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Using a structural competency framework to teach structural racism in pre-health education

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  • Metzl, Jonathan M.
  • Petty, JuLeigh
  • Olowojoba, Oluwatunmise V.

Abstract

The inclusion of structural competency training in pre-health undergraduate programs may offer significant benefits to future healthcare professionals. This paper presents the results of a comparative study of an interdisciplinary pre-health curriculum based in structural competency with a traditional premedical curriculum. The authors describe the interdisciplinary pre-health curriculum, titled Medicine, Health, and Society (MHS) at Vanderbilt University. The authors then use a new survey tool, the Structural Foundations of Health Survey, to evaluate structural skills and sensibilities. The analysis compares MHS majors (n = 185) with premed science majors (n = 63) and first-semester freshmen (n = 91), with particular attention to understanding how structural factors shape health. Research was conducted from August 2015 to December 2016. Results suggest that MHS majors identified and analyzed relationships between structural factors and health outcomes at higher rates and in deeper ways than did premed science majors and freshmen, and also demonstrated higher understanding of structural and implicit racism and health disparities. The skills that MHS students exhibited represent proficiencies increasingly stressed by the MCAT, the AAMC, and other educational bodies that emphasize how contextual factors shape expressions of health and illness.

Suggested Citation

  • Metzl, Jonathan M. & Petty, JuLeigh & Olowojoba, Oluwatunmise V., 2018. "Using a structural competency framework to teach structural racism in pre-health education," Social Science & Medicine, Elsevier, vol. 199(C), pages 189-201.
    • Handle: RePEc:eee:socmed:v:199:y:2018:i:c:p:189-201
    DOI: 10.1016/j.socscimed.2017.06.029
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    References listed on IDEAS

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    1. Metzl, Jonathan M. & Hansen, Helena, 2014. "Structural competency: Theorizing a new medical engagement with stigma and inequality," Social Science & Medicine, Elsevier, vol. 103(C), pages 126-133.
    2. Jones, C.P., 2000. "Levels of racism: A theoretic framework and a gardener's tale," American Journal of Public Health, American Public Health Association, vol. 90(8), pages 1212-1215.
    3. Tajer, D., 2003. "Latin American Social Medicine: Roots, Development during the 1990s, and Current Challenges," American Journal of Public Health, American Public Health Association, vol. 93(12), pages 2023-2027.
    4. Cooper, L.A. & Roter, D.L. & Carson, K.A. & Beach, M.C. & Sabin, J.A. & Greenwald, A.G. & Inui, T.S., 2012. "The associations of clinicians' implicit attitudes about race with medical visit communication and patient ratings of interpersonal care," American Journal of Public Health, American Public Health Association, vol. 102(5), pages 979-987.
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    Cited by:

    1. Khosla, Natalia N. & Perry, Sylvia P. & Moss-Racusin, Corinne A. & Burke, Sara E. & Dovidio, John F., 2018. "A comparison of clinicians' racial biases in the United States and France," Social Science & Medicine, Elsevier, vol. 206(C), pages 31-37.
    2. Willging, Cathleen & Gunderson, Lara & Shattuck, Daniel & Sturm, Robert & Lawyer, Adrien & Crandall, Cameron, 2019. "Structural competency in emergency medicine services for transgender and gender non-conforming patients," Social Science & Medicine, Elsevier, vol. 222(C), pages 67-75.

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