Applying WHO’s Community Social Determinants of Health Framework to Critical Conversations in Anti-Oppressive Pedagogy

Overview: The World Health Organization’s Community Social Determinants of Health (CSDH) – an interdisciplinary conceptual framework for examining the structural, socioeconomic and intermediary causes of injustices – provides the foundation for transforming curricula with a BSW senior capstone project addressing the social determinants of social, economic and environmental injustices.Proposal text: The Grand Challenges for Social Work (2016) calls for using science to eliminate the “glaring inequalities” that underscore social, economic, and environmental injustice. While social work is the profession that is best suited to address inequities (Spence Coffey, 2020), the challenge for BSW education is in adopting pedagogies that “deconstruct the underlying prejudice, bias, and stigmatization” (Grand Challenges Impact Report, 2021) and the accompanying power structures within which inequality flourishes.

The Community Social Determinants of Health (CSDH) conceptual framework, developed by the World Health Organization (2010), offers a scientific framework for examining how socioeconomic, political, cultural, discursive, and institutional mechanisms intersect to impact socioeconomic position which, in turn, shapes exposure and vulnerability to disease through neighborhood environments, biology, and access to basic needs such as food, education, and health care. The CSDH consists broadly of three sets of determinants: structural (including governance, macroeconomic policies, social and public policies, and culture and societal values and prejudices); socioeconomic (social class, gender, ethnicity, education, occupation, and income); and intermediary (material circumstances, behaviors and biological factors, and psychosocial factors) (WHO, 2010). Each set of determinants is influenced by social cohesion and social capital and access to physical and mental healthcare. All determinants intersect to impact equity (and inequity) in health and well-being (WHO, 2010).

Exploring injustices through the CSDH framework is consistent with social work’s values of “commitment to promoting social justice and respect for human relationships” (National Association of Social Workers [NASW], 2021). Importantly, it allows for a common language in interprofessional collaboration to address and eliminate inequity through redistribution of resources (Bonner, 2018). It provides scientific evidence that can translate into macro-level approaches to improving and reducing inequalities in health and wellbeing such as policies that reduce poverty, promote employment, and improve working conditions (Bonner, 2018; Lee et al., 2018, Naik et al., 2019).

Senior Capstone Project

The National Academies of Sciences, Engineering, and Medicine (2016) recommend a focus on transformative learning in pedagogical approaches addressing the SDH, stating that “addressing the social determinants of health go[es] well beyond traditional lecturing... an approach to such transformative learning [results in] creating, through education, highly competent professionals who understand and act on the social determinants of health in ways that advance communities” (p. 72). This presentation provides an overview of a senior capstone project that represents such a transformative learning experience.

Attendees will be given a tutorial about the CSDH. Three scaffolded senior capstone assignments will be presented, each with a grading rubric indicating core competencies (CSWE, 2015). One, an annotated bibliography, demonstrates how to access and organize CSDH research. Next, a problem statement, integrates CSDH research with community-level data to “tell the story of the injustice” at the community level. Finally, a policy brief, provides an anti-oppressive policy-based solution to the injustice.

The CSDH provides an interprofessional framework to raise critical questions about underlying societal values, policies, and structures that hinder human rights. Through a BSW senior capstone assignment, it offers an anti-oppressive lens for understanding and advancing human rights through policy advocacy.