Community-based Teaching about Health Disparities: Combining Education, Scholarship, and Community Service

Abstract

The Institute of Medicine recommends that clinicians receive training to better understand and address disparities. While disparities in health status are primarily due to inequities in social determinants of health, current curricula largely focus on how to teach about disparities within the health care setting. Learners may more fully understand and appreciate how social contextual factors contribute to disparities through instruction about disparities in community settings. Community-based teaching about health disparities may be advantageous for learners, medical institutions, and participating communities. This manuscript aims to guide medical educators in teaching students and residents about health disparities through community-based activities, including service learning and research.KEY WORDS: disparities education; community-based education; public health approach.

A Community-Engaged Cardiovascular Health Disparities Research Training Curriculum

“…The program described by Cene and colleagues, like the one at Johns Hopkins University, includes community-based experiential activities and service learning as part of a health disparities curriculum; however, unlike our program, it does not focus on research skills. 11 Estape and colleagues have described a multicultural, multi-institutional, and multidisciplinary course to teach translational research in health disparities to individuals enrolled in post-doctoral Masters of Science in Clinical Research Programs at 5 minority institutions. 12 This Puerto Rico-based program is focused on reducing health disparities in Hispanic populations.…”

Are We Missing the Mark? The Implementation of Community Based Participatory Education in Cancer Disparities Curriculum Development

“…Gaps in health-care access when comparing black and white populations continue to widen [3], and the disparities in cancer care have become more prominent [4]. While many of the causes and consequences of health and health-care disparities are well known, this knowledge has not translated into significant reductions in disparities in health [5]. …”

“…Medical institutions and professional organizations have had increasing interest in reducing disparities through curricular innovation [5]. In 2007, the Society of General Internal Medicine (SGIM) outlined curricular guidelines for institutions and organizations interested in disparities curricular design [6].…”

“…Yet those most impacted by disparities, the minority and underserved communities, have had little input into curriculum development. To date, only a limited number of studies describe community participation in the curriculum development process [5, 12, 21, 24, 26, 27]. Although important, the existing studies do not detail the involvement or curricular contribution of community members and are therefore difficult to reproduce.…”

“…Although important, the existing studies do not detail the involvement or curricular contribution of community members and are therefore difficult to reproduce. Furthermore, these studies have utilized a number of proxies for the community including (1) community business leaders, who may have minimal personal experience with disparities [26]; (2) patients, who may have personal experience with disparities but are able to access the health-care system [24]; and (3) community councils, which funnel the community voice through one or two people [5, 12]. Consequently, we cannot be certain that the curriculum we develop to address healthcare disparities in academia truly speaks to the issues most pertaining to the community.…”