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Abstract

Recent healthcare reforms have reduced the numbers of uninsured, initiated programs to restrain healthcare spending and have presented the opportunity for a reassessment of population health. Literature spanning the last several decades has made clear that health disparities in the U.S. are driven by social determinants and are reproduced across generations. Medical education, however, has traditionally not trained physicians to identify structural barriers to health, rather patient behavior has been the emphasis. This study analyzes the presence and variation of structural competency among practicing U.S. doctors. Ordered logistic regression and descriptive statistics are used to assess survey data from 1000 primary care physicians in the U.S. I report on which characteristics of physicians themselves - gender, age, exposure to at risk populations - impact their likelihood of identifying social determinants as important to patient health and whether the characteristics of their patient pools (percentages of minority and low income patients) also impact their perceptions and practice. Additionally, I present findings on which factors physicians identify as most negatively impacting their patients’ health, demonstrating discrepancies in theoretical and practical applications of structural competency.

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