The dynamics of poverty, educational attainment, and the children of the disadvantaged entering medical school
The dynamics of poverty, educational attainment, and the children of the disadvantaged entering medical school
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DOI：
10.2147/amep.s196840
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发表时间：
2019-01-01
影响因子：
2
通讯作者：
Baugh, Reginald F.
中科院分区：
文献类型：
--
作者：
Baugh, Aaron D.;Vanderbilt, Allison A.;Baugh, Reginald F.
大约三分之一的美国人口生活在贫困线或附近;然而，这个群体占入学医学生的不到7%。在联合王国，社会最高阶层的人进入医学院的比率是社会最低阶层的人的30倍。为了解决健康差距和改善患者护理，作者认为，必须克服弱势群体子女进入医学院的重大障碍。贫困是代际和多层面的。家庭财富影响机会和教育程度，从孩子小的时候开始，随着年龄的增长而加剧。此外，这些学生在接受高等教育方面存在结构性和其他障碍，例如财政援助的现实和债务的阴影。然而，医学教育界可以采取措施，在整个教育过程中更好地支持弱势群体的儿童，使他们能够进入医学院。如果教育工作者重视丰富学习环境的不同学生的观点和生活经验，他们必须承认弱势儿童带来的独特贡献，并努力增加他们在医学院和医生队伍中的代表性。我们描述了弱势群体与医学院招生所使用的指标进行对比，以确定他们。贫穷的多个方面对教育程度的影响进行了探讨，包括其与其他社会身份的相互作用，代际影响，以及财富与年收入的重要性。结构性障碍准入审查。鉴于贫困的多维度和累积性，我们得出结论，如果没有显著和持续的干预，来自弱势背景的医学院申请者仍然很少，影响护理患者的劳动力问题将无法得到解决。强调了医生和医学院的作用，并倡导必要的社会变革，以缓解这种动态。
Approximately one-third of the US population lives at or near the poverty line; however, this group makes up less than 7% of the incoming medical students. In the United Kingdom, the ratio of those of the highest social stratum is 30 times greater than those of the lowest to receive admission to medical school. In an effort to address health disparities and improve patient care, the authors argue that significant barriers must be overcome for the children of the disadvantaged to gain admission to medical school. Poverty is intergenerational and multidimensional. Familial wealth affects opportunities and educational attainment, starting when children are young and compounding as they get older. In addition, structural and other barriers exist to these students pursuing higher education, such as the realities of financial aid and the shadow of debt. Yet the medical education community can take steps to better support the children of the disadvantaged throughout their education, so they are able to reach medical school. If educators value the viewpoints and life experiences of diverse students enriching the learning environment, they must acknowledge the unique contributions that the children of the disadvantaged bring and work to increase their representation in medical schools and the physician workforce. We describe who the disadvantaged are contrasted with the metrics used by medical school admissions to identify them. The consequences of multiple facets of poverty on educational attainment are explored, including its interaction with other social identities, inter-generational impacts, and the importance of wealth versus annual income. Structural barriers to admission are reviewed. Given the multi-dimensional and cumulative nature of poverty, we conclude that absent significant and sustained intervention, medical school applicants from disadvantaged backgrounds will remain few and workforce issues affecting the care patients receive will not be resolved. The role of physicians and medical schools and advocating for necessary societal changes to alleviate this dynamic are highlighted.