Teaching the Social Determinants of Health: A Path to Equity or a Road to Nowhere?

Academic Medicine

Volumn 93, Issue 1, 2018, Pages 25-30

  Sharma, Malika ^a,b   Pinto, Andrew D ^b,c,d,e   Kumagai, Arno K ^c,f  

^a Canadian HIV Trials Network   (Canada)

^b ST MICHAEL'S HOSPITAL   (Canada)

^c UNIVERSITY OF TORONTO   (Canada)

^d ST MICHAEL'S HOSPITAL   (Canada)

^e Upstream Lab   (Canada)

^f UNIVERSITY OF TORONTO   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

EDUCATION; HEALTH DISPARITY; HUMAN; MEDICAL EDUCATION; SOCIAL DETERMINANTS OF HEALTH; SOCIAL JUSTICE;

EDUCATION, MEDICAL; HEALTH STATUS DISPARITIES; HUMANS; SOCIAL DETERMINANTS OF HEALTH; SOCIAL JUSTICE;

EID: 85039152400     PISSN: 10402446     EISSN: 1938808X     Source Type: Journal    
DOI: 10.1097/ACM.0000000000001689     Document Type: Review

References (69)

1. Seligman HK, Bolger AF, Guzman D, López A, Bibbins-Domingo K. Exhaustion of food budgets at month's end and hospital admissions for hypoglycemia. Health Aff (Millwood). 2014;33:116-123.
2. Olah ME, Gaisano G, Hwang SW. The effect of socioeconomic status on access to primary care: An audit study. CMAJ. 2013;185:E263-E269.
3. Association of American Medical Colleges. Behavioral and Social Science Foundations for Future Physicians. Washington, DC: Association of American Medical Colleges; 2011. https://www.aamc.org/ download/271020/data/behavioraland socialsciencefoundationsforfuturephysicians. pdf. Accessed February 20, 2017.
4. Klein MD, Alcamo AM, Beck AF, et al. Can a video curriculum on the social determinants of health affect residents' practice and families' perceptions of care? Acad Pediatr. 2014;14:159-166.
5. Klein MD, Kahn RS, Baker RC, Fink EE, Parrish DS, White DC. Training in social determinants of health in primary care: Does it change resident behavior? Acad Pediatr. 2011;11:387-393.
6. O'Brien MJ, Garland JM, Murphy KM, Shuman SJ, Whitaker RC, Larson SC. Training medical students in the social determinants of health: The Health Scholars Program at Puentes de Salud. Adv Med Educ Pract. 2014;5:307-314.
7. World Health Organization. What are social determinants of health? http://www.who. int/social-determinants/sdh-definition/en/. Accessed February 20, 2017.
8. Jones CP, Jones CY, Perry GS, Barclay G, Jones CA. Addressing the social determinants of children's health: A cliff analogy. J Health Care Poor Underserved. 2009;20(4 suppl):1-12.
9. Buchanan D, Jain S. Teaching students about health care of the homeless. Acad Med. 2001;76:524-525.
10. Chheda S, Hemmer PA, Durning S. Teaching about racial/ethnic health disparities: A national survey of clerkship directors in internal medicine. Teach Learn Med. 2009;21:127-130.
11. Eddey GE, Robey KL. Considering the culture of disability in cultural competence education. Acad Med. 2005;80:706-712.
12. Collins J. Introduction: Addressing racial and ethnic disparities: Lessons from the REACH 2010 communities. J Health Care Poor Underserved. 2006;17:1-5. doi: 10.1353/ hpu.2006.0071.
13. Müller A. Teaching lesbian, gay, bisexual and transgender health in a South African health sciences faculty: Addressing the gap. BMC Med Educ. 2013;13:174.
14. Dharamsi S, Ho A, Spadafora SM, Woollard R. The physician as health advocate: Translating the quest for social responsibility into medical education and practice. Acad Med. 2011;86:1108-1113.
15. Oandasan IF, Barker KK. Educating for advocacy: Exploring the source and substance of community-responsive physicians. Acad Med. 2003;78(10 suppl):S16-S19.
16. McGarry KA, Clarke JG, Landau C, Cyr MG. Caring for vulnerable populations: Curricula in U.S. internal medicine residencies. J Homosex. 2008;54:225-232.
17. Sharma M. Developing an integrated curriculum on the health of marginalized populations: Successes, challenges, and next steps. J Health Care Poor Underserved. 2014;25:663-669.
18. Hunt JB, Bonham C, Jones L. Understanding the goals of service learning and communitybased medical education: A systematic review. Acad Med. 2011;86:246-251.
