How I teach: Integrating health equity into infectious diseases education for student learners
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“So, you’ve built this equitable model to address disparities in infectious diseases, but what’s your plan for sustainability?”
I’m asked this question nearly every time I give a presentation on the community-based model I’ve developed in partnership with a faith-based organization to address vaccine equity disparities within vulnerable southern Californian Black communities. The first time I was asked, the question shook me. I had to sit with myself and be honest about my goals for the intervention, and I had a running list of questions on a loop in my head.
The one that stood out the most was “How can we maximize the intervention to serve other minoritized communities?” because this was the ultimate endpoint. As I racked my brain for the answer, it became clear that there was only one solution to the dilemma. It would be imperative for me to pass down the vaccine equity knowledge I had gained from working on the intervention to other health care professionals, specifically the students I teach at the UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences.
More importantly, it would be critical for me to translate health equity education into something easily consumable for the students to ensure they could identify practical opportunities for knowledge application.
Building a course with key principles and life experiences
The insight from this internal conversation led to “Exploring the Intersection of Racism, Antimicrobial Resistance and Vaccine Equity,” an elective course that launched in April 2024 for pharmacy and medical students and highlights how social determinants of health inequities influence disparities in infectious diseases.
I quickly realized that the most challenging part of developing the course would be creating the storytelling narrative to deliver the material. As a pharmacokinetics and pharmacodynamics researcher and educator, disseminating equity-focused information was unfamiliar. Thus, I heavily relied on the Centers for Disease Control and Prevention’s Principles on Communicating About Health Equity Concepts. These are:
- Meet the audience where they are.
- Communicate health equity as a “we” issue.
- Frame health equity as achievable.
Each principle includes tips for applying them when discussing health equity. With this guidance, I created a working framework to guide the creation of the content for each lecture deck.
I began each presentation by integrating my personal life experiences as a minoritized person in the U.S., which allowed me to explain concepts such as equality, equity, racism and bias to ultimately meet the audience where they were, addressing the first CHEC principle. To advance the presentation, I wove in data from existing literature to communicate health equity as a “we” issue, or the second CHEC principle. Finally, each lecture ended with a concrete example demonstrating a successful intervention addressing the highlighted disparity from earlier sections of the presentation.
This framed health equity as achievable, the third CHEC principle. For example, the course’s first lecture focused on social determinants of health and the role of healthcare professionals in identifying disparities. Following the above framework, I started the lecture with a story of my upbringing in Detroit, Michigan, and the residential segregation I experienced during my childhood. I explained how the residential segregation resulted in differences in education and health care access.
As I transitioned from my personal experience, I presented the significant findings of several research articles that described the impacts of residential segregation on health and the transmission of infectious diseases, with an intentional focus on HIV. I concluded the presentation with a reference that discussed a community-based intervention led by pharmacists to address HIV pre-exposure prophylaxis health care access barriers within socially vulnerable communities. I used this framework for each successive lecture I created and delivered for the course.
Assessing impact and next steps
Because this was a new course and teaching style for me, I also included a research component to investigate whether the material influenced the student’s perceptions and attitudes related to racism and its impact on antimicrobial resistance and vaccine equity. I also wanted to understand the class’s impact on the students’ perception of their role in addressing the inequities described throughout the course.
The research was a voluntary pre-/post-intervention study that included knowledge-based questions on social determinants of health, antimicrobial resistance, and vaccine equity and several survey questions about the students’ interest and confidence in participating in a community-based intervention to address health inequities.
While the results have yet to be presented or published, 33 students participated in the pre-/post-survey study, and I noted a 20% increase from baseline in the post-intervention assessment of the knowledge-based questions. Ninety percent of students reported that they were “very likely” to partake in a community engagement health intervention following the course. I intend to revisit and refine the material before it is offered in the spring of 2025. However, the preliminary results offer a slight nod to the proficiency of the provided content, which increases my confidence in using this framework for course content development.
As ID professionals, we must pass down what we have learned to future generations. I hope the lessons I learned in creating this course will help others advance equity-focused learning and interventions.
Photo: Jacinda C. Abdul-Mutakabbir PharmD, MPH, gives a presentation on interventions developed to address health inequities to students enrolled in the course “Exploring the Intersection of Racism, Antimicrobial Resistance and Vaccine Equity.”
