A Different Approach to Health (System) Education

One of the greatest challenges in designing systems for public education and health is determining how to properly account for not only the differences in choice that people make, but also the differences in social opportunity and situation that have major implications on where people end up. In education, we find this conversation in the ongoing debate about affirmative action. In health, however, there is a growing movement of people who want to talk more actively about the "social determinants" of health. One group of students has put together a game to teach people more about just what that means.

The idea of the social determinants of health is not new, but as more and more young people become excited about the field of global health after reading the work of people like Paul Farmer, the concept is acquiring a newly important place in the conversation. In 2003, the World Health Organization wrote:

"Health policy was once thought to be about little more than the provision and funding of medical care: the social determinants of health were discussed only among academics. This is now changing. While medical care can prolong survival and improve prognosis after some serious diseases, more important for the health of the population as a whole are the social and economic conditions that make people ill and in need of medical care in the first place. Nevertheless, universal access to medical care is clearly one of the social determinants of health."

The other social determinants include things like social support networks, working conditions, physical environments, income, and more. While this may seem sort of obvious, it has major ramifications for the way we conceive of and design health systems. The primary difference is that it demands a conversation about poverty and economics happen at the core of a system of health care and treatment.

This sort of shift is going to require a new generation of leaders to get far more comfortable thinking beyond the bureaucratic silos that defined government policy in the 20th century. The question is how that shift happens?

Luckily, there are some creative solutions. In 2004, two students at the University of Toronto, Kate Reeve and Kate Rossiter, designed a game called The Last Straw to teach players about the social determinants of health.

In the board game, players adopt a particular set of demographic characteristics such as gender, socioeconomic status and race. The game takes them through an entire life cycle in which they encounter "macro-issues" such as political climate and environmental change, as well as "micro-issues" like family dynamics and education. In each of these situations, players gain or lose "Vitality" chips, in the process seeing how many factors impact their well-being.

I think the game is an incredibly interesting approach to a vitally important education. To learn more about them, check out their website. And to learn more about how young people are thinking about these questions, read the Students for Global Health Equity blog.