Experts: Social Determinants of Health Should Be As Important As Clinical Content in Pharmacy Curricula

Health is more than individuals’ behaviors and has a wide range of factors that affect individual and communities, Katie F. Leslie, PhD, MS, associate professor and director of enrollment and community outreach at Sullivan University in Kentucky, said in a session at the 2024 American Association of Colleges of Pharmacy Annual Meeting.

“The World Health Organization defines social determinants of health as the conditions in which people are born, live, and work, and highlights that these factors are most often the most important determinant of health status,” Leslie said. “We know that social determinants of health have been identified as the root causes of health disparities or those potentially avoidable differences in health outcomes between groups of people who are more or less advantaged socially.”

In the session, Leslie, Jennifer Bhuiyan, PharmD, MPH, an assistant professor at St. John's University in New York; Devra Dang, PharmD, CDCES, FNAP, associate clinical professor at University of Connecticut School of Pharmacy; Tara P. Driscoll, PharmD, clinical assistant professor and clinical pharmacist at University of Illinois at Chicago in Illinois; and Abby A. Kahaleh, PhD, MS, BPharm, MPH, FAACP, dean of the South University School of Pharmacy in Illinois, discussed social determinants of health (SDOH) and the importance of SDOH in pharmacy school curricula.

Leslie explained the Healthy People 2030 model, which includes SDOH in 5 aspects: education access and quality; economic stability; social and community context; neighborhood and built environment; and health care access and quality. She added that SDOH can also be used to promote socioecological and public health. The Healthy People 2030 model is an initiative designed to improve the overall health of the US population by 2030, with one of the overarching themes being SDOH.

“There are numerous opportunities for pharmacists to make a difference at multiple levels of influence. From the interpersonal interactions that pharmacists have with individual patients to advocacy efforts to change health policy,” Leslie said.

Bhuiyan detailed some of the most efficient ways she has seen SDOH being taught in PharmD programs. In a survey, Bhuiyan and her colleagues collected, reviewed, and categorized different exemplars of SDOH teaching models. They found that 75% of exemplars included covered all 5 domains SODH and 87.5% included the socioecological model. Exemplar categories included professional meetings, interprofessional education cases, home visits, advocacy efforts, and community activities.

Driscoll further explained what pharmacists can do for patient care and how to teach this to students in the experiential setting. She has students identify physical and patient-specific factors for each individual as well as identifying and integrating socio-behavioral, socioeconomic, and cultural beliefs and values for every patient that the students encounter.

“I really want my students to identify physical and patient-specific factors that they should consider when developing an assessment and planning,” Driscoll said. “I want to make this as important as checking vital labs or checking the medication history when providing care for these patients.”

Driscoll added that educators should discuss how a treatment plan works for a specific patient and how SDOH would impact the treatment plan. She said the best way to have students thinking about SDOH is to model how to integrate SDOH into practice, introduce and reintroduce SDOH to students, coach students on integration of SDOH into patient care, and debrief with students and provide feedback in the experiential setting.

“It's awesome if a student wants to integrate a new medication that they just saw a commercial for because that’s first thing on their mind,” Driscoll said. “But, maybe it's not affordable for your patient, or maybe it needs to be refrigerated and the patient is housing insecure, and don't actually have access to refrigerator, so it doesn't really make sense to give them a medication that they can't keep stable.”

Reference

Bhuiyan J, Dang D, Driscoll TP, Kahaleh AA, Leslie KF. Greater than its parts: effective integration of SDOH in pharmacy and interprofessional curricula. Presented at: 2024 American Association of Colleges of Pharmacy Annual Meeting; July 20-July 23, 2024; Boston, MA.