By: Hector Haddock-Martinez
Unfortunately, there are evident inequalities and inequities in the overall health of the US population. Race, education level, social status, and even zip codes continuously dictate the health risks of individuals. These conditions are known as the social determinants of health. Although medical facilities and technology have increased significantly in the past decades, this improvement has done little to change the narrative of the social determinants of health in the US.
Recently, structural competency has been proposed as a solution to some of the disparities that exist due to the social determinants of health. In a nutshell, structural competency refers to teaching health professionals (nurses, physicians, first responders) about the social determinants of health, and how these external conditions can influence the health of an individual. Moreover, the goal of structural competency is to allow health professionals to recognize the underlying networks that can promote improved health for the general population (for example: food supplies, housing security, transportation, etc).
In the context of cardiovascular disease (CVD), structural competency is one of the most powerful resources we may have to reduce the toll of heart disease on the US population. Currently, minorities have a significantly highest risk for developing CVD when compared to Caucasians. An overwhelming amount of evidence has suggested that this disparity in CVD is directly linked to the social determinant of health. By training a generation of health professionals that is fully immersed in structural competency, we can work to build a society in which every group can benefit from having a healthy heart. Specifically, these health professionals can push to incorporate food banks, housing security assistance, and equal health resource access to future hospitals and health care centers, which will help address health disparities and reduce CVD nationwide. Additionally, these trained professionals will have the necessary background to research CVD from the perspective of health disparities and structural competency, which will allow for novel studies that can provide valuable information regarding future steps that must be taken to address inequity and inequality in the US health system.
Although the media project I am currently working on is not targeted towards health professionals, I still believe that it directly addresses structural competency. According to a recent JAMA article, one of the four domains of intervention that emerges from structural competency analysis is the democratization of information. The goal of my media project is to present highly specialized information regarding the link between mental and cardiovascular health to a non-scientific audience, particularly to those who suffer from mental health issues. Normally, the primary sources for this information are filled with scientific jargon that is difficult to understand by the lay person. However, by presenting this information in a much more approachable way, I am helping to democratize information to a community that is directly affected by social determinants of health.
Despite having the intention of addressing structural competency through my media project, I am aware that we must incorporate metrics that actually allow us to determine whether or not this issue was truly addressed. In the case of the “democratize education” domain of structural competency, I believe that a valuable metric could be to apply a Flesh-Kincaid score to the script of our media projects. The goal of this score is to determine the grade level needed to understand what is being said in the script. Since our goal is to “democratize information”, we could establish a maximum grade level of 6th grade for our scripts. This would ensure that are message is understandable to the majority of the general population. Moreover, there is automated software that can determine the grade level of text. This metric also ties in with the goal of assuring proper science communication to the masses.
Note: democratizing information also involves making sure that the information reaches the population most affected by the social determinants of health. Thus, other measures (such as social media analytics, hashtag engagements, or surveys) must be used in order to determine the reach of our media projects.