Abstract

Over the last fifty years various schools of thought have begun to consider factors that determine not only health but also behavioural wellness for disadvantaged communities. Historically, bench science focused on biomedical findings which, through translation endeavours, contributed to lifesaving applications in clinical care. Contemporary investigations in public health, however, suggest that a second paradigm, nonmedical factors, may exert a broader influence on physical and behavioural wellness than targeted medical strategies. Some [1] posit that this emerging body of research suggests that social factors have a significant impact on the physical and mental wellness of populations. This does not deny that medical care influences health; rather, it indicates that medical care is not the only influence and suggests that it effects may be more limited than commonly thought, particularly in determining who becomes sick or injured in the first place. Authors [2] continue to elaborate that current medical intervention strategy to reduce health disparities do not typically take a “life-course perspective” and tend to be disease-specific, often targeting individual and health systems factors without addressing social or behavioural influences. Shifting from a medically driven paradigm, Social Determinants of Health (SDOH) are generally broad based and diverse with drivers such as socioeconomic status, education, employment, gender, and race/ethnicity. While all are significant, major academic sector suggests that employment has the most potential for positive health outcomes that are not medically driven.

To qualitatively evaluate the execution of the social determinant of employment, we present a case of an individual who participated in project Ascend, a job training portal for inner city opportunity youth that is embedded in a medical setting. The significance of our findings is discussed in the context of the importance of such a platform which uses clinical settings as a portal to address non-medical and behavioural challenges to economic advancement of underserved populations. Such a portal provided significant social support and therapeutic sessions which were critical to program continuation and ultimate employment success.