9/16 - Introduction to Cultural & Structural Humility

Social determinants of health

nonmedical factors what influence a person’s health outcomes

5 domains of social determinants of health

1. economic stability

2. education access and quality

3. health care access and quality

4. neighborhood and built environment

5. social and community context

Examples of education access & quality

• early childhood education/development programs

• highest level of education

• completion of high school

• literacy levels

Examples of healthcare access & quality

• accessibility of health services as a whole

• accessibility of primary care services

• health literacy

Examples of neighborhood and built environment

• access to healthy foods

• crime levels

• environmental conditions

• transport options/walkability

Social and community context examples

• social support network

• incarceration

• engagement in community

Cultural humility

an ongoing process that involves becoming aware of your own cultural background, values, and beliefs, as well as being willing and interested in learning other’s cultural backgrounds, values, and beliefs

Structural humility

the capacity of healthcare professional to understand knowledge and practice gaps regarding structures, partner with other stakeholders to fill these gaps, and engage in self-reflection throughout the process

Upstream factors

large scale factors that influence health, health systems, governmental policy and social, physical, economic, and environmental

What is considered the “origin” of a particular issue?

upstream factor

Downstream factors

immediate, individual-level factors that directly affect a person’s health and well-being

What is considered the “outcome” or aftermath of an issue?

downstream factors

Social needs

individual level nonmedical acute resource needs related to SDOH

Health disparities

preventable differences in disease burden, injury, violence, or opportunities to achieve optimal health that are experience by socially disadvantaged populations

Structures

policies, economic systems, and other institutions that have produced and maintained social inequities and health disparities

Structural inequities

systems and behaviors that may influence how people are treated

Navigating

strategies provided by individuals or teams that reduce barriers to care

Structural competency

the trained ability to discern how a host of issues represent the downstream implications of upstream decisions