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Year:: 2017
Contributor:: Bourgois, Phillippe (Author); Holmes, Seth M. (Author); Sue, Kim (Author); Quesada, James (Author)
Subject:: medical education; health disparities; graduate medical education; structural competency; structural vulnerability; social history; assessment instrument

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Abstract:: In this perspective piece, Bourgois et. al describe the concept of “structural vulnerability,” how it was incorporated into a questionnaire designed to address structural forces that affect health outcomes and the potential impact of this tool on the reduction of health disparities and promotion of health equity. While medical education has recognized the presence of healthcare disparities, it has chosen to address them by focusing on “cultural differences.” Medicine emphasizes the importance a social history, but it has traditionally focused on a examining “risky behavior,” and ignoring structural forces that influence behavior and outcomes. The authors encourage a shift from this “cultural competency” framework to a more complex “structural competency” framework, that goes beyond attributing health disparities to essentializing descriptions of minoritized groups. They present a “structural vulnerability assessment questionnaire,” which will allow clinicians to quantify how at risk patients are for poor health outcomes. This tool can be used to guide treatment, mobilize resources outside of the clinic and improve providers relationship to the community. They demonstrate the impact of this tool - including a reduction in overall healthcare costs - by examining patient cases.

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Use and Reproduction: This work is licensed under a Creative Commons Attribution 4.0 International License

Citation

Bourgois, Phillippe, Holmes, Seth M., Sue, Kim, et al., "Structural Vulnerability: Operationalizing the Concept to Address Health Disparities in Clinical Care" (2017). Medicine and Race: AMS Annotated Bibliography. Brown Digital Repository. Brown University Library. https://repository.library.brown.edu/studio/item/bdr:825322/

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Medicine and Race: AMS Annotated Bibliography

This annotated bibliography was created to serve as a resource for medical students, residents, and faculty interested in learning more about how race is used in medicine and how racism results in disparate health outcomes for racial and ethnic minorities. …

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Structural Vulnerability: Operationalizing the Concept to Address Health Disparities in Clinical Care