Novel Integration of a Health Equity Immersion Curriculum in Medical Training.

Health disparities education is an integral and required part of medical professional training, and yet existing curricula often fail to effectively denaturalize injustice or empower learners to advocate for change. We discuss a novel collaborative intervention that weds the health humanities to the field of health equity. We draw from the health humanities an intentional focus retraining provider imaginations by centering patient narratives; from the field of health equity, we draw the linkage between stigmatized social identities and health disparities. We describe a longitudinal health equity curriculum for the Hospice and Palliative Medicine fellowship in Memphis, Tennessee, to give trainees exposure to the concept of structural violence and how it affects clinical care. The curriculum was developed in partnership with humanities and social sciences faculty who staff a Health Equity academic program at a small liberal arts college in Memphis. This curriculum has been implemented for the past four years in support of 22 hospice and palliative medicine fellows. Group debriefs and a mixed methods survey have revealed widespread and lasting impact towards understanding health equity concepts, enhanced communication and treatment of patients, and empowerment to address the broader needs and policies affecting patients and the communities in which they live. Ultimately, we model an educational initiative that integrates equity across the full scope of healthcare practice and equips learners with skills for sustaining compassionate practices, focusing on equity-oriented, person-centered care across the full scope of healthcare practice.

"Big Momma Had Sugar, Imma Have It Too" Medical Fatalism and the Language of Faith Among African-American Women in Memphis.

This essay offers a theological exploration of the relationship between medical fatalism and religious belonging among African-American women in Memphis. Drawing on the work of black and womanist theologians and on conversations with participants in a diabetes intervention program administered by a faith-based community health provider, I argue that how we narrate the meanings of our bodies is irreducibly religious. The language we use to interpret and communicate the meaning of our bodily existence emerges from a set of assumptions, often unarticulated, about what is of ultimate value to us. The essay focuses on three interlocking features that link faith with fatalism or hope: (1) The idea that if "I don't claim that" disease cannot enter my body; (2) the role of faith-based clinics in re-establishing trust with marginalized communities; and (3) how nuanced attention to the social location of health seekers can re-frame our understanding of patient compliance. Disrupting fatalism can only be done from within a health seeker's own narrative, and therefore, healthcare providers who learn these narratives and respect their holiness will develop more effective interventions.