Oral Health Equity & Social Determinants of Health

The authors of these articles discuss why and how health equity, social determinants, and health disparities should be scaffolded and integrated throughout dental curricula. 

Cultural competence:  Having the ability to provide care to patients with diverse backgrounds, values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs.  Cultural competence training includes the development of a skill set for more effective provider-patient communication and stresses the importance of providers’ understanding the relationship between diversity of culture, values, beliefs, behavior and language and the needs of patients.

Dimensions of Diversity: The dimensions of diversity include:  structural, curriculum and institutional climate. 

• Structural:  Structural diversity, also referred to as compositional diversity, focuses on the numerical distribution of students, faculty and staff from diverse backgrounds in a program or institution. 
• Curriculum: Curriculum diversity, also referred to as classroom diversity, covers both the diversity-related curricular content that promote shared learning and the integration of skills, insights, and experiences of diverse groups in all academic settings, including distance learning. 
• Institutional Climate:  Institutional climate, also referred to as interactional diversity, focuses on the general environment created in programs and institutions that support diversity as a core value and provide opportunities for informal learning among diverse peers. 

Standard 1-4

The dental school must have policies and practices to:

• achieve appropriate levels of diversity among its students, faculty and staff; 
• engage in ongoing systematic and focused efforts to attract and retain students, faculty and staff from diverse backgrounds; and
• systematically evaluate comprehensive strategies to improve the institutional climate for diversity. 

Intent: The dental school should develop strategies to address the dimensions of diversity including, structure, curriculum and institutional climate. The dental school should articulate its expectations regarding diversity across its academic community in the context of local and national responsibilities, and regularly assess how well such expectations are being achieved. Schools could incorporate elements of diversity in their planning that include, but are not limited to, gender, racial, ethnic, cultural and socioeconomic. Schools should establish focused, significant, and sustained programs to recruit and retain suitably diverse students, faculty, and staff. 

Standard 2-17

Graduates must be competent in managing a diverse patient population and have the interpersonal and communications skills to function successfully in a multicultural work environment.  

Intent: Students should learn about factors and practices associated with disparities in health status among subpopulations, including but not limited to, racial, ethnic, geographic, or socioeconomic groups. In this manner, students will be best prepared for dental practice in a diverse society when they learn in an environment characterized by, and supportive of, diversity and inclusion.

Such an environment should facilitate dental education in:  

• basic principles of culturally competent health care;
• basic principles of health literacy and effective communication for all patient populations
• recognition of health care disparities and the development of solutions; 
• the importance of meeting the health care needs of dentally underserved populations, and;
• the development of core professional attributes, such as altruism, empathy, and social accountability, needed to provide effective care in a multi- dimensionally diverse society. 

Source: Commission on Dental Accreditation (CODA) Standards for Predoctoral Dental Education.