Integrating health disparities content into health informatics courses: a cross-sectional survey study and recommendations (Preprint)

BACKGROUND Research suggests that while informatics solutions can help understand and address health disparities, there is potential for solutions to exacerbate existing or create new health disparities. To help future research and development of equitable solutions, we need to look upstream at how disparities are being integrated into informatics training programs. Doing so provides understanding and informs development of curricula that provide a foundation for future informaticists to build solutions that are ethical and equitable. OBJECTIVE To examine how the topic of health disparities is integrated into informatics courses. METHODS This cross-sectional, descriptive study took place April-October 2019 in the United States. Individuals teaching courses in informatics programs were recruited via listservs and email to complete an online survey. Instructors were eligible if they integrated disparities content into their informatics courses. Survey questions examined administrative aspects of the course (e.g., class size, mode of teaching, discipline of enrolled students) and disparities content integrated into the course (e.g., social determinants of health [SDOH] covered, how students were assessed on disparities related content). Participants also reported challenges they faced integrating disparities content into their courses. Quantitative data were analyzed using descriptive statistics; qualitative data were analyzed using inductive coding. RESULTS Invitations were sent to 141 individuals, including contacts for the National Library of Medicine (NLM) biomedical informatics training programs, and 11 listservs. We obtained data for 24 informatics courses that contained health disparities content. Courses were taught primarily in graduate programs (n=21, 87.5%) in informatics (n=9, 33.3%), nursing (n=7, 25.9%), and information science (n=6, 22.2%). Of the 24 courses, six (25.0%) were taught in an NLM training program. The most frequently covered SDOHs were socioeconomic status and race/ethnicity (both n=21, 87.5%); the least frequently covered were body type (n=0), low resource areas (n=2, 8.3%), and urban residences (n=3, 12.5%). Instructors noted three main types of challenges when integrating disparities related content into their courses: the need for additional resources, student-related challenges, and topic sensitivity. CONCLUSIONS Our sample included 24 informatics courses -- fewer than we had hoped -- that integrated disparities content; these courses spanned disciplines and varied in terms of the topics covered. Based on our findings, we provide recommendations for the intentional development of informatics programs to support the training of future generations of informaticians with foundational and transnational knowledge in health disparities so they are well-equipped to develop equitable informatics solutions. CLINICALTRIAL This study was not a clinical trial.