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Where you are born, the school you attend, your highest level of education, your race, age, and sex, these are all things that can directly, or indirectly impact your health. The social determinants of health is a phrase that can better be used to sum them all up. It refers to the social situation you exist in, and how that affects your ability to purchase healthy foods or obtain the medical care you need, and so much more. When it comes to certain measurements of health, people who fall within certain groups or populations, for example, minorities, or people of lower socio-economic statuses (SES), tend to have worse results than their white, or higher SES counterparts. These differences in health outcomes are referred to as disparities. As social scientists, healthcare professionals, and anyone with the means to address these disparities, we are ethically obligated to do so. There are already several initiatives aimed at addressing the social determinants of health. Through these initiatives, those in need are provided with things such as food vouchers, ride vouchers, and health education. What is missing, are organized studies with specific goals and appropriate sample sizes to address the efficacy of these initiatives. Once we have more such studies to provide us with data that supports the efficacy of these interventions, we can then advocate for policies that will make these resources widely available and encourage health equity. / Urban Bioethics

The social and structural determinants play a significant role in community health, and differences in the experience of these factors facilitate some of the health disparities that are seen in the US along racial and socioeconomic lines. In this manuscript, I propose a conceptual model of the social determinants of health hierarchy and discuss the positioning of the structural determinants of the built environment within that hierarchy. I discuss the research connecting some of the structural determinants to health outcomes. Finally, I review several opportunities for local government to alter the built environment in ways that can promote community health and mitigate health inequity. / Urban Bioethics

In this paper, I explore the relationship between academic medical centers and the local school districts in which they are situated within the context of what I experienced as a medical student working in an education non-profit. This analysis is intended to arrive at actionable reccomendations for the non-profit, RISE, with the end goal of transforming the organization into one in line with the principles of urban bioethics. The hope is that applying what I learned in the classroom, in the Urban Bioethics master’s degree program, will improve the success of RISE in its adaptation by the community and result in greater impact on education and mentorship of our students. First, in the introduction, I will describe the general healthcare landscape in the United States and how education is viewed by the healthcare system. I will also discuss in the introduction my personal experience as a medical student at Temple in Philadelphia and my exposure to the school district that led me to be involved with the education non-profit. Second, I demonstrate that education is a key social determinant of health by exploring the literature and research that supports this notion. Third, I explore the economic and political context that I believe foreshadows greater investment in education from academic health centers. Fourth, I describe the Philadelphia RISE educational organization and its current status of operations. Fifth, I consider Temple’s strategy in community engagement as a veteran role model for the fledgling non-profit. Sixth, I discuss the role of urban bioethics in shaping my ultimate recommendations to the non-profit. Seventh (and finally), I articulate the recommendations, which will most notably alter the leadership structure to incorporate community stakeholders. / Urban Bioethics

Data consistently shows that firearm violence affects minority populations disproportionately. In the 1970s, firearm injury related death was the 13th leading cause of death in America. The problem has only worsened, costing the US economy almost $230 million a year and is now the second-leading cause of injury related death. Gun violence should be considered a public health crisis given its costs in terms of morbidity, mortality, and economics, but also can be considered a social determinant of health as it contributes significantly to minority populations’ medical histories and health outcomes. Homicide is the leading cause of death in Black males between the ages of 15 and 34, with 91% of these deaths being the result of firearm injury. However, the way gun violence is portrayed in the media inaccurately generalizes White populations fulfilling the victim role while Black populations in the criminal role. The media considers shootings involving Black populations as “commonplace,” and therefore these incidents receive less attention from media sources. The constant impact of firearm violence places on healthcare providers is also significant, as the incidence of post-traumatic stress disorder is three times higher for trauma surgeons than the general population. Many healthcare organizations have recognized the devastating impact of firearm injury by coming out with position statements, developing patient education and advocacy resources, and community engagement initiatives to help support populations most affected. While more is to be learned in terms of research about the impact of this public health issue, we need to take a multifaceted approach to work towards equitable care for our most vulnerable populations. / Urban Bioethics