Human Science Professor Develops New Course on Social Determinants of COVID-19

March 24, 2021 – This semester, Dr. Debbie Barrington, assistant professor of human science, is teaching a new course she developed on the social determinants of COVID-19.

As a social epidemiologist, Barrington conceptualized the class last year as the world and the United States were learning more and more about the SARS-CoV-2 coronavirus and the disproportionate impact it would have on the most vulnerable. 

“It made me sick to my stomach to know that there was going to be differential pain and suffering – once again, these profound social inequalities with a new emerging disease,” she said. 

“What do you do,” Barrington recalled asking herself. The professor’s answer: “You teach, you train the next generation to understand the social determinants of health.”

Social Determinants

Barrington added that the social determinants of health and disease involve “where we live, we learn, we work, we play, we pray, we age, we grow” and that COVID-19 threatened to illuminate and exacerbate the “social inequalities that we already have.”

Given that many students go on to medical and graduate school, Barrington wanted to offer a course to really immerse undergraduates in the complex issue. She also has some graduate students in the class. 

“Food insecurity; low-wage jobs, especially those in factories and food processing plants and services; poor education – the list goes on and on,” she explained. “We keep reproducing our social inequalities, and we have to train people how to think about them in real time when new diseases emerge.”

‘Highlight of My Week’

Diana Keeler (NHS’22), who is on the policy track in the health care management & policy major, says the class “is always the highlight of my week” and has introduced her to the “predominant role” of social determinants in COVID-19 and previous pandemics.

“Through readings, writing assignments, lectures, and group discussions, the class has been able to identify bi-directional relationships between SDOH and COVID-19,” said Keeler, who minors in women’s and gender studies. “We have seen how COVID-19 has impacted social determinants of health – the virus is perpetuating issues with food insecurity, depression and anxiety, failing grades in school, job losses, physical inactivity, and religious practices.” 

She added, “Conversely, we have seen how social determinants of health have influenced COVID-19 outcomes – residential segregation, income inequality, access to nutrition, and ability to exercise have all shown significant effects on COVID-19 morbidity and mortality rates.”

Keeler said that, so far, her favorite assignment has been doing a photo-based comparison showing attitudes toward alcohol – as a social determinant – during the 1918 influenza and COVID-19.

A Community Focus

Building on the Jesuit ethos of cura personalis, or care of the whole person, Barrington discussed a concept she calls cura civitas, or caring for the community. 

“It requires a population-based solution,” she said, noting a core focus on changing the inequalities adults and children who have the least are and have been experiencing. 

Barrington highlighted she is really proud to be able to introduce her students to the work of the transformative medical historians, medical sociologists, and social epidemiologists who contributed to her own educational formation in the field.

“It’s wonderful to introduce this next generation to some of the people who trained me, so that they can see where they sort of left off, and where we can move on ahead so that we could finally make a dent in and eventually eliminate inequalities in health,” she said.  

Advancing Equity

Barrington described that within the past 20 years progress has been made in being able to name racism – versus “perceived discrimination” – as a factor in health inequity. 

“We have to do more than just changing the language,” she said, adding that solutions must involve improving “the economic status of people” and eliminating “racial and ethnic disparities.”

For Barrington, this means finally addressing poverty, improving educational opportunity, bettering housing options, focusing on income disparities, and advancing food equity.

“We have these disparities by social identity, by racial identity,” Barrington said. “But the solutions have to be amenable to all who are in lower socioeconomic strata, regardless of identity, and that’s how we get ourselves out of it.”  

‘Going Forward’

Maeve Williams (C’22), a biology of global health major, said the course “has given me so much insight into how the current pandemic is affecting health and inequality in the U.S.”

“What I love most about the class is that Dr. Barrington encourages us to think creatively and come up with potential solutions to problems that have arisen due to COVID-19 while still emphasizing the importance of remaining grounded in facts and data,” Williams said. “The topics we are learning aren’t just going to be relevant during the pandemic. They are also critical to creating a more equitable health care system and society going forward.”

By Bill Cessato