Integrating the social determinants of health framework in the medical school curricula

BACKGROUND: Research has shown that the social determinants of health (SDH) or the “conditions in which people are born, grow, live, work and age” affect health more than previously realized. The Association of American Medical Colleges and the Royal College of Physicians have advocated for more holistic curricula in medical schools to enable future physicians to recognize and address SDH-related risk factors, particularly in chronic disease prevention. OBJECTIVE: Since landmark SDH studies have been conducted in the United Kingdom (UK), this study determined how UK medical students: (1) Perceive the impact of SDH on disease prevention; (2) View the importance of integrating the SDH concept in medical school curricula; (3) Value their role as future physicians in addressing SDH. METHODS: A 37-item online survey was given to medical students from five medical universities. Respondents were recruited through email, handouts, and student organizations. Quantitative and qualitative analyses were performed. RESULTS: The majority of medical students perceived that SDH played a larger role in disease causation than genetic and biological factors. They feel the addition of SDH in medical school curricula is essential to their education. However, there was lack of consensus on how to specifically address SDH in future practice and who has the main responsibility for population health. CONCLUSIONS: Education and training in both biological and behavioral sciences are essential if future physicians are to effectively address the increasing prevalence of lifestyle-based chronic diseases. Physicians should be equipped with competencies and given incentives to incorporate SDH in their medical practice.