David S. Jones’s research while affiliated with Harvard Medical School and other places

In a world of growing health inequity and ecological injustice, how do we revitalize medicine and public health to tackle new problems? This groundbreaking collection draws together case studies of social medicine in the Global South, radically shifting our understanding of social science in healthcare. Looking beyond a narrative originating in nineteenth-century Europe, a team of expert contributors explores a far broader set of roots and branches, with nodes in Sub-Saharan Africa, South America, Oceania, the Middle East, and Asia. This plural approach reframes and decolonizes the study of social medicine, highlighting connections to social justice and health equity, social science and state formation, bottom-up community initiatives, grassroots movements, and an array of revolutionary sensibilities. As a truly global history, this book offers a more usable past to imagine a new politics of social medicine for medical professionals and healthcare workers worldwide. This title is also available as open access on Cambridge Core.

Climate change, air pollution, and ecological degradation impact health through numerous, complex mechanisms. To train future physicians to understand these impacts, medical schools can deliver longitudinal climate curricula in undergraduate medical education, but the field remains nascent. This report describes the development, implementation, and evaluation of the longitudinal, integrated Climate Change, Environment, and Health curricular theme and novel competency framework at Harvard Medical School (HMS). A group of HMS students collaborated with faculty to integrate climate content into the pre-clerkship curriculum. The team subsequently pursued institutional recognition as a formal HMS curricular theme and created a new competency framework that guided curriculum integration mapping and evaluation tool development. The competencies cover the impact of climate change, air pollution, and ecological degradation on health in the context of historical and structural inequities and explore the role of healthcare in contributing to both climate change and solutions. A retrospective, eight-item survey using a seven-point Likert scale and two open-ended questions was administered at the end of the pre-clerkship curriculum. HMS approved a required, four-year Climate Change, Environment, and Health curricular theme in January 2023. Survey data from 100/134 (74.6%) study participants showed that most students agreed (somewhat agree/agree/strongly agree) the curricular theme was valuable (76.0%) and improved their understanding of the health impacts of climate change (80.0%). Most students agreed that their abilities in the five competencies improved because of exposure to the curricular theme. Qualitative comments indicated that students found the curriculum valuable, and also provided constructive feedback. Efforts to expand the curriculum to all four years of medical school and conduct further evaluation continue. Further scholarship is needed to present different curricular approaches and competency frameworks, which can ultimately support effective training of future physicians to understand and respond to the impacts of climate change on health and health equity.

As Shanghai industrialised, its Chinese and European residents suffered the scourge of coal-powered cities: smoke. Air pollution became a multi-sensory reality. Residents could see, smell, feel and taste the smoke that shrouded the city. Inspired by anthropologists and historians of the senses, we mined Chinese- and English-language sources to document the emergence of experiences of air pollution in Shanghai. Concerns began earlier than other historians have appreciated. The vigorous complaints from all parts of Shanghai society illuminate how the city’s governments attempted to respond to the crisis and mitigate the toxic consequences of industrialisation. We found many obstacles to the success of the governments’ approaches. While other scholars have emphasised Shanghai’s fractured governance, we also found evidence of financial conflicts of interest, industry obfuscation and anti-Chinese racism. Our work expands the understanding of the history of air pollution in China and offers a model that can be used to extend global histories of air pollution beyond their traditional focus on Europe and North America.

OBJECTIVE To improve patient outcomes and promote health equity, medical students must be taught not only biomedicine, but also the social sciences to understand the larger contexts in which patients live and health care operates. Yet, most undergraduate medical education does not explicitly cover these topics in a required, longitudinal curriculum. METHODS In January 2015 at Harvard Medical School, we created a two-part sequence (pre- and post-clerkship) of required, 4-week multidisciplinary courses—“Essentials of the Profession I and II”—to fill this gap. “Essentials of the Profession II (EOP2)” is an advanced social sciences course anchored in patient narratives and the lived experiences of students and includes clinical epidemiology and population health, healthcare delivery and leadership, health policy, medical ethics and professionalism, and social medicine that engages students to conduct structural analyses to be effective healers, advocates, and leaders. RESULTS Per student course evaluations, the overall course rating was 1.7 (SD 0.9, 1 = excellent and 5 = poor); its overall rating has improved over time; and it has scored well even when run virtually. It was rated highly in application of critical thinking, integration of the disciplines, and relevance for clinical work. Qualitative analyses of student responses revealed the following key course strengths: breadth of topics, teaching faculty and guest speakers, and small group discussions. The weaknesses included workload, lack of diversity of opinions, repetition, and time spent in lectures. CONCLUSIONS We argue that EOP2 is “essential” for post-clerkship medical education. It offers an opportunity to re-ignite and enhance humanism and activism; remind students why they chose the medical profession; equip them with frameworks and toolkits to help them to overcome challenges; and devise solutions to improve health care and patient outcomes that are applicable to their future training and ongoing practice of medicine.