Teaching Undergraduate Social Determinants of Health: “Bad” Neighborhoods, “Those” People, and Dispelling the Stereotypical Portrayal of Poor, Urban Communities

Abstract

The current racial climate, the subsequent protests taking place in the state of Minnesota, and the social spotlight that followed, brought forth the importance of creating anti-racism initiatives in higher education. This article describes a significant curriculum redesign of an undergraduate social determinants of health (SDOH) course to include a module on examining social and community context with an emphasis on racism, discrimination, and violence. Course materials focused on a notorious urban housing project subject to media scrutiny, and a corrupt political system that resulted in policies perpetuating generational segregation, poverty, and violence. SDOH factors are presented in an upstream public health approach from the lens of individuals, and their perceptions of top down, uncontrollable institutional level forces that impact their quality of life. This module aims to disrupt students’ deep-rooted understanding about underserved urban populations and introduces them to a nuanced understanding of intersectionality around five key SDOH. The module incorporates an intersectional analysis within the praxis of public health and sociology to explore discrimination, institutional racism, and segregation beyond public health data driven indicators that examine race and disparate health outcomes. We found that preconceived notions of student knowledge, behavior, and belief systems contribute to the stereotypical views of urban, poor minority populations. Students discovered that despite neighborhood dysfunction, residents created strong social cohesive networks, were political advocates for change, and sought promised governmental economic opportunities. Students are better informed about “those” people in “bad” neighborhoods that struggle to overcome decades of institutionally designed obstacles created from subversive policies.