Session 6. Conduct a Multilevel Analysis of Social Determinants of Health

2 hours

Drawing on their literature reviews, students work in discipline-specific groups to cluster social determinants at different levels: individual, household, community, national and global. They explore the links between them. Together as a full group, students map out a conceptual framework.

Prepare

Preparation for you, the facilitator

  • Watch or re-watch the CARTA video: Multidisciplinarity. Note that this is an aid to your preparation, not for students.
  • Prepare a presentation to define and explain ‘social determinants of health’.
  • Bring sticky notes in five different colours, and string.
  • Set up a board with headings matching the colours of the post-it notes:
    Individual | Household | Community | National | Global
Outcomes

By the end of the session, students can:

  • explain the social determinants of health
  • apply a multilevel framework to analyse how social determinants operate at different levels
Steps
TimeStepWho
20 minutes1. Present: Social determinants of healthFacilitator
30 minutes2. Identify social determinantsStudents in discipline-specific groups
60 minutes3. Create a multilevel frameworkFull group
10 minutes4. Trace the impact of social determinantsVolunteers, full group
  • Step 1. Present: Social determinants of health
    20 minutes
    Introduce the concept to the whole group, with examples. Invite questions and comments. Explain the activity to come and distribute sets of sticky notes. Explain which colour signifies which level: individual, household, community, national and global.
  • Step 2: Identify social determinants30 minutes
    In their discipline-specific groups, students draw on the findings from their literature searches to identify various social determinants of the specific public-health issue. (The example in the video is under-five mortality and morbidity in Uganda.) For each determinant, the group discusses the level at which it operates: individual, household, community, national or global. Examples could be:
    • health knowledge at the individual level
    • household income at household level
    • distance from the nearest clinic at community level
    • policy at national level
    • migration at a global levelThey write down each social determinant on a sticky note in the relevant colour.
  • Step 3: Identify social determinants
    60 minutes

    In the full group, invite a spokesperson from each small group to place their sticky notes in the relevant section (as demonstrated in the video). For each determinant, the student explains why they decided it should fit at that level and how it operates as a social determinant. Encourage discussion, especially if the determinant is not placed at the correct level.Explain that, together, the group has created a research framework, and populated it. Discuss the ways in which different disciplines contribute important and often very different kinds of knowledge.

  • Step 4: Trace the impact of social determinants
    10 minutes
    Describe a different case – for example, a 40-year-old man who develops Diabetes Type 2. Invite one or more volunteers to use string to trace how social determinants might influence health outcomes in this case

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