Thinking outside the box: Addressing Social Determinants of Health in Pediatric Medicine

Background: Pediatric residency training programs do not specifically address the social determinants of health. Pediatricians are serving a population that cannot speak for themselves, by default they have stepped into the roles of health advocate, educator, collaborator and communicator. To fulfill these roles pediatricians must be aware of the social determinants of health that affect their patients and how to intervene on their behalf.

Methods: A comprehensive review of relevant literature on the social determinants of health, competencies, learning approaches and the existence of such curricula in pediatric resident training programs were conducted. Critical evaluation of two well-known pediatric training curriculum and 4 informative interviews with experts in the fields of public health and pediatrics also took place.

Results: Review of the literature found the need for more comprehensive social determinants of health curricula in pediatric resident training programs. This comprehensive Social Determinants of Health Curriculum Framework consists of an Introduction – social determinants of health (what, why, how), Competencies – pediatrician as advocate, educator, collaborator and communicator, Concepts and Principles – social justice, equity, humility, sustainability, and respect, and Teaching Methods and Evaluation – case based learning sessions, service learning, small study groups, individual readings, video screenings, simulations, lectures, eLearning modules and self-reflection.

Conclusions: The project resulted in a new curriculum for teaching pediatric residents about social determinants of health.