Medical training in social determinants of health: risk factors or protective factors?

Abstract

Medical graduate profiles include training in social determinants of health (SDH), which influence people's lives and are linked to the distribution of resources and power. These determinants are grouped into three dimensions: socioeconomic-political context, structural, and intermediate factors. Bronfenbrenner's ecological model allows us to understand the dynamic interaction between individuals and their environment. SDH can act as risk or protective factors for the health of individuals, families, and communities. It is important to overcome the negative view of SDH, as they can also have positive impacts, such as social support or community networks. Governance is key to generating public health policies; its absence increases epidemiological risks and inequalities. Examples show how inadequate policies increase sexually transmitted infections or unwanted pregnancies. Social media and digitalization can reduce health information gaps, but they can also generate misinformation or digital inequality. It is proposed to include SDH in medical training with active methodologies such as interviews, statistical analysis, and community exploration. Finally, service-learning stands out as an effective pedagogical strategy for developing social skills and civic engagement in future physicians.