By: Vivian Iloabuchi
Simply put, structural competency in healthcare aims to educate healthcare professionals on how various social determinants of health can affect health outcomes. It creates room for both the analysis of elements that influence health disparities and the implementation of healthcare mediation to curb those disparities. Structural competency intends to discover ways to help patients without blaming them for the health conditions they may suffer. Health professionals must be able to point out and examine the relationship between structures- such as racism, health policy, and stigma- and adverse health outcomes.
The ultimate goal of a structural competent healthcare system is to curb health disparities. To do this all healthcare providers must be well-informed on the roles that socioeconomic factors, health policies, and access play in an individual’s health. For a structurally competent system to emerge, there must be a change in infrastructure, sustainable methods of communication (for disproportionately affected communities), and knowledgeable healthcare professionals.
When it comes to cardiovascular health, the need for structural competency cannot be overemphasized. It is no news that groundbreaking discoveries and great progress have been made in scientific research for the past few decades. However, some groups such as minority populations in the US are still disproportionately affected. In 2017, African Americans were 20% more likely to die from heart disease than non-Hispanic Whites. African American women are 60% more likely to have high blood pressure as compared to non-Hispanic white women. The Black population of the United States has a risk of first-ever stroke that is almost two times that of their white counterparts. By training researchers and healthcare professionals to look out for and advocate against structures that continue to exacerbate these disparities, we can bridge the gap that currently exists in cardiovascular health outcomes.
While the media project my team and I are working on is not directed to healthcare professionals, it still addresses structural competency to an extent. This is because it presents the audience with what the current statistics are. The goal of the project is to educate the general populace on the relationship between the food we consume and heart health. This project democratizes information by breaking down the usual scientific jargon that makes it difficult for anyone who is not a scientist to understand the information.
I think the best way to ensure that the goal is achieved is by asking people who watch the media project to give feedback on it. We intend to create surveys (before and after watching the video) which will test if the audience can identify a heart-healthy combination of food items. We will also ask questions that help us understand how clear the information presented was.
Metzl JM, Maybank A, De Maio F. Responding to the COVID-19 Pandemic: The Need for a Structurally Competent Health Care System. JAMA. Published online June 04, 2020. doi:10.1001/jama.2020.9289
APA Metzl, Jonathan M. MD, PhD; Petty, JuLeigh PhD Integrating and Assessing Structural Competency in an Innovative Prehealth Curriculum at Vanderbilt University, Academic Medicine: March 2017 – Volume 92 – Issue 3 – p 354-359 doi: 10.1097/ACM.0000000000001477
AMA J Ethics. 2018;20(3):211-223. doi: 10.1001/journalofethics.2018.20.3.peer1-1803.