“You make me sick” is a colloquialism, but it reflects a reality. Our health depends on more than our own biology or even our own choices and actions. Our health also depends quite literally on the biology, choices, and actions of those around us.
Back pain is an example of a condition that can spread via social networks. A group of German investigators studied the possible transmission of back pain by exploiting a natural experiment provided by the reunification of Germany. Before the Berlin Wall fell, East Germany had much lower rates of back pain than West Germany, but within ten years of reunification, rates had converged to be the same, with East Germany emulating West Germany’s higher rates. Exposure to new media messages among formerly insulated East Germans about how back pain was “frequent and unavoidable” and “a diagnostic and therapeutic enigma in need of careful medical attention” appeared to play a role. But these investigators also argued that back pain was a “communicable disease” and that a kind of “psychosocial decontamination” might be helpful to break the transmission.In some ways, this varying prevalence, and the culturally specific ways in which back pain is experienced, suggest that back pain can be seen as a culture-bound syndrome—a disease recognized in one society but not others, such that people can experience the disease only if they inhabit a particular social milieu.