Teaching the Social Determinants of Health

A Path to Equity or a Road to Nowhere?

Bibliographic Data

ID23372115
AuthorsMalika Sharma (0000-0002-3729-4554, M. Sharmais an infectious diseases physician and Canadian Institutes of Health Research (CIHR) Canadian HIV Trials Network (CTN)/Canadian Foundation for AIDS Research (CANFAR) postdoctoral fellow, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada., corresponding author), Andrew D Pinto (0000-0003-1841-9347, University of Toronto), Arno K Kumagai (0000-0001-7088-0208, A.K. Kumagaiis endocrinologist, professor, and vice chair of education, Department of Medicine, University of Toronto, and F.M. Hill Chair in Humanism Education, Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada.)
Year2018
Volume93
Issue1
Pages25-30
Publication date2018-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAcademic Medicine (JOURNAL)
Journal identifiersISSN: 1040-2446 • E-ISSN: 1938-808X
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1097/acm.0000000000001689
PMID28445214
OpenAlexW2609486760
LanguageEN
Citations received77
References cited61

Medical schools are increasingly called to include social responsibility in their mandates. As such, they are focusing their attention on the social determinants of health (SDOH) as key drivers in the health of the patients and communities they serve. However, underlying this emphasis on the SDOH is the assumption that teaching medical students about the SDOH will lead future physicians to take action to help achieve health equity. There is little evidence to support this belief. In many ways, the current approach to the SDOH within medical education positions them as “facts to be known” rather than as “conditions to be challenged and changed.” Educators talk about poverty but not oppression, race but not racism, sex but not sexism, and homosexuality but not homophobia. The current approach to the SDOH may constrain or even incapacitate the ability of medical education to achieve the very goals it lauds, and in fact perpetuate inequity. In this article, the authors explore how “critical consciousness” and a recentering of the SDOH around justice and inequity can be used to deepen collective understanding of power, privilege, and the inequities embedded in social relationships in order to foster an active commitment to social justice among medical trainees. Rather than calling for minor curricular modifications, the authors argue that major structural and cultural transformations within medical education need to occur to make educational institutions truly socially responsible.

Economic growth · Economics · Equity (law) · Health care · Health equity · Medical education · Path (computing) · Political science · Social determinants of health · Social equality · Sociology · Computer Science · Food Security and Health in Diverse Populations · Global Health Workforce Issues · Medicine · Primary Care and Health Outcomes · Psychology

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