Reconsidering Systems-Based Practice: Advancing Structural Competency, Health Equity, and Social Responsibility in Graduate Medical Education
Castillo Enrico G. MD, MSHPM; Isom Jessica MD, MPH; DeBonis Katrina L. MD; Jordan Ayana MD, PhD; Braslow Joel T. MD, PhD; Rohrbaugh Robert MD
Journal of the Association of American Medical Colleges
Health inequities stem from systematic, pervasive social and structural forces. These forces marginalize populations and create the circumstances that disadvantage these groups, as reflected in differences in outcomes like life expectancy and infant mortality and in inequitable access to and delivery of health care resources. To help eradicate these inequities, physicians must understand the political and economic structures that create and sustain inequalities and give rise to structural vulnerability, racism, sexism, oppression, historical marginalization, implicit bias, power, and privilege. A new educational paradigm emphasizing the knowledge, skills, and attitudes to achieve health equity is needed.
