Swimming ‘upstream’ to tackle the social determinants of health

Kiran, Tara; Pinto, Andrew D.

doi:10.1136/bmjqs-2015-005008

Cited by 22 publications

(21 citation statements)

References 24 publications

(18 reference statements)

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“…Our purpose is providing frameworks addressing the "causes of the causes," or the underlying social factors leading to biomedical disturbance, of patients' health issues, 3 as if to sail "upstream" through a cautionary zone near the crest of a waterfall. 1,4 We have focused on and expanded the concept of social vital signs (SVS) so that primary care providers have more insight about SDH and higher sensitivity of their patients' social problems. The term "SVS" was introduced in 2014 as an indicator of social characteristics which is easily measurable and broadly applicable.…”

Section: Social Vital Signs For Improving Awareness About Social Detementioning

confidence: 99%

Social vital signs for improving awareness about social determinants of health

Mizumoto

Terui²,

Komatsu

et al. 2019

J of Gen and Family Med

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Section: Social Vital Signs For Improving Awareness About Social Detementioning

confidence: 99%

Social vital signs for improving awareness about social determinants of health

Mizumoto

Terui²,

Komatsu

et al. 2019

J of Gen and Family Med

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“…3 Acquiring the knowledge and skills to advocate and influence policy might prepare students to act on healthcare inequities in an informed manner, rather than simply to know them. 4,5 Prior studies have described curricular interventions designed to teach advocacy skills such as editorial writing 6 and writing letters to the editor. 7 However, researchers did not examine the content or the quality of the written pieces.…”

Section: Introductionmentioning

confidence: 99%

Missing the target? Teaching undergraduate medical students to “go upstream” and advocate on social determinants of health

et al. 2019

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We describe a pilot project aimed at teaching advocacy skills to pre-clinical medical students, using the lens of the social determinants of health. During the pilot, students were tasked with performing a mock deputation to a policymaker and writing an opinion editorial piece for a lay audience. Students excelled in identifying the relevant social and structural factors impacting health, yet demonstrated uncertainty about how to identify, approach and best influence stakeholders around policy change. To be effective health advocates, medical trainees require training in specific advocacy skills such as oral and written communication, however this alone may be insufficient. As future advocates, medical trainees must also acquire a specific skill set to navigate the complex political systems in which they will practice.

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“…7 Primary care providers follow patients longitudinally are community based and often have knowledge of the broader familial and social contexts that shape health and disease. 8 One of the most important SDOH is income security: a person's actual, perceived and expected income. 9 10 Income influences the presence and severity of most health conditions.…”

Section: Introductionmentioning

confidence: 99%

“…People living in poverty may have difficulty paying rent, 11 affording nutritious food, [12][13][14][15] affording transportation and engaging with others socially. [6][7][8][9] Many studies have shown that economically marginalised people tend to live shorter lives, experience a greater burden of disease and disability and rate their health Implementation and impact of an online tool used in primary care to improve access to financial benefits for patients: a study protocol Open Access status as worse than the wealthy. [16][17][18][19][20][21] One aspect of income security is access to financial benefits.…”

Section: Introductionmentioning

confidence: 99%

Implementation and impact of an online tool used in primary care to improve access to financial benefits for patients: a study protocol

Aery

Singer²,

Halas³

et al. 2017

BMJ Open

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ObjectivesAddressing the social determinants of health has been identified as crucial to reducing health inequities. However, few evidence-based interventions exist. This study emerges from an ongoing collaboration between physicians, researchers and a financial literacy organisation. Our study will answer the following: Is an online tool that improves access to financial benefits feasible and acceptable? Can such a tool be integrated into clinical workflow? What are patient perspectives on the tool and what is the short-term impact on access to benefits?MethodsAn advisory group made up of patients living on low incomes and representatives from community agencies supports this study. We will recruit three primary care sites in Toronto, Ontario and three in Winnipeg, Manitoba that serve low-income communities. We will introduce clinicians to screening for poverty and how benefits can increase income. Health providers will be encouraged to use the tool with any patient seen. The health provider and patient will complete the online tool together, generating a tailored list of benefits and resources to assist with obtaining these benefits. A brief survey on this experience will be administered to patients after they complete the tool, as well as a request to contact them in 1 month. Those who agree to be contacted will be interviewed on whether the intervention improved access to financial benefits. We will also administer an online survey to providers and conduct focus groups at each site.Ethics and disseminationKey ethical concerns include that patients may feel discomfort when being asked about their financial situation, may feel obliged to complete the tool and may have their expectations falsely raised about receiving benefits. Providers will be trained to address each of these concerns. We will share our findings with providers and policy-makers interested in addressing the social determinants of health within healthcare settings.Trial registration numberClinicaltrials.gov: NCT02959866. Registered 7 November 2016. Retrospectively registered. Pre-results.

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Swimming ‘upstream’ to tackle the social determinants of health

Cited by 22 publications

References 24 publications

Social vital signs for improving awareness about social determinants of health

Social vital signs for improving awareness about social determinants of health

Missing the target? Teaching undergraduate medical students to “go upstream” and advocate on social determinants of health

Implementation and impact of an online tool used in primary care to improve access to financial benefits for patients: a study protocol

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