19. Ivory K, Bandler L, Hawke C, Armstrong B. A clinical approach to population medicine. Clin Teach. 2013;10:94-98.
20. Bakshi S, James A, Hennelly MO, et al. The Human Rights and Social Justice Scholars Program: A collaborative model for preclinical training in social medicine. Ann Glob Health. 2015;81:290-297.
21. DasGupta S, Fornari A, Geer K, et al. Medical education for social justice: Paulo Freire revisited. J Med Humanit. 2006;27:245-251.
22. Witten NA, Maskarinec GG. Privilege as a social determinant of health in medical education: A single class session can change privilege perspective. Hawaii J Med Public Health. 2015;74:297-301.
23. Peluso MJ, Seavey B, Gonsalves G, Friedland G. An inter-professional "advocacy and activism in global health" module for the training of physician-advocates. Glob Health Promot. 2013;20:70-73.
24. Reeve K, Rossiter K, Risdon C. The Last Straw! A board game on the social determinants of health. Med Educ. 2008;42:1125-1126.
25. Bainbridge L, Dharamsi S, Wood V. A Parisian-style salon addressing social determinants of health. Med Educ. 2012;46:520-521.
26. Klein MD, Schumacher DJ, Sandel M. Assessing and managing the social determinants of health: Defining an entrustable professional activity to assess residents' ability to meet societal needs. Acad Pediatr. 2014;14:10-13.
27. Meili R, Fuller D, Lydiate J. Teaching social accountability by making the links: Qualitative evaluation of student experiences in a service-learning project. Med Teach. 2011;33:659-666.
28. van den Heuvel M, Au H, Levin L, Bernstein S, Ford-Jones E, Martimianakis MA. Evaluation of a social pediatrics elective: Transforming students' perspective through reflection. Clin Pediatr (Phila). 2014;53:549-555.
29. Furin J, Farmer P, Wolf M, et al. A novel training model to address health problems in poor and underserved populations. J Health Care Poor Underserved. 2006;17:17-24.
30. Meurer LN, Young SA, Meurer JR, Johnson SL, Gilbert IA, Diehr S. The urban and community health pathway. Am J Prev Med. 2011;41(4 suppl):S228-S236.
31. Klein M, Vaughn LM. Teaching social determinants of child health in a pediatric advocacy rotation: Small intervention, big impact. Med Teach. 2010;32:754-759.
32. Cole McGrew M, Wayne S, Solan B, Snyder T, Ferguson C, Kalishman S. Health policy and advocacy for New Mexico medical students in the family medicine clerkship. Fam Med. 2015;47:799-802.
33. Kruger J, Dunning D. Unskilled and unaware of it: How difficulties in recognizing one's own incompetence lead to inflated self-assessments. J Pers Soc Psychol. 1999;77:1121-1134.
34. Eva KW, Regehr G. Self-assessment in the health professions: A reformulation and research agenda. Acad Med. 2005;80(10 suppl):S46-S54.
35. Mikkonen J, Raphael D. Social Determinants of Health: The Canadian Facts. Toronto, Ontario, Canada: York University, School of Health Policy and Management; 2010. http://www.deslibris.ca/ID/223317. Accessed February 20, 2017.
36. Pinto AD. Denaturalizing "natural" disasters: Haiti's earthquake and the humanitarian impulse. Open Med. 2010;4:e193-e196.
37. Hubinette M, Dobson S, Towle A, Whitehead C. Shifts in the interpretation of health advocacy: A textual analysis. Med Educ. 2014;48:1235-1243.
38. McNeil R, Guirguis-Younger M, Dilley LB, Turnbull J, Hwang SW. Learning to account for the social determinants of health affecting homeless persons. Med Educ. 2013;47:485-494.
39. To MJ, Sharma M. Training tomorrow's physician-advocates. Med Educ. 2015;49:752-754.
40. Dobson S, Voyer S, Hubinette M, Regehr G. From the clinic to the community: The activities and abilities of effective health advocates. Acad Med. 2015;90:214-220.
41. Masson N, Lester H. The attitudes of medical students towards homeless people: Does medical school make a difference? Med Educ. 2003;37:869-872.
42. Wen CK, Hudak PL, Hwang SW. Homeless people's perceptions of welcomeness and unwelcomeness in healthcare encounters. J Gen Intern Med. 2007;22:1011-1017.
