Public understanding of health inequality and our duty

This article was exclusively written for The European Sting by Ms. Alaa Alfadel, Final year medical student at the University of Almughtaribeen, Sudan. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Despite the improvements in healthcare, inequalities in health have remained for so many decades and led to higher rates of mortality and morbidity affecting all aspects of our health.

According to WHO “health inequities are differences in health status or in the distribution of health resources between different population groups, arising from the social conditions in which people are born, grow, live, work and age. Health inequities are unfair”

“The lower an individual’s socio-economic position, the higher their risk of poor health” Not all inequalities in health are derived from being able to access to health services, there are a number of factors linked to social determinants. Decades of medical students have been taught to make a diagnose based on centralized factor or race. We are taught to link patient’s age, gender and race to a list of main symptoms to make a list of potential diagnosis. For example, race has always been linked as a genetic/or biological factor and does not sufficiently represent race as a social construct whose historical, political and economic implications factor into patient’s outcomes. Despite the fact that there are genetic factors that may lead a population to disease. One of the factors that widens inequality in health is the education in medical school for example, Sickle Cell disease in African people, Kawasaki disease in Asian children and cystic fibrosis in white children. In order for medical schools to address health inequity, structural changes in how medical education is delivered, including race is fitted, however not using it as main driver for diagnosing patients 

The institute of medicine (IOM) performed an assessment on the differences in kinds and quality of healthcare received by US racial and ethnic minorities and found that:

• Inequity in health care exist and are associated with worse health outcomes.
• Health care inequity occur in the context of broader inequality.
• There are many sources across health systems, providers, patients and managers that contribute inequity.
• Bias, stereotyping, prejudice and clinical uncertainty contribute to inequity.
• A small number of studies suggest that racial and ethnic minority patients are more likely to refuse treatment.

So, Can we, as medical students, effect meaningful change in this arena? I strongly believe we can.

Medical students are passionate, well-placed to be powerful and influential advocates for change in the community and later on they will become greater advocates in healthcare as our next generation of physicians equipped with knowledge that would improve the care of patients in the future. 

Therefore, it is important that future physicians receive training that allows them to identify and understand the impact of social determinants on a patient’s health while minimizing their dependance on race as a risk factor in clinical decision-making.

It’s an important step to educate medical students as they are not aware of how serious is this issue. The widening gaps in society’s health, and the variability in people’s experience of the healthcare system is incredibly disturbing.

About the author

Alaa Alfadel, Final year medical student at the University of Almughtaribeen, Sudan. She is an ex local officer of standing committee on sexual and reproductive health and rights. Alla enjoys reading books, writing, watching movies and animes and meeting new people. Passionate about researches. She aspires to become a neurologist someday.