COVID-19 and Structural Competency

By: C’Aira Dillard

In the title, three is a term that has been used periodically during these COVID-19 times. According to Dr. Jonathan Metzl, structural competency “calls on methods from sociology, economics, urban planning, and other disciplines to systematically train health care professionals and others to recognize ways that institutions, neighborhood conditions, market forces, public policies, and health care delivery systems shape symptoms” (Responding to the COVID-19 Pandemic: The Need for a Structurally Competent Health Care System).In other words, identify and change ways that certain individuals in certain community’s health is affected based on their social and economic factors. Structural competency applies to cardiovascular health disease and research because cardiovascular disease is the leading cause of death in the United States. For example, if an African American woman presents with high blood pressure the physician most likely will prescribe a medication to regulate the high blood pressure. The physician may conclude that their part is complete and within a couple weeks have a follow-up appointment with that patient to see if the medication is working. The physician did not take into consideration whether the patient has access to a pharmacy to pick up the medication. Do they have medical insurance to cover the cost or are they living paycheck to paycheck? Structural competency has been identified, but now there needs to be changes implemented to address the issue.

In the article, “Responding to the COVID-19 Pandemic: The Need for a Structurally Competent Health Care System” the authors suggest four main areas that first needs to be addressed to combat the broader range of structural competency. These four areas include promoting truth and reconciliation, reimagining infrastructure, democratizing information, and educating. Promoting truth and reconciliation would allow the U.S. health care system to take full account on why they have failed certain people in certain communities. Reimagining infrastructure suggest building more health centers and hospitals that address patients’ social and medical needs. Then, democratizing information would be to have more efficient communication channels. Allow community leaders to inform health strategies and emergency preparedness to the public so they can better understand. Lastly, educate by training health care professionals on health equity, structural competency, and social determinants. Structural competency is a broad topic and my media project group, Hypertension and Pregnancy, plan to address this issue. For instance, each of the four domains that was briefly described in the previous paragraph all relate to our media project. With promoting truth and reconciliation, studies show that African American women are more prone to having hypertension during pregnancy. Physicians should be truthful with their patients from the beginning to allow them to plan accordingly during their pregnancy. My group will discuss reimagining infrastructure by acknowledging the lack of not only health centers but healthy food options and grocery stores in impoverished and low-income neighborhoods. With democratizing information allow community activists, who are professionally educated in health topics, relay certain information to the community in a way they will understand. Lastly, we will address education that applies for everyone. The patient needs to be educated on how to eat a proper diet to maintain their blood pressure during pregnancy. Also, health care professionals need to be educated in knowing that medication and health therapies is not always the answer to combat an illness or disease. Social and economic factors can play a role in a person’s health. Due to the media projects being virtual the most effective way to evaluate the metrics of structural competency and science communication would be through pre and post surveys, quizzes, and analytics, such as number of views and clicks of provided links.

Published by cairadillard

I am a rising sophomore at Johnson & Wales University majoring in Biology Pre-Med.

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