Teaching Population Health and Community Health Assessment to Undergraduate Medical Students

Abstract

Over the past four decades, undergraduate medical students at the Sophie Davis School of Biomedical Education/CUNY Medical School have taken two linked and evolving courses designed to equip them with the knowledge and specific techniques necessary to measure and understand community and population health status, to guide their anticipated future primary care practices. The first course, community health assessment, is an examination of the student’s own zip code of residence, using the structured approach of community-oriented primary care and combining “shoe leather” inspection of key health-related structures with detailed analysis of US Census, demographic, and health data. The students then conduct a similar examination of population health status in a high-poverty zip code in New York City. Next, fieldwork in community medicine provides an 8-week placement in a community health center or community-based social service agency serving a high-poverty population, in which students apply their data gathering and analytic skills to their contact with individual patients and the delivery of health-related interventions. Both courses are designed to facilitate student discovery of the nature and meaning of the social determinants of health and their application to patient-centered community-oriented primary care. Currently, the community health assessment course utilizes a problem-based learning model with intensive small group workshops, planned and directed by peer teaching assistants. Student evaluations have consistently been extremely high, and graduates now practicing in poor and disease-burdened communities have reported that the skills learned years earlier in these courses continue to shape their approaches to practice.