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Achieving health equity: how academic medicine is addressing the social determinants of health


Association of American Medical Colleges

The mission of the Association of American Medical Colleges (AAMC) and of its member medical schools and teaching hospitals is to “improve the health of all.” This seemingly simple, five-word phrase underscores two issues of paramount importance to the patients and communities we serve: health and health care equity. To truly benefit all, academic medicine and its partners must increasingly focus on efforts to address health and health care inequities that continue to undermine the well-being of various groups in the United States. These inequities—systematic, measureable, and avoidable health differences between populations that stem from social factors such as racism, poverty, lack of healthful food, and homophobia—result in disproportionate disease and death for the poor, racial and ethnic minorities, persons living with disabilities, LGBT communities, and others.

The need to address these social factors, these “social determinants of health,” is integral to academic medical centers’ mission to improve health. According to the World Health Organization’s constitution, good health is “a state of complete physical, social, and mental well-being.” Given that scientists estimate that at least 40 percent of health outcomes are the result of social and economic factors, a sole focus on treating disease will not “improve health.”

Rather, a concomitant focus on social determinants is needed to address inequities, promote community well-being, and improve the health of all. As the AAMC’s senior director of health equity research and policy, I have seen firsthand the passion and commitment academic medical centers bring to the patients and communities they serve. This passion—coupled with other drivers such as the move to value-based health care, the new MCAT exam sections focused on sociocultural contributors to health, and new requirements for not-for-profit hospitals to identify and intervene on prioritized community health needs—has sparked innovation across the research, education, and clinical missions of academic medicine to engage local communities in service of addressing social factors that affect health.

Over the course of 2015, the AAMC’s Reporter chronicled some of these innovations in its Addressing Social Determinants of Health series. From cutting-edge, NIH-funded research centers to novel environmental health curricula to social and behavioral data collection in the clinical record, the series explored the ways in which academic medicine rises to the challenge of providing exceptional clinical care to the individual while also addressing social factors in the communities where patients are born, grow, work, and play.

The articles, commentaries by AAMC President and CEO Darrell G. Kirch, MD, and resources that are bundled together in this compilation offer a snapshot of some of the strategies medical schools and teaching hospitals have launched to narrow inequities and address social factors that affect community health. By sharing these stories and successes, medical schools and teaching hospitals can build, adapt, and implement relevant interventions for their own communities to meet their mission to improve the health of all.

Achieving health equity: how academic medicine is addressing the social determinants of health. Washington, DC: Association of American Medical Colleges; 2016: Available online.

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Issue Briefs & Reports