43. Beagan BL. "Is this worth getting into a big fuss over?" Everyday racism in medical school. Med Educ. 2003;37:852-860.
44. Allan B, Smylie J. First Peoples, Second Class Treatment: The Role of Racism in the Health and Well-Being of Indigenous Peoples in Canada. Toronto, Ontario, Canada: Wellesley Institute; 2015. http://sac-oac.ca/sites/default/ files/resources/Report-First-Peoples-Second- Class-Treatment.pdf. Accessed February 20, 2017.
45. Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med. 1994;69:861-871.
46. Martimianakis MA, Michalec B, Lam J, Cartmill C, Taylor JS, Hafferty FW. Humanism, the hidden curriculum, and educational reform: A scoping review and thematic analysis. Acad Med. 2015;90(11 suppl):S5-S13.
47. Whitehead C, Kuper A, Webster F. The conceit of curriculum. Med Educ. 2012;46:534-536.
48. Metzl JM, Hansen H. Structural competency: Theorizing a new medical engagement with stigma and inequality. Soc Sci Med. 2014;103:126-133.
49. Verdonk P. When I say ... reflexivity. Med Educ. 2015;49:147-148.
50. Flynn L, Verma S. Fundamental components of a curriculum for residents in health advocacy. Med Teach. 2008;30:e178-e183.
51. Diversi M, Finley S. Poverty pimps in the academy: A dialogue about subjectivity, reflexivity, and power in decolonizing production of knowledge. Cult Stud Crit Methodol. 2010;10:14-17.
52. Dharamsi S, Richards M, Louie D, et al. Enhancing medical students' conceptions of the CanMEDS Health Advocate Role through international service-learning and critical reflection: A phenomenological study. Med Teach. 2010;32:977-982.
53. Boelen C, Woollard R. Social accountability: The extra leap to excellence for educational institutions. Med Teach. 2011;33:614-619.
54. Woollard RF. Caring for a common future: Medical schools' social accountability. Med Educ. 2006;40:301-313.
55. Huddle TS. Perspective: Medical professionalism and medical education should not involve commitments to political advocacy. Acad Med. 2011;86:378-383.
56. Wear D, Kuczewski MG. Perspective: Medical students' perceptions of the poor: What impact can medical education have? Acad Med. 2008;83:639-645.
57. Essa-Hadad J, Murdoch-Eaton D, Rudolf MC. What impact does community service learning have on medical students' appreciation of population health? Public Health. 2015;129:1444-1451.
58. Hubinette M, Dobson S, Regehr G. Not just "for" but "with": Health advocacy as a partnership process. Med Educ. 2015;49:796-804.
59. Loutfy M, Tyndall M, Baril JG, Montaner JS, Kaul R, Hankins C. Canadian consensus statement on HIV and its transmission in the context of criminal law. Can J Infect Dis Med Microbiol. 2014;25:135-140.
60. Kuper A. When I say... equity. Med Educ. 2016;50:283-284.
61. Chokshi DA. Teaching about health disparities using a social determinants framework. J Gen Intern Med. 2010;25(suppl 2):S182-S185.
62. Cené CW, Peek ME, Jacobs E, Horowitz CR. Community-based teaching about health disparities: Combining education, scholarship, and community service. J Gen Intern Med. 2010;25(suppl 2): S130-S135.
63. Kumagai AK, Lypson ML. Beyond cultural competence: Critical consciousness, social justice, and multicultural education. Acad Med. 2009;84:782-787.
64. Wear D, Zarconi J, Aultman JM, Chyatte MR, Kumagai AK. Remembering Freddie Gray: Medical education for social justice. Acad Med. 2017;92:312-317.
65. Bourgois P, Holmes SM, Sue K, Quesada J. Structural vulnerability: Operationalizing the concept to address health disparities in clinical care. Acad Med. 2017;92: 299-307.
66. Boler M. Feeling Power: Emotions and Education. New York, NY: Psychology Press; 1999.
67. Wear D, Kumagai AK, Varley J, Zarconi J. Cultural competency 2.0: Exploring the concept of "difference" in engagement with the other. Acad Med. 2012;87:752-758.
68. Wear D. Insurgent multiculturalism: Rethinking how and why we teach culture in medical education. Acad Med. 2003;78: 549-554.
69. Martin D, Whitehead C. Physician, healthy system: The challenge of training doctor- citizens. Med Teach. 2013;35:416-417.