Cultural and Structural Competency: An Application Among Patients Awaiting Spinal Surgery

Abstract

Socioeconomic and demographic factors have been linked to clinical markers of health and general feelings of well-being in healthcare settings. Current conceptualizations of the social determinants of health and how such factors manifest to create health disparities is limited. To overcome this gap in knowledge, the concepts of cultural and structural competency work to provide physicians with a deeper understanding of how patient culture and large, societal structures shape patient narratives of health and healing. My thesis explores how patient sociodemographic factors associate with subjective health measures for adults with chronic back pain. Specifically, my research displays a descriptive, pre-operative study of patients awaiting spine surgery at the Vanderbilt University Medical Center. I use multivariable regression models to determine the relationship between patient sociodemographic factors and poor health status, depression, and disability and argue that physicians trained in cultural and structural competency are able to administer better care to the patients they serve. Overall, this project sheds new light on the traditional view of the social determinants of health and shows how patient health can be cultivated outside the confines of medical practice.