Successes and challenges of teaching the social determinants of health in secondary schools: case examples in Seattle, Washington.

This article describes a new curriculum developed by Just Health Action (JHA), which teaches the social determinants of health (SDOH) as a strategy to promote health equity. Motivated by the mounting evidence that improvements in health ultimately require taking action on the social, political, and economic determinants of health, JHA has worked since 2004 to teach adolescents critical health literacy, which combines the understanding of the SDOH with skills to take action. This article explains JHA's curricular methodology, provides two case examples of school-based partnerships, and discusses the successes and challenges the authors have experienced in their efforts. JHA's teaching has been enthusiastically received, but its biggest barrier in teaching the SDOH in secondary schools is general lack of awareness of the SDOH and their impact on health outcomes. The authors echo international and national calls to raise awareness of the SDOH through training and education. Incorporating the SDOH into secondary school curriculum first requires a citizenry convinced by its importance who will in turn influence curriculum change. The authors recommend that the SDOH be taught to health professionals in continuing education, as a required course in schools of public health, and in the new initiative to teach public health in undergraduate education.