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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.

Faith, belief, and religion can powerfully shape how people live with and heal from illness. Engaging in religious practices, from gathering for services to reading the holy texts and engaging in private prayer, can serve as a critical way of coping or building resilience amidst everyday social, moral, and medical challenges. In this article, we investigate why, what, and how people living with chronic illness in an urban South African township prioritise healing practices of the Church over the Clinic. We conducted 88 in-depth qualitative interviews to understand how people think about health, chronic illness, and healing. Most people described complex socio-spiritual beliefs and practices that many prioritised or practiced apart from biomedical care. This included religious practices, such as prayer and drinking church water, as well as one's spirituality, which was an essential way in which people found healing. Recognising how socio-spiritual practice fosters healing and wellness is critical for thinking about health and healing for Soweto residents.

What does it mean to live a flourishing life in Soweto? This article investigates how people residing in Soweto, located in South Africa's Gauteng province, define, experience, and express flourishing both on its own and in relation to health. We interviewed 30 people who had expressed some interest in flourishing and health in a previous interview, and found that the IsiZulu term ukuphumelela – roughly translated as “becoming victorious” – best approximated the English notion of flourishing. We found that interviewees' conceptions of ukuphumelela diverged significantly from current scholarship on flourishing in general and flourishing and health in particular. Three central elements of ukuphumelela illustrate three elements: external, material, or structural factors (like financial security), internal or personal characteristics (including discipline), and relationality of social dynamics, such as dynamics of reciprocity, mutual obligation, and care. Moreover, we identified seven ways people drew from their personal journeys to define ukuphumelela: 1) determination and drive to reach their goals; 2) broader opportunity to attain a good education and learn from strong role models or mentors; 3) having enough money or material support to cover basic needs; 4) overcoming odds or conquering challenges from childhood; 5) prayer, faith, and trust in God; 6) a journey or path (a pursuit); and 7) caring for and giving back to others, emphasizing ubuntu. Our findings suggest that what it means, and what it takes, to flourish varies from one setting to the next.