Neighborhood clinical advocates
The importance of optimizing the collective health resources available to underserved communities is highlighted in the “Socio-Ecological Determinants of Health” chapter in Health Systems Science, a 2016 textbook that is the first to explore the “third pillar” of medical education. (The chapter was co-written by Dr. Fancher, with co-authors Elizabeth G. Baxley, MD, and Daniel Goldberg, JD, MPH.)
At UC Davis, a collaborative approach to combating the social determinants of health is being instilled among medical students. One such initiative is a collaborative clinic in which medical students work with nurse practitioner students and pharmacy residents.
The trajectory of an individual’s lifelong health is significantly shaped during childhood. According to research cited in Health Systems Science, “conditions—whether favorable or adverse—during early childhood have a significant and enduring impact on population health, not simply across one individual’s lifespan, but internationally as well.”
With that, Dr. Fancher’s pediatric colleagues at UC Davis are partnered with undergraduate students in expanding family care beyond a clinical setting. As part of an elective course, undergrads with an interest in medicine and public health are trained to act as neighborhood clinical advocates for families at risk of adverse health outcomes.
“When there’s something beyond the scope of the treating physician, they bring the advocate in and ensure that the family has access to resources, that they are following up with them and helping them to troubleshoot any barriers,” Dr. Fancher said.
Learning from the community
One of the best resources for understanding socioeconomic struggles within a community are the people who live in and have leadership roles in that community. To facilitate an open dialogue with the communities they are serving, students at UC Davis hold an annual conference during which they bring in community members and regional leaders to teach.
“It allows us to flip the idea that the professors at UC Davis are experts,” Dr. Facher said. “Now we’re saying that’s not the case. It’s really these folks in the community that are the experts, and we are here to learn from them and understand how we can be of best help to those folks.”
Health Systems Science, which is already in use in medical schools across the country, was co-written by experts from the AMA and faculty from 11 of the 32 member schools in the AMA’s Accelerating Change in Medical Education Consortium.
The book retails for $59.99 and can be ordered from the AMA Store and the publisher, Elsevier, as well as from Amazon and other online booksellers. AMA members may order it from the AMA Store for $54.99. Individual chapters are available from Elsevier’s Student Consult platform for $6.99 each.