Health Through the Lens of Newborn Syphilis
Curandi's social health integration is a multi-system approach. Newborn syphilis is an example of a treatable condition where social and behavioral engagement is essential for success. Today’s flawed solution requires medicine to coordinate a reduction in complicating social factors in an environment it doesn't understand.
In the November 7, 2023 Morbidity and Mortality Weekly Report, the CDC released new data showing that the number of reported newborn syphilis cases grew by a factor of 10 from 2012 to 2022.(1)
Here in Oregon, the rate of syphilis infection has been climbing for a decade. The chart below is from the Oregon Health Authority(2).
Closer to home, the Marion County Health Department reported STDs increased 216% from 2018-2022(3).
The big picture: Newborn syphilis is an example of something that happens all the time -- A medical condition with significant mortality, morbidity, and downstream cost, and where public health and medicine have limited effectiveness.
This is a big deal. We know that disease reporting undercounts, making this problem more significant than it looks.
All three public health agencies hit all the crucial points with links to data, resources, and recommendations. Mostly, these are things we already know and should be doing. Clearly, we can do better.
So…why aren't we doing better? One part of the answer isn't that hard to understand. In 2022, a UC Davis study(4) published in the Journal of Perinatology found that rates of congenital syphilis infection were more dependent on socioeconomic indicators than the county classification. For this condition, those indicators are female poverty rates and education levels.
Why it matters: This is bigger than medicine. Newborn syphilis is a symptom of a more extensive and growing social gangrene. Because the foundation of humanity is its social structure, everything we hope to achieve is at risk.
What we call health varies wildly and requires different knowledge and methods. Biological and social systems have little in common.
Physical health is the maintenance of an individual's human biology, which is its core physical reality. Human biology has been unchanged for over 75,000 years. As a system, the behavior of human biology is predictable, consistent, and knowable.
Behavioral and social health are properties emerging from individual and collective human thought. The behavior of social systems is “true complexity” and inherently uncertain. It requires a different understanding and approach.
A multi-system approach is the only path to success. Behavioral and social health must have the support and infrastructure necessary to deliver what is needed.
There may be many ways to get this done, but what we need to do is clear.
Curandi's work is to support human and social service networks with the infrastructure and support they need to improve their ability to create a real difference.
References
1. Centers for Disease Control and Prevention - U.S. Syphilis Cases in Newborns Continue to Increase: A 10-Times Increase Over a Decade
2. Oregon Public Health Division - HIV, STD & TB Section - Syphilis
3. Marion County Oregon - Sexually Transmitted Diseases
4. Journal of Perinatology - Examining associations in congenital syphilis infection and socioeconomic factors between California’s small-to-medium and large metro counties (2022) 42:1434–1439;