Communities, Social Justice, and Academic Health Centers

Abstract

In November 2015, the Association of American Medical Colleges (AAMC) held its annual meeting in Baltimore, Maryland. In response both to health and health care inequities faced by residents of Baltimore and to the imminent trial of the police officers charged with Freddie Gray's death, AAMC leaders thought it crucial to address issues of health inequity, social injustice, and the role an academic health center (AHC) can play in improving the health of the community it serves. In collaboration with community-engaged researchers from Johns Hopkins University and University of Maryland, Baltimore, AAMC staff interviewed Baltimore residents, soliciting their perspectives on how medical education, clinical care, and research can and should respond to social injustice and the social determinants of health. The authors used the resulting videoed interviews to frame a conversation during the annual meeting aimed at developing concrete actions that an individual, an institution, or the AAMC can take to address social injustice and health inequities in the Baltimore community and beyond. The robust conversation and the action steps identified by participants led to the development of a toolkit to build the capacity of AHCs and their communities to engage in similar, action-oriented programming. The success of the conversation inspired future meeting sessions that purposefully incorporate community voices and expertise. This Perspective presents results of this action planning and places the proposed set of activities within the current health care context to demonstrate how community expertise and wisdom can inform and advance efforts to improve the health of all.

The color of health: how racism, segregation, and inequality affect the health and well-being of preterm infants and their families

“…59,89,90 This pivot from "follow-up" to "follow through" is accelerated by patient-level social needs screening, the use of electronic health record (EHR) data in combination with complementary datasets to support population-level pattern recognition, and bolstered clinical-community partnerships driving both patient-and population-level action. [91][92][93][94][95][96] Many such actions elevate the relevance of SDH, which, in many ways, are thought to be "fundamental causes" of disease, factors that place individuals and populations at "risk of [having] risks." 97 The National Academy of Medicine and American Academy of Pediatrics, among others, now recommend routine SDH-related screening.…”

“…With this as the goal, we suggest that health-care systems, including academic health centers, consider their role in population health improvement and social justice. 91,94 Such a re-envisioned mission, one that elevates the importance of community well-being, is likely to require the added, complementary expertise that comes from meaningful community integration. 107,108 Indeed, although health-care systems and providers have expertise in managing medical complexity, they may not always have the expertise necessary to manage social complexity.…”

Cooling The Hot Spots Where Child Hospitalization Rates Are High: A Neighborhood Approach To Population Health

“…Whether driven by mission or margin, health care systems increasingly see themselves as accountable to more than just the people who walk through their doors. [16][17][18][19][20] They recognize that achieving equitable outcomes requires different-often multilevelapproaches, but little has been published about how to do this for, and with, populations.Population health is defined as "the health outcomes of a group of individuals, including the distribution of outcomes within that group." 21(p381) Cincinnati Children's Hospital Medical Center recently committed "to help[ing] ensure Cincinnati's 66,000 children are the healthiest in the nation through strong community partnerships," as part of its strategic plan for 2020.…”

“…Whether driven by mission or margin, health care systems increasingly see themselves as accountable to more than just the people who walk through their doors. [16][17][18][19][20] They recognize that achieving equitable outcomes requires different-often multilevelapproaches, but little has been published about how to do this for, and with, populations.…”

Study of a social justice curriculum for students with special needs in a middle school setting through action research

“…In addition to a social justice curriculum being reciprocal for students and teachers, the knowledge of social justice or injustice could also help community members come together and become reciprocal learners (Alberti, 2018). Having exposure to social justice knowledge as an adult in the community-even if not even explicitly taught-could demonstrate how a community can work together towards common goals when there is an underlying understanding of difference.…”