Examining Privilege as a Social Determinant of Health with Undergraduate Health Care Students

Abstract

Discussions about privilege as a social determinant of health (SDOH) may increase awareness of privilege and SDOH for health care students and improve quality of care. The study aimed to examine students’ perception of privileges related to various SDOH, including race and social class. Health care students completed a pre-survey prior to a Modified Privilege Walk (MPW) and then a post-survey immediately after the MPW. Nonparametric tests were used to analyze data. Data included 18 matched pre- and post-surveys. The MPW assignment resulted in a significant improvement of 1.5 points in recognition of parents’ education as a privilege (p = 0.047). Student responses showed a decline in guilt about personal privilege (-0.11 points, p = 0.7656). On average, students agreed the MPW assignment made them more aware of their privilege and positively impacted how they will interact with future patients. The pre- and post-survey identified SDOH that students, on average, felt gave them more privilege (e.g., parents’ profession and education). This pilot project illustrates the need to teach about SDOH and include frank discussions about personal privilege as an integral component of SDOH