Barrere-Cain Rio, Garriga Meera, Kaki Dahlia A, Lawrence Carlton, Reardon Alexander, Martin Alister
R. Barrere-Cain is an MD-PhD student, University of California, San Francisco, San Francisco, California; ORCID: https://orcid.org/0000-0002-0522-253X .
M. Garriga is a medical student, University of California, San Francisco, San Francisco, California; ORCID: https://orcid.org/0000-0002-8603-621X .
Acad Med. 2022 Dec 1;97(12):1760-1764. doi: 10.1097/ACM.0000000000004765. Epub 2022 Jun 2.
Civic health refers to the ability of a community to organize and collectively address problems that affect the well-being of its members through democratic participation. Civic health should be an integral part of the medical school curriculum because improving a community's civic health shifts the distribution of power toward patients, better enabling them to address social determinants of health that are affecting their well-being. This article details how to effectively integrate civic health curriculum into already-existing medical education frameworks, outlines how these interventions will improve both patient care and the student experience, and addresses barriers that might restrict the implementation. Civic health can be integrated into the didactic curriculum in the form of lunchtime guest lectures, panels with community organizations, and small-group discussions; it can be integrated into experiential curriculum by distributing QR codes to aid in voter registration, organizing voter registration drives, and participating in nonpartisan canvassing. This civic health content can be integrated into existing social justice curricula without massive investment or structural change. Medical students are capable and effective messengers of civic health and can affect change at all levels of training. Notably, because civic health is directly actionable, it can be a source of motivation rather than burnout for medical students. As students develop into medical professionals, the training in civic health improves their understanding of social determinants of health and enables them to play an important role in promoting civic engagement and empowering patients with the democratic tools necessary to enact social change.
公民健康是指一个社区通过民主参与来组织并共同解决影响其成员福祉的问题的能力。公民健康应成为医学院课程的一个组成部分，因为改善社区的公民健康会使权力分配向患者倾斜，使他们更有能力应对影响其福祉的健康的社会决定因素。本文详细介绍了如何将公民健康课程有效地融入现有的医学教育框架，概述了这些干预措施将如何改善患者护理和学生体验，并探讨了可能限制实施的障碍。公民健康可以通过午餐时间的客座讲座、与社区组织的小组讨论等形式融入理论课程；它可以通过分发二维码以协助选民登记、组织选民登记活动以及参与无党派拉票活动等方式融入实践课程。这种公民健康内容可以在不进行大规模投资或结构变革的情况下融入现有的社会正义课程。医学生是公民健康的有力且有效的传播者，能够在各级培训中推动变革。值得注意的是，由于公民健康是直接可行的，它可以成为医学生的动力来源而非倦怠之源。随着学生成长为医学专业人员，公民健康方面的培训增进了他们对健康的社会决定因素的理解，并使他们能够在促进公民参与以及赋予患者进行社会变革所需的民主工具方面发挥重要作用。
