Social determinants of health in emergency care: An analysis of student reflections on service-learning projects

Abstract

Prehospital emergency medical care systems have traditionally focused on 'stopping the bleeding' and other forms of acute medical intervention. However, in 1996, the US National Highway Traffic Safety Administration recognised the role of emergency medical service (EMS) personnel in health promotion and injury prevention: 'Emergency medical services (EMSs) of the future will be community-based health management that is fully integrated with the overall health care system. It will have the ability to identify and modify illness and injury risks, provide acute illness and injury care and follow-up, and contribute to treatment of chronic conditions and community health monitoring. ' [1] Approaches to integrating emergency care and primary healthcare have subsequently been explored internationally. [2,3] In 2015, the Professional Board for Emergency Care, Health Professions Council of South Africa (HPCSA), adopted a position statement on social determinants of health. [4] This statement committed the Professional Board to review the EMS scope of practice and protocols to be explicitly inclusive of health promotion and preventive care. [4] The position statement also called on all providers of EMS education to educate students and practitioners on the importance of social determinants on health outcomes, and their role in identifying and responding to social determinants of health. This call is consistent with the 2008 report of the World Health Organization (WHO) Commission on Social Determinants of Health, which called on ministries of health and education, in collaboration with institutions offering health education, to make social determinants of health a standard and compulsory part of the curriculum of medical and health practitioners. [5] Social determinants of health are conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of wealth, power and resources at global, national and local levels. [5] However, little practical guidance is provided in these documents as to the most effective pedagogical methods by which to introduce social determinants of health into the emergency medical care curriculum. It is therefore imperative that EMS educators explore and share knowledge on experience of contextually relevant learning activities that serve to achieve this purpose. Service learning is one such activity that has been used in education of medical and other health science students. It combines the academic curriculum with service to a community in such a way that both Background. The inadequacy of training with regard to the social determinants of health in medical education has led to calls for a greater public health focus in medical and health education. This call is no less applicable to the education of emergency care students and other emergency care personnel than to any other category of healthcare practitioner. Emergency care personnel work within communities and are therefore uniquely positioned to identify social causes of poor health and to pl...

A Systematic Review of the Outcomes, Level, Facilitators, and Barriers to Deep Self-Reflection in Public Health Higher Education: Meta-Analysis and Meta-Synthesis

“…After reading the remaining 68 articles, 14 were not relevant to selfreflection, 11 did not include evaluation results, five did not meet the target population criteria, and we were unable to isolate the results of undergraduate from the graduate population in four studies. The remaining 34 studies were included in our systematic review (Schaffer et al, 2005;Champagne, 2006;Brondani, 2010;Carroll and Mccarthy, 2010;Shepherd, 2010;Lee et al, 2011;Solomon and Risdon, 2011;Leipert and Anderson, 2012;Fortugno et al, 2013;Sendall and Domocol, 2013;Koh et al, 2014;Lencucha, 2014;Oakes and Sheehan, 2014;Stefaniak and Lucia, 2014;Hoffman and Silverberg, 2015;Karlsen et al, 2015;Krumwiede et al, 2015;McKay and Dunn, 2015;Babenko-Mould et al, 2016;Olson and Burns, 2016;Dundas et al, 2017;Padykula, 2017;Rooks and Holliman, 2018;Adams, 2019;Burnett and Akerson, 2019;Harver et al, 2019;Janssen Breen et al, 2019;Njoku and Ferris State University, 2019;Andina-Díaz, 2020;Chang and Chen, 2020;Harrison et al, 2020;Sambell et al, 2020;Suwanbamrung and Kaewsawat, 2020;Haffejee, 2021). Of the 34 studies, 29 reported qualitative evaluation results, and five reported mixed methods evaluation results.…”

A Scoping Review of Experiential Learning in Public Health Education From the Perspective of Students, Faculty, and Community Partners

“…Campbell & Sasnett, 2011 Chastonay et al, 2012Dos Santos, 2019Dundas et al, 2017Essa-Hadad et al, 2015Harrison et al, 2020Hoffman & Silverberg, 2015Hoffman et al, 2020Housman et al, 2012Karlsen et al, 2015Knight et al, 2016Kristina et al, 2006Krumwiede et al, 2015León-Montoya et al, 2018Mackenzie et al, 2019Mason & Dunens, 2019Nelson-Hurwitz & Buchthal, 2019Rusnak et al, 2019Shaw et al, 2020Spinello & Fischbach, 2008Zandee et al, 2010 …”