears had psychosocial repercussions, but little attention was paid to mental health. Anti-racist proposals call for: repairing precariousness by recognizing the State's debt to the black population; valuing experiences, way of life, cosmovision, and Afro-centered ancestral civilizational values. Finally, the aim is to strengthen, reaffirm, and implement anti-racist actions, such as the Statute of Racial Equality and the PNSIPN, in all possible spaces, policies, and institutions.
Comunidades quilombolas têm sentido efeitos do racismo aprofundados com a COVID-19 cujas repercussões se amplificam em contextos de desigualdades raciais, caracterizando-se como sindemia. O termo remete à sinergia de elementos biológicos, econômicos, ambientais, políticos e sociais que potencializam condições e estados coexistentes, repercutindo na vida e afetando a saúde. Assim, analisamos as repercussões da sindemia da COVID-19 a partir das percepções de lideranças de comunidade quilombola em Mato Grosso. Em estudo qualitativo entrevistamos três lideranças em maio/2022, usando roteiro semiestruturado e tratamos os dados pela análise temática. A sindemia da COVID-19 visibilizou a precariedade estrutural quanto ao transporte, estradas, saneamento, acesso à água, alimentos e serviços de saúde. O isolamento, mortes, medos tiveram repercussões psicossociais, mas ausência de atenção à saúde mental. Propostas antirracistas clamam por: reparar precariedades reconhecendo a dívida do Estado com a população negra; valorizar experiências, modo de vida, cosmovisão, valores civilizatórios ancestrais afrocentrados. Enfim, fortalecer, reafirmar e efetivar ações antirracistas como o Estatuto da Igualdade Racial e a PNSIPN em todos possíveis espaços, políticas e instituições.
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COVID-19 , Racismo , Humanos , Brasil/epidemiología , Sindémico , Población NegraRESUMEN
Much progress has been made in advancing antiretroviral (ART) adherence, yet disparities remain. To explore relationships of syndemic conditions - co-occurring health conditions caused by combinations of biological, social, and structural factors - to ART adherence among African American men, we used data from longitudinal assessments of 302 African American men enrolled in a study designed to increase physical activity and healthy eating. Syndemic conditions included alcohol dependency, drug dependency, depression, post-traumatic stress disorder, and unstable housing. A syndemic conditions variable was operationalized to indicate the presence of 0-5 conditions. About 55% of participants had 1 or more syndemic conditions. Age and marriage were positively associated with ART adherence, whereas number of syndemic conditions was negatively associated with adherence during the 12-month period. The interaction of being married and the syndemic conditions variable significantly predicted greater adherence. Similarly, the interaction of more education and the syndemic conditions variable predicted greater adherence. In multiple regression models, the syndemic conditions variable remained significant (-0.018) in predicting adherence; however, there was no significant interaction among the 5 conditions. This study lends evidence to syndemics literature indicating deleterious consequences of negative life experiences on health outcomes.
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Fármacos Anti-VIH , Negro o Afroamericano , Infecciones por VIH , Cumplimiento de la Medicación , Sindémico , Población Urbana , Adulto , Humanos , Masculino , Persona de Mediana Edad , Alcoholismo/epidemiología , Fármacos Anti-VIH/uso terapéutico , Negro o Afroamericano/estadística & datos numéricos , Negro o Afroamericano/psicología , Depresión/epidemiología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Estudios Longitudinales , Cumplimiento de la Medicación/estadística & datos numéricos , Cumplimiento de la Medicación/psicología , Factores Socioeconómicos , Trastornos por Estrés Postraumático/epidemiología , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
Households affected by tuberculosis have syndemic vulnerability, reflecting a concentration of and interactions between multiple biomedical, psychosocial, and structural determinants of health. Traditional approaches to tuberculosis screening do not address pre-existing risks, such as undernutrition and other chronic conditions, or the indirect effects of tuberculosis, such as loss of livelihood. These pre-existing risks and consequences not only perpetuate the global tuberculosis epidemic but, for those affected, lead to poor health and deepen poverty. We propose reimagining tuberculosis screening as an opportunity to deliver a contextually relevant package of services that address the needs of households affected by tuberculosis. This approach puts people and their rights at the centre of efforts to end tuberculosis, and has equity at the core. This approach could support progress towards universal health coverage, benefiting communities and health systems. Leadership, flexibility in funding allocation, and innovative care models will be required to realise this approach at scale.
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Tuberculosis , Humanos , Tuberculosis/diagnóstico , Tuberculosis/prevención & control , Tuberculosis/epidemiología , Pobreza , Composición Familiar , Tamizaje Masivo , SindémicoRESUMEN
Chronic rhinosinusitis (CRS) has recently undergone a significant paradigm shift, moving from a phenotypical classification towards an "endotype-based" definition that places more emphasis on clinical and therapeutic aspects. Similar to other airway diseases, like asthma, most cases of CRS in developed countries exhibit a dysregulated type-2 immune response and related cytokines. Consequently, the traditional distinction between upper and lower airways has been replaced by a "united airway" perspective. Additionally, type-2 related disorders extend beyond respiratory boundaries, encompassing conditions beyond the airways, such as atopic dermatitis. This necessitates a multidisciplinary approach. Moreover, consideration of possible systemic implications is crucial, particularly in relation to sleep-related breathing diseases like Obstructive Sleep Apnoea Syndrome (OSAS) and the alteration of systemic inflammatory mediators such as nitric oxide. The trends in epidemiological, economic, and social burden are progressively increasing worldwide, indicating syndemic characteristics. In light of these insights, this narrative review aims to present the latest evidence on respiratory type-2 related disorders, with a specific focus on CRS while promoting a comprehensive perspective on the "united airways". It also introduces a novel concept: viewing these conditions as a multiorgan, systemic, and syndemic disease.