Enhancing student understanding of cardiovascular disease burden in marginalized communities in the physiology classroom.

Physiology education is at the core of biomedical science and medicine. Physiology unites multiple disciplines to explain the mechanisms whereby a risk factor is associated with disease. Race, ethnicity, sexual orientation, and gender identity are associated with risk of cardiovascular disease (CVD). Minority stress theory attempts to explain the association of identity variables in sex and gender minority (SGM) and Black, Indigenous, and people of color (BIPOC) populations with CVD. However, instruction on how to effectively incorporate the ways that social determinants of health are linked to disease outcomes in marginalized populations, such as the SGM and BIPOC communities, is needed. We investigated the efficacy of teaching minority stress theory concepts in a single lecture in an upper-level cardiovascular pathophysiology course (N = 44 students). To test students' understanding of minority-related disease, we used both subjective and objective measures to evaluate student understanding before and after the lecture. Student self-assessment of understanding of health disparity physiological mechanisms and lifestyle and pharmacological interventions to reduce health disparities in SGM communities increased post intervention. We observed similar results of self-assessment of understanding of health disparity physiological mechanisms and appropriate lifestyle and pharmacological interventions to reduce health disparities regarding the BIPOC community. Our findings suggest that integrating social determinants of health into pathophysiology courses may result in a more inclusive-minded scientific and medical workforce.NEW & NOTEWORTHY Physiology education has historically lacked the inclusion of the social determinants of health and discussion of medically marginalized communities. Here, we show that discussion of cardiovascular disease and psychosocial stress in marginalized communities improves student understanding of the distribution of and causes of cardiovascular disease in marginalized groups. We conclude that more physiology instructors should include discussions on chronic diseases within multiple communities and programs should incorporate social determinants of health into their curricula.