Educational tools to dismantle disparities by addressing social determinants of health


  • Edgar Diaz-Cruz College of Pharmacy, Belmont University, Tennessee, United States
  • Stephanie Long College of Pharmacy, Belmont University, Tennessee, United States



Health disparities, Patient-centred care, Social determinant of health, Socio-ecological model


Background: Social determinants of health (SDOH) are personal, social, economic, and environmental factors that contribute to health disparities in the United States.   

Objectives: To develop educational interventions to teach and assess students’ knowledge about health disparities using a SDOH framework, and design assessment methods to identify theory-based interventions to improve patient health outcomes.   

Methods: Educational tools utilising a SDOH framework were designed for students to learn about health disparities. A socio-ecological model allowed students to assess multi-level determinants of health and propose more effective interventions. Evidence-based questions were designed to address the health of a specified population. A case study allowed students to apply therapeutic knowledge and clinical interventions to improve patient health.

Results: Exactly 44 students enrolled in three iterations of the course and completed pre- and post-surveys. Upon completion, students’ perception of health disparities significantly increased.   

Conclusion: The SDOH model offers strategies for other pharmacy programs seeking to increase public health-related topics. Students can develop skills to directly apply to a current problem and then build theory to engage in problem-solving. This innovative approach utilising SDOH for pharmacy students positively impacted awareness and knowledge.

Author Biographies

Edgar Diaz-Cruz, College of Pharmacy, Belmont University, Tennessee, United States

Department of Pharmaceutical, Social & Administrative Sciences

Stephanie Long, College of Pharmacy, Belmont University, Tennessee, United States

Department of Pharmaceutical, Social & Administrative Sciences


Accreditation Council for Pharmacy Education (ACPE). (2015). Accreditation standards and key elements for the professional program in pharmacy leading to the doctor pharmacy degree “Standards 2016”.,

Adelman, L. (2009). Unnatural causes: California Newsreel, UNNATURAL CAUSES | CALIFORNIA NEWSREEL.

Agency for Healthcare Research and Quality (AHRQ) (2022). National Healthcare Quality and Disparities Report.

American Public Health Association (2006). The role of the pharmacist in public health.

Brown, B., Heaton, P.C. & Wall, A. (2007). A service-learning elective to promote enhanced understanding of civic, cultural, and social issues and health disparities in pharmacy. American Journal of Pharmaceutical Education, 71(1)

Diaz-Cruz, E.S. (2019). If cultural sensitivity is not enough to reduce health disparities, what will pharmacy education do next?. Currents in Pharmacy Teaching and Learning, 11(5):538-540

Durand, C., Abel, C., Silva, M. & Desilets, A. (2012). An elective course in cultural competence. Currents in Pharmacy Teaching and Learning, 4(2):102-108.

Fielding, J.E., Teutsch, S. & Breslow, L. (2010). A framework for public health in the United States. Public Health Reviews, 32(1):174-189

Hall, W.J., Chapman, M.V., Lee, K.M., Merino, Y.M., Thomas, T.W., Payne, B.K., Eng, E., Day, S.H. & Coyne-Beasley, T. (2015). Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. American journal of public health, 105(12):e60-e76

Healthy People 2030 (2023). Healthy People 2030.

Hernandez, C.M., Moreno, O., Garcia-Rodriguez, I., Fuentes, L. & Nelson, T. (2022). The Hispanic paradox: A moderated mediation analysis of health conditions, self-rated health, and mental health among Mexicans and Mexican Americans. Health Psychology and Behavioral Medicine, 10(1):180-198

Marsh, M.C., Supples, S., McLaurin-Jiang, S., Brown, C.L. & Linton, J.M. (2019). Introducing the concepts of advocacy and social determinants of health within the pediatric clerkship. MedEdPORTAL, 15:10798

McDonald, M., West, J. & Israel, T. (2015). From identification to advocacy: a module for teaching social determinants of health. MedEdPORTAL, 11:10266

Neff, J., Holmes, S.M., Knight, K.R., Strong, S., Thompson-Lastad, A., McGuinness, C., Duncan, L., Saxena, N., Harvey, M.J., Langford, A., Carey-Simms, K.L., Minahan, S.N., Satterwhite, S., Ruppel, C., Lee, S., Walkover, L., De Avila, J., Lewis, B., Matthews, J. & Nelson, N. (2020). Structural competency: curriculum for medical students, residents, and interprofessional teams on the structural factors that produce health disparities. MedEdPORTAL, 16:10888

Palombi, L., Kading, M. & Hayes, C.J. (2013). The public health pharmacist and the role of the pharmacy curriculum: a call to action. Currents in Pharmacy Teaching and Learning, 5(5):477-482

Powell, D.L. (2016). Social determinants of health: Cultural competence is not enough. Creative Nursing, 22(1:5-10

Song, A.Y., Poythress, E.L., Bocchini, C.E. & Kass, J.S. (2018). Reorienting orientation: introducing the social determinants of health to first-year medical students. MedEdPORTAL, 14:10752

Thornton, R.L., Glover, C.M., Cené, C.W., Glik, D.C., Henderson, J.A. & Williams, D.R. (2016). Evaluating strategies for reducing health disparities by addressing the social determinants of health. Health Affairs, 35(8):1416-1423

Truong, H. A. & Patterson, B. Y. (2010). Professional and educational initiatives support, and opportunities for advanced training in public health. American Journal of Pharmaceutical Education, 74(7)

Vela, M.B., Kim, K.E., Tang, H. & Chin, M.H. (2008). Innovative health care disparities curriculum for incoming medical students. Journal of General Internal Medicine, 23(7):1028-1032

White, F. (2013). The imperative of public health education: a global perspective. Medical Principles and Practice, 22(6):515-529




How to Cite

Diaz-Cruz, E., & Long, S. (2023). Educational tools to dismantle disparities by addressing social determinants of health. Pharmacy Education, 23(1), p. 252–261.



Research Article