Dissemination of a Social Determinants of Health Curriculum for Emergency Medicine Residents

Social determinants of health, defined as “conditions in which people are born, grow, live, work, and age”, are crucial, yet often overlooked aspects of a patient’s wellbeing. Studies show that social determinants of health have a larger impact on a person’s health than the healthcare that physicians provide. By addressing these aspects of health in the Emergency Department, patients will receive improved care, and residents will be empowered to make effective treatment plans. The objective of this study was to increase the knowledge of Emergency Medicine residents regarding the importance of addressing social determinants of health in patient care.

This study was a retrospective interventional study performed at UCSF Fresno. Four lectures covering key topics of social determinants of health – food insecurity, race and racial disparities, sex and gender disparities, and gender identity and sexual orientation – were given via powerpoint to EM residents attending weekly didactic conference. Pre and post-lecture anonymous surveys were given to residents via Qualtrics to evaluate changes in their attitudes, beliefs, and knowledge base. Residents rated statements on a Linkert scale from 1 to 5, 1 being “strongly disagree” and 5 being “strongly agree”.

Analysis of the surveys demonstrated a 17%, 5%, 8%, and 16% increase in the residents’ beliefs that the topics of food insecurity, racial disparities, gender disparities, and gender and sexual orientation, should be considered more often when managing patients in the ED. In addition, residents had increased comfort levels integrating SDH into their treatment plans after the lectures with a 15% increase in the topic of food insecurity and an 8% increase in the topic of gender and sexual orientation.

Survey results showed that this social determinants of health curriculum increased residents’ beliefs in the importance of addressing SDH and their level of comfort in incorporating these concerns into treatment plans. In the future, additional topics could be included in the curriculum to best address the needs and concerns of a hospital’s specific patient population.