Nipping it in the Bud: Looking to the Roots of Health Disparities in Structural Systems

By: Grace Garrett

The human race is 99.9% identical on a molecular, genetic level. The cause of an illness in an individual person may be molecularly based, but it doesn’t explain differences in burden of illness and injury for entire groups of people. The social determinants of health are social, environmental, and interpersonal factors that influence a person’s ability to engage in healthy behaviors and risk for injury or illness. These factors include the neighborhood conditions, availability of a social support network, and socioeconomic status. Invisible institutions in society contribute to the creation of the social determinants of health such as public policy which can change environmental conditions, healthcare delivery systems like insurance, and redlining. Structural competency is the application of this knowledge by health care workers to address unique needs for each individual patient by understanding where the social determinants came from. 

            In regards to cardiovascular disease in particular, it has been evidenced that the social determinants of health play a significant role in development of cardiovascular disease. Current directions in research include exploring depth to which specific factors affect development of CVD as well as effective solutions to mitigate risk. Suggestions for health care providers to actively diminish these effects include recording socioeconomic data during healthcare visits and including this data’s relation to co-morbidities in publications, partnering with community organizations to provide social support for patients, and advocating for public policy which address the social determinants of health. 

            To address the social determinants of health in the summer media projects, the purpose of the videos will be to highlight a current topic in cardiovascular research and disease, especially for those most at risk, with the risk often in part due to social determinants affecting them. Data will be presented evidencing the disparities of development of cardiovascular disease among socioeconomic strata and racial differences. The goal of the video is also to present possible mechanisms of changing trajectory the viewer has control over to empower him/her to make a change. 

            For evaluation of the quality of structural competency and science communication, using the viewer’s understanding may be most objective as to whether the video goal was achieved or not. This assessment would simultaneously address the effectiveness of science presented and the viewer’s grasp of social determinants of health. It might be in the form of multiple choice questions asking the viewer to pick which option counts as a social determinant or which of the following is true regarding risk of developing congenital heart defects. Percent of questions answered correctly could serve as an indicator of effectiveness of communication. To incentivize viewers into completing the assessment, a completion could count as an entry for a reward like an Amazon gift card. 

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