Medical students' motivations for participating in an elective focused on social inequalities and health disparities.

In this study, we examine students' reasons for pursuing elective training focused on medical racism and systemic health inequities at a midwestern medical school. Data collection included semi-structured interviews with students who participated in an optional course focused on these topics. We analyzed their motivations, goals, and interests using reflexive thematic analysis and created three themes based on students' responses. Theme (1) "pre-existing conditions" focuses on students' knowledge, beliefs, worldviews and experience prior to the class. Theme (2) "enacting change" examines their desires to become effective physicians and improve medicine overall. Theme (3) "creating community" considers their preferences for a supportive and connected learning and social environment. We discuss the findings within the context of adult learning theory and Self-Determination Theory. The research provides insight about the overt and underlying factors that drive medical students' participation in training focused on social inequality. We also share recommendations for curriculum development and future research based on the patterns we found in students' discussions of their needs and expectations.

Assessing Organizational Capacity to Advance Health Equity: Mixed-Methods Approach at a Local Health Department.

Local health departments (LHDs) play a leading role in eliminating health inequities as they proactively identify and address barriers to optimal health within the community they serve. This study evaluated a Midwestern County LHD's commitment, collaborations, and capacity to advance health equity in their organization. A total of 81 employees completed the online survey (response rate = 51%) and 12 among randomly selected employees completed the qualitative interviews (31.5%). More than 75% of participants reported that all departments had explicit work plans and 50% had a strong capacity to address social determinants of health. Almost 50% of the participants reported strong internal collaboration, but less than 25% indicated that no external partners were involved during the program planning process. Finally, a few participants identified the need for increased diversity in leadership and expressed the importance of quality training and feedback.