Multimorbidity, Polyiatrogenesis, and COVID‐19

• Published in: Medical Anthropology Quarterly Vol. 34; no. 4; pp. 488 - 503
• Main Author: Ecks, Stefan
• Format: Journal Article Web Resource
• Language: English
• Published: United States John Wiley & Sons, Inc 01.12.2020; Blackwell Publishing Ltd; John Wiley and Sons Inc
• Subjects: Anthropology, Medical; Biomedicine; Chronic Disease; Chronic illnesses; Coinfection; Comorbidity; COVID-19; COVID-19 - complications; COVID-19 - mortality; Deprivation; Disorders; Drugs; Embeddedness; Female; Humans; iatrogenesis; Inequality; Integrated care; Male; Models, Biological; Mortality rates; Multimorbidity; Original; Polypharmacy; SARS-CoV-2; social inequality; Social isolation; Socioeconomic Factors; Suffering; Treatment methods; COVID-19; multimorbidity; social inequality; polypharmacy; iatrogenesis
• ISSN: 0745-5194; 1548-1387
• DOI: 10.1111/maq.12626

To date, the strongest predictor for dying with COVID‐19 is suffering from several chronic disorders prior to the viral infection. Pre‐existing multimorbidity is highly correlated with socioeconomic inequality. In turn, having several chronic conditions is closely linked to multiple medication intake, especially in richer countries with good access to biomedical care. Owing to its vertical structure, biomedicine often risks giving multiple treatments in an uncoordinated way. Such lack of integrated care can create complex forms of iatrogenic harm. Multimorbidity is often exacerbated by a pharmaceuticalization of social deprivation in place of integrated care. In this article, I explore the possibility that clusters of over‐medication are a contributing factor to higher death rates from COVID‐19, especially in poorer areas within richer countries. Anthropological perspectives on the social embeddedness of multimorbidity and multiple medication use can expand our understanding of who is most vulnerable to SARS‐CoV‐2.