Education as a Path to Health Equity: Lessons for Medical Education in the Development of a High School Health Careers Curriculum
AdvisorJones, Nora L.
Permanent link to this recordhttp://hdl.handle.net/20.500.12613/1476
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AbstractCompared to other developed countries, the United States has healthcare spending that far outpaces other nations, but achieves below-average life expectancy. In urban cities, this disparity is most striking among predominantly black and Latino communities. There is increasing recognition that the reason for this is improper allocation of resources; we have a system that funds clinical services which contribute to only 20% of health outcomes, while providing inadequate support for social and environmental factors which account for 80% of the impact. When one considers the history of the United States, it becomes clear that such a system is not only inefficient, but also fundamentally unjust. African American patients have been used (often without consent) to obtain much of our current medical knowledge, but suffer most from healthcare disparities. Medical school is a fascinating lens from which to view this healthcare system, as students stand at the threshold between layperson and physician. Medical students, who predominantly come from backgrounds of privilege, benefit from access to institutions of medical knowledge. They often practice their fledgling skills on urban underserved patients who are disproportionately cared for in academic medical centers. Medical students also participate in service projects in the surrounding community, with common projects involving schools, churches, and free clinics. As a medical student, I spent nearly 100 hours with a class of ninth grade students at a Philadelphia public high school as I developed and implemented a health careers elective program. Through this experience, I gained a firsthand appreciation for the incredible barriers that prevent urban underserved students from equal representation in our medical schools and health care workforce. Here, I reflect on my experiences over the course of medical school, review relevant literature in the fields of ethics, medicine, education, and history, and present recommendations to move us closer to a just healthcare system by increasing investment in underserved communities and instilling in medical students a moral imperative to reduce health disparities, as well as the tools to do so effectively.
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