Identifying and Addressing Social Determinants of Health in the Primary Care Clinical Training Environment: A Survey of the Landscape

Parzuchowski, A; Wright, Katherine; Lipiszko, Dawid; Cooper, Andrew; Persell, Stephen D.; Ravenna, Paul; Ngongo, Wivine; O’Brien, Matthew J.; Goel, Mita Sanghavi

doi:10.1353/hpu.2020.0155

Cited by 2 publications

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“…The NASEM 5As framework on integrating social care into health care delivery offers a useful schema for organizing and advancing undergraduate medical education on SDOH. 6 Future curricular redesign efforts will benefit from a focus on multimodal or experiential learning efforts over strict didactic learning, 1,5 thoughtful engagement of faculty and community experts, 4,49 and critical evaluation of impacts on both learners and patients. 50…”

Section: Discussionmentioning

confidence: 99%

Awareness, Adjustment, Assistance, Alignment, and Advocacy: Operationalizing Social Determinants of Health Topics in Undergraduate Medical Education Curricula

2023

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Social and economic factors, such as those related to food, housing, and transportation, are major drivers of health and health inequities. Multiple national professional organizations have articulated roles for physicians in identifying and addressing social determinants of health (SDOH) and the need to include SDOH in all stages of physician education. Despite encouragement from these professional organizations, medical schools still do not routinely offer SDOH education alongside basic and clinical sciences curricula. A recent national expert consensus process identified priority SDOH knowledge domains and professional skills for medical students but lacked an organizing schema and specific pedagogical examples to help translate prioritized skills into routine pedagogical practice. One such schema is the 5As framework developed by the National Academies of Sciences, Engineering, and Medicine, which elaborates on 5 strategies to strengthen social care: awareness, adjustment, assistance, alignment, and advocacy. In this article, the authors highlight and provide examples of how mapping SDOH skills to the 5As framework can help educators meaningfully operationalize SDOH topics into specific curricular activities during the preclinical and clinical stages of undergraduate medical education. As a foundational first step in this direction, medical schools should conduct an internal curricular review of social care content (ideally mapped to the 5As framework) and identify opportunities to integrate these topics into existing courses when relevant (e.g., in social medicine, population health, and health systems science courses). Given that health and social care integration is highly context dependent, each medical school will likely need to tailor curricular changes based on their own institutional needs, mission, patient populations, and ties to the community. To increase interinstitutional alignment, medical schools might consider using or adapting peer-reviewed materials and assessments curated and centralized by the National Collaborative for Education to Address the Social Determinants of Health.

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Section: Discussionmentioning

confidence: 99%

Awareness, Adjustment, Assistance, Alignment, and Advocacy: Operationalizing Social Determinants of Health Topics in Undergraduate Medical Education Curricula

2023

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“…The education pipeline plays an important role in determining the future workforce—who enters the workforce, which professions are produced, and whether graduates choose high-need specialties, practice in underserved populations, and have the skills and courage to advance health equity. Yet again, evidence demonstrates significant variation across training programs in their social mission outcomes14,15 and their engagement in social mission activities, such as interprofessional education, training in social determinants of health, and addressing racial equity and inclusion in their institutions 16–20…”

Section: A Health Workforce Equity Frameworkmentioning

confidence: 99%

“…Yet again, evidence demonstrates significant variation across training programs in their social mission outcomes 14,15 and their engagement in social mission activities, such as interprofessional education, training in social determinants of health, and addressing racial equity and inclusion in their institutions. [16][17][18][19][20]…”

Section: Social Mission Of Health Professions' Educationmentioning

confidence: 99%

Health Workforce for Health Equity

et al. 2021

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T he health workforce is a critical component of any health care system. There is no health care without the people who provide service. As such, the health workforce has a central role in addressing (or maintaining) health disparities.Health disparities are significant and have worsened over the last 20 years in the United States. 1 A growing body of evidence has exposed the role of health care systems in contributing to these disparities. Based on race/ethnicity, sex, sexual identity, socioeconomic status, and geography, communities face disproportionately higher disparities in access, diagnosis, and treatment, ultimately resulting in adverse health outcomes. With coronavirus disease 2019 (COVID-19), it became clear that the inequities are experienced by health workers and those at high risk and who need care. Early challenges with limited personal protective equipment (PPE) increased risks for all health workers but also highlighted the disproportionate risk and lack of PPE for different workers, such as home health care workers who often work at or below minimum wage. 2 Evidence suggests Black and other minority health workers have been at higher risk of COVID-19 infection. 3 At least 6 critically important factors determine whether and what kind of care our society's most disadvantaged sectors receive. These include: who enters the workforce (its composition); how they are educated and trained; how they are distributed geographically and by specialty; which patients and communities are served; how their practice is oriented; and, lastly, the working conditions of the entire health workforce-including home health care workers, support staff, allied health professionals, public health, physicians, nurses, and many others.

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Identifying and Addressing Social Determinants of Health in the Primary Care Clinical Training Environment: A Survey of the Landscape

Cited by 2 publications

References 0 publications

Awareness, Adjustment, Assistance, Alignment, and Advocacy: Operationalizing Social Determinants of Health Topics in Undergraduate Medical Education Curricula

Awareness, Adjustment, Assistance, Alignment, and Advocacy: Operationalizing Social Determinants of Health Topics in Undergraduate Medical Education Curricula

Health Workforce for Health Equity

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