Breaking Down Silos: The Importance of Interdisciplinary Work in Healthcare.

June 17, 2024. By Lisa Regula

2023-24 Schweitzer Fellow Lisa Regula

Much to my mother’s chagrin, I will never be a doctor. More specifically, I will never be a physician, clinician, or the individual responsible for providing direct medical care to a patient in need. My role, as an epidemiologist and public health professional, is often described as distinct and independent from clinical work; public health focuses on the population while clinicians focus on the individual. The allocation of responsibility into easy-to-digest, dichotomized roles helps provide a simple framework from which health education can be developed. However, with technological advancements greatly expanding the diseases we can manage and treat, acknowledgment of how social determinants impact health will be increasingly necessary to make the next leap forward with respect to treatment. To address this effectively, it will be crucial to break down the traditional silos that dictate the existing roles of healthcare professionals and work towards an integrated approach where professionals learn from each other.

Social determinants of health refer to the non-medical factors that influence health outcomes, such as socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to healthcare. These determinants can significantly impact health outcomes. For instance, studies have shown that up to 80% of health outcomes are influenced by social, behavioral, and environmental factors.

Despite the significant body of evidence highlighting the importance of social determinants of health, there are substantial barriers to incorporating these concepts into health education programs. In fact, a 2020 study conducted by the American Medical Association found that 34% of institutional representatives indicated that teaching social determinants of health was a low priority. In discussions surrounding perceived barriers, a recurring theme was that addressing social determinants was outside the scope of the physician’s role .

Public health professionals learn extensively about social determinants of health. However, many public health students do not spend time directly interacting with patients, nor do they often engage with clinical providers in a meaningful way. This lack of interaction means that the transfer of knowledge about social determinants cannot happen organically. My own experiences as a student at UNC Chapel Hill highlight the systemic separation in health education and the inefficiency of siloed learning environments. All the health sciences-related buildings are grouped along the southwest edge of campus. The school of social work is sandwiched between the pharmacy and public health buildings, with the dental and medical schools situated directly across the street, backing up to the hospital complex. Despite sharing a cafeteria and library spaces, I rarely have the opportunity to interact with students outside of my program. Conversations with others on campus confirm that this experience is not unique. This systemic isolation among different health disciplines underscores the need for a more integrated approach to healthcare education, where collaboration and cross-disciplinary

learning are prioritized to enhance the understanding and addressing of social determinants of health.

Although shifting the traditional approach to health education feels daunting, interdisciplinary frameworks are becoming increasingly popular in health-related fields. For example, the One Health framework integrates perspectives from human, animal, and environmental health to emphasize our interconnectedness with our environment and the importance of considering multiple perspectives to accurately understand and evaluate health conditions. Such frameworks provide a promising model for how health education can move forward, breaking down traditional silos and fostering a more integrated approach to healthcare.

Prioritizing interdisciplinary work in healthcare, particularly concerning our understanding of social determinants of health, is essential. By bridging the gap between public health and clinical practice, we can ensure a more holistic approach to health that considers all factors influencing patient outcomes. This integrated approach is not just beneficial but necessary for advancing healthcare for generations to come.

Lisa Regula

2023-24 Schweitzer Fellow

UNC Gillings School of Public Health, Class of 2024