A key to more effective strategies for improving health and healthcare, in particular for underserved individuals and communities, lies in educating current and future health professionals about the social determinants of health. The Institute of Medicine of the National Academies of Sciences, Engineering and Medicine recently convened a global committee of experts, led by Sandra D. Lane, professor of public health in , to develop a high-level framework for such health professional education.
Sandra Lane
The resulting report, “A Framework for Educating Health Professionals to Address the Social Determinants of Health,” proposes a conceptual model to help organizations, educators and communities collaborate to address health inequalities.
“The innovative learning strategies encompass experiential, community-oriented, problem-based and other types of transformative learning to identify the social determinants that lead to health disparities. Such learning should take place in basic health professional education and in the continuing education of health workers,” says Lane. This report defines health professionals broadly, including public health, nutrition, social work, communication specialists and clinicians.
The World Health Organization defines the social determinants of health as “the conditions in which people are born, grow, work, live and age, and the wider set of forces and systems shaping the conditions of daily life.” These forces and systems include economic policies, development agendas, cultural and social norms, social policies and political systems. Social determinants of health promote or lower health and include factors such as access to education and employment, exposure to violence or toxins and access to food.
The committee’s review supports the need for a holistic, consistent and coherent framework that can align the education, health and other sectors, in partnership with communities, to educate health professionals in the social determinants of health. Educating health professionals about the social determinants of health generates awareness among those professionals about the potential root causes of ill health and the importance of addressing them in and with communities, contributing to more effective strategies for improving health and health care for underserved individuals, communities and populations.
According to the recently published report, the terms “health inequities,” “health disparities” and “health inequalities” are all used to reflect stark differences in health and health outcomes among and between populations. A consistent message embedded in each of these terms’ definitions is that without addressing the underlying causes of disease and ill health, the risk of perpetuating a cycle of inequity, disparity and inequality will remain for generations to come.
“The goal of this transformative education is to help students and professionals to gain the understanding and skills to take action, in partnership with community members and other organizations,” says Lane, who has several examples of this action. She has developed a model that links the community-participatory analysis of public policy with pedagogy, called CARE (Community Action Research and Education). Her CARE projects include food deserts in Syracuse, lead poisoning in rental properties, health of the uninsured and her current project on neighborhood trauma and gun violence.
Lane, a Laura J. and L. Douglas Meredith Professor of Teaching Excellence and research professor in the Department of Obstetrics and Gynecology at Upstate Medical University, researches the impact of racial, ethnic and gender disadvantage on maternal, child and family health in urban areas of the United States and the Middle East. She has published 40 peer reviewed journal articles; 19 book chapters; a 2008 book, “Why Are Our Babies Dying? Pregnancy, Birth and Death in America”; and a policy monograph, “The Public Health Impact of Needle Exchange Programs in the United States and Abroad.”
