{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:04:50Z","timestamp":1789430690271,"version":"build-2803163510"},"reference-count":46,"publisher":"PAGEPress Publications","issue":"2","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geospat Health"],"abstract":"<jats:p>Lyme disease is a growing public health threat driven by interplay of climatic, ecological and social factors. This review adopts an eco-syndemic framework, viewing Lyme disease emergence as the confluence of multiple synergistic drivers rather than a single- cause phenomenon. We synthesize evidence that climate conditions, ecological circumstances and human behavioural patterns inter- sect to amplify Lyme disease risk. By integrating these seemingly separate domains, our review highlights novel insights; for exam- ple, habitat fragmentation and predator loss may magnify the effects of a warming climate on reservoir or host populations, and human activities in suburban green spaces may mediate infection cycles. This holistic perspective is a departure from reductionist explanations and emphasizes the importance of coupled human\u2013environment systems in studies of disease emergence. We discuss how an eco-syndemic frame can improve surveillance and prevention emphasizing One Health approaches that unite environmental management with animal health and public health outreach. Understanding the interactive and non-linear dynamics of Lyme disease drivers is crucial for developing effective interventions and preparing for future tick-borne disease challenges. While selected com- parative evidence from Europe is used where relevant, the review\u2019s primary empirical focus is North America.<\/jats:p>","DOI":"10.4081\/gh.2026.1479","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T14:27:20Z","timestamp":1785853640000},"source":"Crossref","is-referenced-by-count":0,"title":["Synergistic drivers of Lyme disease emergence in North America: an eco-syndemic review"],"prefix":"10.4081","volume":"21","author":[{"given":"Michael F.","family":"Ojo","sequence":"first","affiliation":[{"name":"Department of Geography, Virginia Tech, Blacksburg, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Korine N.","family":"Kolivras","sequence":"additional","affiliation":[{"name":"Department of Geography, Virginia Tech, Blacksburg, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"38701","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0116767"},{"key":"38702","doi-asserted-by":"publisher","DOI":"10.1007\/s10393-024-01677-8"},{"key":"38703","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-012-0126-6"},{"key":"38704","doi-asserted-by":"publisher","DOI":"10.1016\/j.apgeog.2020.102383"},{"key":"38705","doi-asserted-by":"publisher","DOI":"10.1016\/j.ttbdis.2022.101925"},{"key":"38706","doi-asserted-by":"publisher","DOI":"10.1007\/s10393-004-0139-x"},{"key":"38707","doi-asserted-by":"publisher","DOI":"10.1186\/s13071-016-1894-6"},{"key":"38708","doi-asserted-by":"publisher","DOI":"10.1111\/tbed.14268"},{"key":"38709","unstructured":"CDC, 2024. 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