Social Medicine Grand Rounds: A Collaborative Education Hub to Promote Action on Social Determinants of Health Across Community Sectors in Rural Alaska

• Main Authors: Trout, Lucas Jacob, Salters, Kristine, Inglis, Robert, Tobey, Matthew, Kasper, Jennifer, Harris, N. Stuart
• Format: Article in Journal/Newspaper
• Language: English; Spanish
• Published: Social Medicine Publication Group 2018
• Subjects: social medicine; Alaska Native; health disparities; social determinants of health; health equity; social stratification; tribal health; medicina social; indígenas de Alaska; disparidades de salud; determinantes sociales de la salud; equidad en salud; estratificación social; salud tribal; Arctic; Alaska
• Online Access: https://www.socialmedicine.info/index.php/socialmedicine/article/view/965

Background: The connection between social stratification and health inequalities in the United States suggests the need for medical education and practice to address social determinants of health as a key condition for achieving health equity. This reading of the project of social medicine—to wed health care delivery to a pragmatic and operationalized equity agenda—is particularly relevant to tribal health systems, where patient populations bear a disparate burden of injury and disease, where social and historical forces play a large role in the generation and maintenance of these health disparities, and where social and economic forces constrain the availability, accessibility, and efficacy of health care. Objectives: This paper describes the conceptual framework and educational materials from a social medicine grand rounds program in an Alaskan arctic tribal health system, aimed at building clinical, organizational, and community capacity to address social determinants of health. Led by the Maniilaq Association Division of Social Medicine with partners at Harvard Medical School and Massachusetts General Hospital, social medicine grand rounds bring together hospital and village clinic-based care teams, social and tribal service workers, and community members to study and apply social medicine perspectives to health care delivery across 12 circumpolar Alaska Native villages. The model utilizes a case-based curriculum to drive clinical-community collaboration and critical analysis of health care delivery challenges focused on four broad priority areas established by tribal leadership: maternal and child health, chronic disease, mental health, and infectious disease. Methods: The social medicine grand rounds program was piloted in April 2017 and will be formally launched in November 2017. Researchers will utilize a mixed methods approach, pairing analysis of electronic health record data with participant interviews and surveys to investigate changes in provider practice patterns relating to action on social ...