Metzl and Hansen want healthcare workers trained to be "structurally competent" in basic economics, urban infrastructure, and other societal factors that can harm health. They two psychiatrists say that training could be part of pre-med undergraduate curriculum or included in employee orientations at hospitals and clinics.
Helena Hansen, MD
New York University
"Doctors are well trained to address the individual needs of patients. We train doctors about communication with patients, diagnosing the individual patient in front of them in the exam room," Metzl says.
"But increasingly we know there are medical conditions that are caused by a host of social and economic problems. We know that growing up in a poor area is bad for someone's brain development. It causes a host of psychiatric and other mental conditions. We know that dietary factors are linked to diabetes that is worse off in low-income areas where there are no grocery stores. The evidence mounts every day that infrastructures, economic issues, [and] wealth imbalances are all causing medical conditions. The point we are trying to make is that doctors need to be aware of the ways these social factors can impact people's lives and livelihoods."