“Your zip code is a better predictor of health than your genetic code.”
A picture of this quote was projected onto the screen during our lecture. Our professor’s words echoed throughout the auditorium as he described the importance of understanding the social aspects of our patients’ lives rather than just their genetic predisposition to disease. Understanding the social and economic conditions that impact health, disease and the practice of medicine lies at the core of social medicine. As I listened to this lecture, I realized that my role as a physician-in-training is not simply to understand how the human body functions and the pathophysiology of disease — it was to understand the patient as a whole, to view the community as a unit and to use my position to foster the development of a healthier society.
Far too many future health care professionals ignore the importance of the social determinants of health. Where a person lives, learns, works and plays can affect a wide array of health risks and outcomes. These forces shape one’s lifestyle and continue to influence their health for many years to come. Racism, xenophobia, sexism and other forms of prejudice can have a more dramatic influence on health than biological factors. These factors play into poverty, the safety of neighborhoods, substandard education, and overall access to resources. How can a patient get access to proper health care if they are living on minimum wage and cannot skip work to go to the urgent clinic? During the school year, there are children who only get a full meal every day because it is provided by the school. If you were to compound this problem with a diagnosis of diabetes, health inequity would become our primary obstacle in treating our patients.
As future health care professionals, we need to look at the statistics and reject the stereotypes that are associated with these at-risk communities. It is immoral for minorities and the impoverished to die earlier than others. It is immoral for the South Side of Chicago to have a lower life expectancy compared to the richer North Side of Chicago. It is immoral to cherish a chosen few lives over others. We must reject these notions and affirm equality amongst all people.
Achieving health equity is a daunting task, but even as a medical student, I can advocate for my future patients. Advocacy takes many forms: contacting our congressional leaders to discuss health care reforms, discussing health issues with the community, staying informed on current events in global health, educating our peers or protesting at a rally. it could even be as simple as attending a conference like those hosted by the Social Medicine Consortium. Even with the grueling workload of our daily affairs, future medical professionals can still engage in activism and advocacy to build towards health equity for all communities; especially those at risk.
To start advocacy and activism, start off by focusing on a topic that you are most passionate about. Think about what matters to you most: LGBTQ+ health, women’s health, gun violence, climate change, opioid epidemic, etc. Begin to open a conversation on these topics with your peers. Start by questioning the underlying issues behind these topics. What systems are in place that are preventing the betterment of these issues? And the most important question to discuss is, what can I do? As we begin to open a dialogue on these issues, we can start to engage in our communities and give a voice to the voiceless. Go out and advocate — even if it is just at your school or within your own homes. And as we spread the news of our advocacy and raise awareness to these issues, the snowball effect can lead to the global health equity that we all envision.
As we continue our medical training, we learn the biomedical model of health: the anatomy of the human body, the physiology behind sleep, the pathology of skin cancer and so on. However, as we start supplementing this biomedical model for the biopsychosocial model of health to include social, environmental and cultural factors, we start seeing our patients as more than just a collection of symptoms. Through advocacy and activism, we can educate not only our patients, but our peers, our community and our congress people — and work towards a possibility of global health equity.
Rohan Patel is a medical student.
Image credit: Shutterstock.com
