Understanding the Social Determinants of Health: A Self-Guided Learning Module for Rural Health Care Teams

Date of Review: June, 2019

This resource introduces rural health care and social determinants of health to a general health care audience. In fact it is intended to be a self-guided learning module that groups can work through and complete activities relevant to their context. There are five distinct modules that have specific activities (typically using county maps) where disparities in health; disease; risk factors including up stream social factors are examined. The first two sections introduce and define Social Determinants of Health and how rural health, poverty and other conditions contribute to the SDH. The following sections examine the NCD (non-communicable diseases) of CVD (cardiovascular disease) and diabetes and using current research asks the learner to identify the many SDH risks and barriers that lead to differences in CVD mortality and diabetes diagnosis and management to demonstrate the health disparities due to SDH. The diabetes section and final summary discussion section also introduce resources and community projects examples that target social interventions. Each section includes discussion questions where the learner uses online maps/data to identify the risks; burdens and management in their own communities/counties and some sections have suggested ‘Action’ sections to design/think about potential opportunities to address some of these SDH to improve health at the community level. This is a very easy to use resource which uses maps; discussion questions and videos to provide an interactive experience. This would be easily used in a preclinical curriculum in a case-based learning format for family medicine; health equity; community medicine or similar curricula. It is designed for small groups and I would recommend using it in small groups with an expert facilitator. I would use the modules individually when relevant in the curriculum as the instructional strategies with maps and discussion lose their novelty when repeated. The video in section 5 is a good (and very basic) way to show students the impact of SDH. Of note, cultural competency (last section of resources) is an outdated term however the resource actually is a repository of community examples of contextually appropriate interventions. –Ashti Doobay-Persaud, MD, NCEAS

Corresponding Author’s Email:



University of Iowa

Source of the Curriculum/Resource:


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