Paper short abstract:

Social determinants of health are increasingly acknowledged as major driving force behind health inequities. At first glance, the concept looks very similar to the approach of structural competency. This contribution investigates the overlap between both concepts and discusses their differences.

Paper long abstract:

The concept of social determinants of health (SDoH) aims to explain the differentials in health outcomes across populations. It does so by highlighting that environmental, economic and social factors are the main influences on individuals’ health, and that exposure to such (harmful or beneficial) factors depends in turn on wealth, education, place of residence, discrimination and other stratifying forces.

In practical terms, this implies that health professionals need to be aware of these determinants and consider them in their diagnostic and therapeutic reasoning. At first glance, one could therefore think that teaching SDoH automatically entails improving health professionals’ structural competency.

Still, at a closer look there are substantial differences between the two approaches in terms of epistemology, didactics and practical implications. My contribution will map these differences and explain why teaching health professionals about SDoH needs to be embedded in a broader framework of structural competency.

Hereby, I will show that the concept of SDoH lacks a clear epistemology and does not necessarily imply an emancipatory framework or critical reasoning. In addition, critical reflexion of researchers’ and health professionals’ positionality is not required to work with SDoH but is an integral part of structural competency.

Therefore, training health professionals in structural competency will look different from teaching SDoH, and will entail more critical self-awareness and an explicit epistemological grounding. By adding these elements to already existing curricula on SDoH, we can promote health professionals’ structural competency, increase their ability to address SDoH and overall improve the care patients’ routinely receive.