Identifying the Position of Social Determinants of Health in Higher Medical Sciences Education System

Document Type : Original Article (s)

Authors

1 Associate Professor, Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The higher medical education system’s mission is to maintain and improve the health in society. Furthermore, the roles of social determinants of health in health situation of society have been emphasized, and require in-depth and expansive studies. Therefore, the current study aimed to identify the position of social determinants of health in higher medical sciences education system.Methods: This study was conducted using qualitative approach with 20 experts in focus group discussion, and 8 experts in semi-structured interviews. The gathered information was reported using qualitative content analysis approach using codes, subcategories, and main categories.Findings: The findings of focus group discussion and semi-structured interviews with experts resulted in 500 codes, 17 subcategories, and 4 main categories of education, policymaking, legislation, and implementation, participation and accountability in public and private sectors, and weakness in areas related to social determinants of health.Conclusion: The findings of this study play a strategic role in medical education system for identification and expansion of social determinants of health. These findings can be used by policymakers, planners, and executives of education system to apply the teachings provided in medical education system, and create a more focused and productive system in the area of social determinants of health.

Keywords


  1. World Health Organization. Social determinants of health [Online]. [cited 2017 Dec 12]; Available from: URL: https://www.who.int/social_determinants/en/
  2. Healthy People. Social Determinants [Online]. [Cited 2020]; Available from: URL: https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Social-Determinants.
  3. Klein M. Addressing the health professional's role in social determinants: New educational approaches. Proceedings of the Meeting of the Advisory Committee on Training in Primary Care Medicine and Dentistry; 2015 Aug; Rockville, MD, USA.
  4. Bachrach D. Addressing Patients' Social Needs: An Emerging Business Case for Provider Investment [online]. [cited 2014 May 29]; Available from: URL: https://www.commonwealthfund.org/publications/fund-reports/2014/may/addressing-patients-social-needs-emerging-business-case-provider
  5. UCL Institute of Health Equity. Working for Health Equity: The Role of Health Professionals [Online]. [cited 2013 Mar]; Available from: URL: https://www.who.int/workforcealliance/knowledge/resources/healthequity/en/
  6. Martinez IL, Artze-Vega I, Wells AL, Mora JC, Gillis M. Twelve tips for teaching social determinants of health in medicine. Med Teach 2015; 37(7): 647-52.
  7. 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(5): 485-94.
  8. To MJ, Sharma M. Training tomorrow's physician-advocates. Med Educ 2015; 49(8): 752-4.
  9. Chokshi DA. Teaching about health disparities using a social determinants framework. J Gen Intern Med 2010; 25 Suppl 2: S182-S185.
  10. World Health Organization. Rio Political Declaration on Social Determinants of Health [Online]. [cited 2011]; Available from: URL: https://www.who.int/sdhconference/declaration/en/
  11. Advisory Committee on Training in Primary Care Medicine and Dentistry. Addressing the Social Determinants of Health: The Role of Health Professions Education. 13th Annual Report to the Secretary of the United States Department of Health and Human Services and the Congress of the United States (December 2016) [Online]. [cited 2016]; Available from: URL: https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/primarycare-dentist/reports/report-2016.pdf
  12. Martinez IL, Artze-Vega I, Wells AL, Mora JC, Gillis M. Twelve tips for teaching social determinants of health in medicine. Med Teach 2015; 37(7): 647-52.
  13. 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(2): 214-20.
  14. Swain GR, Grande KM, Hood CM, Inzeo PT. Health care professionals: Opportunities to address social determinants of health. WMJ 2014; 113(6): 218-22.
  15. Buchanan D, Jain S. Teaching students about health care of the homeless. Acad Med 2001; 76(5): 524-5.
  16. 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(2): 127-30.
  17. Eddey GE, Robey KL. Considering the culture of disability in cultural competence education. Acad Med 2005; 80(7): 706-12.
  18. Collins J. Introduction: Addressing racial and ethnic disparities: Lessons from the REACH 2010 Communities. J Health Care Poor Underserved 2006; 17: 1-5.
  19. Heckler M. Report of the Secretary's Task Force on Black and Minority Health. Washington, DC: U.S.Department of Health and Human; 1985.