August 12, 2019 04:56 pm Chris Crawford – The AAFP has unveiled its Health Equity Curricular Toolkit, which provides family physicians a structured curricular tool to facilitate discussions about social determinants of health, vulnerable populations, and economics and policy.
Championed by the Health Equity Team of Family Medicine for America's Health and inspired by the Starfield II Health Equity Summit,(www.starfieldsummit.com) the toolkit is intended to be used by clinical and public health learners and primary care faculty who want to further explore this area, which often isn't prioritized in medical school and residency curricula.
The accompanying Guidebook to the Health Equity Curricular Toolkit(57 page PDF) includes a description of the socioecologic framework, the modular design, facilitation strategies, a glossary of definitions and health equity resources, and a worksheet to promote real-time application of an equity lens.
The toolkit comprises 14 modules, including an introductory, prerequisite two-part module. The remaining modules are grouped into three categories: social determinants of health, vulnerable populations, and economics and policy.
Three short videos serve to introduce the toolkit to users:
Natabhona Mabachi, Ph.D., M.P.H., is an assistant professor in the research division of the Department of Family Medicine & Community Health at the University of Kansas Medical Center in Kansas City and is leading the evaluation of the toolkit on behalf of the AAFP National Research Network.
"In the face of the current and persistent health disparities experienced by nondominant groups in the U.S., primary care and public health experts need to address the avoidable human-made inequities in health care created due to racism, sexism, ageism, ableism, and homo- and transphobia," Mabachi told AAFP News.
"This toolkit offers health professionals and students a way to deeply examine the factors that create these inequities and suggests strategies on a personal and structural level that we may consider using as we educate students and practice medicine that could mitigate these inequities," she said.
The toolkit uses a social accountability framework that challenges users to think about issues of inequities in a deeper way, said Mabachi, which may often be uncomfortable because it's designed to generate self-reflection, honest discussion and questioning around issues such as structural racism, historical trauma and bias, and how they have deeply impacted the way physicians have taught and practiced medicine.
"It also challenges the users to use a collaborative approach to solution-building that requires people of diverse ideas and backgrounds to come together," she added.
Mabachi said she thinks the toolkit gives family physicians the opportunity to return to what the resource's authors -- Jennifer Edgoose, M.D., of Madison, Wis., and colleagues -- called the "foundational principles of social medicine."
"I think family docs get mired in addressing issues on an individual level, but this toolkit is a reminder that they can use their practice to holistically engage with patients and their communities and become advocates by building partnerships and using their privilege to take the stories and experiences their patients have entrusted them with and use them to make change," she said. "I know many docs are already doing this, but this toolkit offers strategies, ideas and language to amplify this work."
Finally, said Mabachi, "In our current sociopolitical climate, if this toolkit stretches the thinking of learners and educators, if this toolkit has users adapting an attitude of social accountability, if this toolkit inspires collaboration among diverse groups and thinkers to solve equity issues at the educational, practice, organizational and community levels and beyond, then I will say that it is a success."
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