biostudies-literatureMendenhall EThe South African Medical Research Council and the Department of Science and Innovation (DSI)-National Research Foundation (NRF) Centre of Excellence in Human DevelopmentFIC NIH HHSU.S. Department of Health & Human Services | NIH | Fogarty International CenterU.S. Department of Health & Human Services | National Institutes of Health64-73https://www.ebi.ac.uk/biostudies/studies/S-EPMC8799501biostudies-literatureUnknown6(1)A syndemic has been theorized as a cluster of epidemics driven by harmful social and structural conditions wherein the interactions between the constitutive epidemics drive excess morbidity and mortality. We conducted a mixed-methods study to investigate a syndemic in Soweto, South Africa, consisting of a population-based quantitative survey (N = 783) and in-depth, qualitative interviews (N = 88). We used ethnographic methods to design a locally relevant measure of stress. Here we show that multimorbidity and stress interacted with each other to reduce quality of life. The paired qualitative analysis further explored how the quality-of-life impacts of multimorbidity were conditioned by study participants' illness experiences. Together, these findings underscore the importance of recognizing the social and structural drivers of stress and how they affect the experience of chronic illness and well-being.Nature human behaviourA mixed-methods, population-based study of a syndemic in Soweto, South Africa.PMC8799501D43 TW010543D43TW010543R21TW010789R21 TW010789Cele LKim AWNorris SATsai ACBosire ENMpondo FMendenhall EPanasci AfalseA mixed-methods, population-based study of a syndemic in Soweto, South Africa.A syndemic has been theorized as a cluster of epidemics driven by harmful social and structural conditions wherein the interactions between the constitutive epidemics drive excess morbidity and mortality. We conducted a mixed-methods study to investigate a syndemic in Soweto, South Africa, consisting of a population-based quantitative survey (N = 783) and in-depth, qualitative interviews (N = 88). We used ethnographic methods to design a locally relevant measure of stress. Here we show that multimorbidity and stress interacted with each other to reduce quality of life. The paired qualitative analysis further explored how the quality-of-life impacts of multimorbidity were conditioned by study participants' illness experiences. Together, these findings underscore the importance of recognizing the social and structural drivers of stress and how they affect the experience of chronic illness and well-being.2022-01-01T00:00:00Z2022 Jan2025-04-04T07:48:08.083Z2025-04-04T07:48:08.083ZS-EPMC87995013494978310.1038/s41562-021-01242-1