Minimizing the Effects of Social Determinants of Health by Incorporating Structural Competency

By: Ximena Leon

COVID-19 has brought light to the inequalities and inequities caused by discriminatory systems in the U.S. Moreover, COVID-19 has highlighted the vulnerable populations through each of the stages of the virus including information dissemination, viral transmission, quarantine, and reopening. Marginalized and minoritized communities have increased health risks due to differences in race, ethnicity, social class, zip codes, and education levels. These differences among individuals and communities are known as social determinants of health. Although clinical systems have made an effort to target the individual patient and remove biases, the social determinants of health that affect communities in the U.S. have made little to no improvement.

The health risks that an individual will encounter in their lifetime is greatly impacted by the social determinants of health. Minority groups are at a higher risk of developing cardiovascular disease (CVD) than non-minority groups. Marginalized communities do not have the resources like accessible hospitals, financial security, and safe neighborhoods that they need in order to live a healthier lifestyle. These resource-poor communities can lead to an individual having chronic stress and developing CVD. Building an environment that puts each patient on an equal playing field, will minimize the CVD risks caused by social determinants of health.

Structural competency can be the gateway for studies to find novel ways to target inequalities and inequities and improve the health of marginalized communities. Structural competency is a newly proposed idea that educates health professionals on social determinants of health and how to target those inequalities and inequities within clinical interventions. By minimizing the marginalization of patients and using cross-cultural evaluations, health professionals are acting on the systemic causes. The goal is for health professionals to treat and educate patients to improve the overall health of the population by paying attention to the underlying forces associated with the health outcomes of the marginalized communities at levels beyond just the individual. By introducing structural competency, future health professionals, researchers, and science communicators can target the social determinants of health and pave the way for equality and equity.

Our goal in our video is to remove the stigmas surrounding mental health and cardiovascular disease by understanding the various perspectives found within marginalized communities and educating the audience on the inequalities and inequities caused by the social determinants of health. Though we are not directly targeting health professionals, we hope to educate the audience on the existing systemic inequalities. Our video will educate a non-scientific audience, particularly those who suffer from mental health issues, on how marginalized communities are at higher risk for both mental health problems and development of CVD. Directly targeting the general population can help to diminish the stigmas and lead to a change in their active participation in minimizing their own risks.

Metrics are important in evaluating whether the media projects have made an impact on the audience. It is important that we communicate our research in a way that is easily understood by the audience and causes a behavioral change. By using pre- and post-surveys, we can gauge if the audience was able to learn about the social determinants of health and structural competency.

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