ReviewSocial science & medicine (1982)2014
Structural competency: theorizing a new medical engagement with stigma and inequality.
Review in Social science & medicine (1982), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 630 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
630 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Structural Vulnerability in Health Research: A Systematic Mixed Studies Review.Journal of advanced nursing · 2026Pooled it
- Impact of Multidisciplinary Team Care on Patient-Reported Outcomes in Patients with Lung Cancer: A Systematic Review.Current oncology (Toronto, Ont.) · 2025Pooled it
- A Systematic Review of Interpersonal Interactions Related to Racism in Studies Assessing Breast and Gynecological Cancer Health Outcomes Among Black Women.Journal of racial and ethnic health disparities · 2024Pooled it
- Effects of behavioral intervention components to increase COVID-19 testing for African American/Black and Latine frontline essential workers not up-to-date on COVID-19 vaccination: Results of an optimization randomized controlled trial.Journal of behavioral medicine · 2025Trial
- The roots of resistance: An institutional ethnography of faculty opposition to social justice curricula in undergraduate medical education.Medical education · 2026Article
- Storytelling and Citizen Science for Transcultural Critical Care Nursing: The C4 Framework.Journal of transcultural nursing : official journal of the Transcultural Nursing Society · 2026Article
- Accessible Communication in Healthcare for Deaf People as a Linguistic Minority: A Scoping Review of Barriers, Mediation Strategies, and the Governance of Care.Journal of immigrant and minority health · 2026Article
- Challenges and strategies in the multicultural sexual and reproductive healthcare encounter - a qualitative study on the perspectives of health professionals.Reproductive health · 2026Article
- Structural Racism in Healthcare: Nurses' Ethical and Professional Responsibility to Lead Structural Reform.Nursing open · 2026Article
- Preparing Resident Physicians to Protect Immigrant Patient Rights During Immigration Enforcement Encounters: A Pre-Post Educational Intervention.Journal of immigrant and minority health · 2026Article
- Article
- "It's why I'm the doctor that I am": a qualitative study of the long-term outcomes of a longitudinal service-learning medical education program.BMC medical education · 2026Article
- Combating Medical Violence Against Deaf, DeafBlind, Blind and Partially Sighted Communities: A Community-Based Research Agenda for Canada and Abroad.Healthcare (Basel, Switzerland) · 2026Article
- The English-Only Nature of Vaccine Deservedness and Harms of Racialized Administrative Burdens.Journal of racial and ethnic health disparities · 2026Article
- Understanding Multilevel Barriers to Healthcare Access Among Immigrants with Limited English Proficiency: A Qualitative Study.Journal of immigrant and minority health · 2026Article
- Between fate and fault: a qualitative study on the presence, absence and ambivalence of guilt in subjective theories of illness among patients with advanced cancer in palliative care.BMC palliative care · 2026Article
- What We Owe: A Liberatory Ethics of Harm Reduction.Nursing inquiry · 2026Article
- Diversity, equity, and inclusion considerations for anti-racist, equity-focused NICU family mental health.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Addressing the causes of 'missingness' in healthcare: a co-designed suite of interventions.BMC medicine · 2026Article
- Coming Home to the Fire: Community, Belonging, and Justice-Centered Telehealth for Transmasculine Aging Adults.Healthcare (Basel, Switzerland) · 2026Article
570 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
This paper describes a shift in medical education away from pedagogic approaches to stigma and inequalities that emphasize cross-cultural understandings of individual patients, toward attention to forces that influence health outcomes at levels above individual interactions. It reviews existing structural approaches to stigma and health inequalities developed outside of medicine, and proposes changes to U.S. medical education that will infuse clinical training with a structural focus. The approach, termed "structural competency," consists of training in five core competencies: 1) recognizing the structures that shape clinical interactions; 2) developing an extra-clinical language of structure; 3) rearticulating "cultural" formulations in structural terms; 4) observing and imagining structural interventions; and 5) developing structural humility. Examples are provided of structural health scholarship that should be adopted into medical didactic curricula, and of structural interventions that can provide participant-observation opportunities for clinical trainees. The paper ultimately argues that increasing recognition of the ways in which social and economic forces produce symptoms or methylate genes then needs to be better coupled with medical models for structural change.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.