Social Inequity and Pressing Health Needs: Thoughts for Health Educators twenty twenty

Social Inequity and Pressing Health Needs: Thoughts for Health Educators twenty twenty

Executive Summary

CACMS Accreditation Standard seven point five "Societal Problems" specifies the need for medical education to include instruction on the health consequences of common social issues. Centering medical school programming and curriculum on pressing social equity issues enables medical graduates to respond appropriately and directly to related health needs. The CoM Division of Social Accountability supports UGME curriculum in fulfilling this standard by producing this report on a regular basis. The report summarizes current areas of concern for Saskatchewan; the social systems of oppression at the root of these issues; the health conditions they manifest as; and recommendations for training for health care providers along with additional curricular resources. CanMEDS competencies that align with these issues are also presented in the Appendix A.

In our Canadian context, there are a number of social inequalities that lie at the root of disproportionately poorer health outcomes for various communities. There is demonstrated commitment to addressing a number of these inequities from our local and national governments and various health governing bodies. Aligned with these commitments, this twenty twenty report highlights five social inequity issues of particular concern for Saskatchewan:

One) Indigenous health inequities

Two) Poverty

Three) Mental health, suicide risk and substance use

Four) Early childhood development

Five) Climate change

Curricular considerations related to these issues are outlined in the table below and discussed in greater detail in the report.

Background

At the request of the College of Medicine Curriculum Committee, the Division of Social Accountability regularly produces reports to help ensure medical curriculum includes instruction on the health consequences of common social equity issues. More commonly known as the social determinants of health - these issues are the interrelated social, political and economic factors that create the conditions in which people live, work and play and drive inequities in health outcomes. Social determinants play a pivotal role in persistent, and in some cases growing, health inequities. Under the CanMEDS framework, physicians act as health advocates by promoting health equity and contributing their knowledge of the determinants of health to positively influence the health of the patients, communities and populations they serve. Centering medical school programming and curriculum content on pressing social determinant issues enables CoM graduates to respond appropriately and directly to health needs. EQUALITY SOUNDS FAIR EQUITY IS FAIR

The inaugural Pressing Health Needs report was produced in October twenty sixteen and highlighted three issues of particular concern for Saskatchewan: one) Indigenous health inequities among First Nations and Métis peoples, two) poverty, and three) mental health, suicide risk and substance use. Public Health Frerenk Fremste. Tretiet A document review to identify local, regional and national priorities corroborated the focus on these three issues. The twenty seventeen report added two other areas requiring attention: four) early childhood development and five) climate change. A small group of key stakeholders were consulted by the division to validate the information in the twenty seventeen report and identify additional background sources of data and curriculum planning tools. The Social Accountability Committee and the Indigenous Health Committee was engaged to provide feedback on the twenty eighteen report, which was updated with the current status of inequity in the areas, recommendations for training for health care providers and additional resources. After gathering feedback from UGME course chairs, we added an Executive Summary to the twenty twenty report. Further, the overlapping nature of these issues and the impact of the intersectionality of factors on health is outlined.

Intersectionality is an approach that recognizes that health is shaped by overlapping factors that intersect at the individual level to reflect multiple interlocking systems of privilege and oppression at the social-structural level. It goes beyond single factor explanations which sometimes assume that groups are homogenous in their composition and pays attention to the relationships between determinants. Intersectionality considers how different systems of oppression overlap and are compounded. A focus on intersectionality allows us to solve the systemic problems, instead of just replacing one system of oppression with another.