Activity: Making community health diagnoses through community walks

Learning outcomes

By the end of the activity, students should be able to:

• Identify the social determinants of health in communities
• Analyse the health status of a specific community and relate it to the social determinants of health
• Balance the influence of social determinants of health on the health of communities. 

As regards transversal skills, students should be able to:

Interpersonal and socio-emotional skills:

• Express ideas clearly and fluently
• Use precise and descriptive/content-specific vocabulary to enhance the topic or message
• Share information in an organised and interesting way
• Share an analysis of the main message to interpret, synthesise and/or evaluate the meaning of the content in order to draw a logical conclusion about the topic
• Show empathy and use non-verbal communication and active listening
• Create a non-discrimination atmosphere
• Facilitate conflict resolution, remain calm under pressure, and control one’s emotions in conflict situations

Critical and creative thinking:

• Acquire, process, produce, and evaluate information critically and from the perspectives of different fields and decisions, taking into account both individual and community perspectives
• Question norms, practices, and opinions, and to reflect on own one’s values, perceptions and actions
• Develop innovative solutions to answer different questions and to create new and worthwhile ideas; elaborate and evaluate ideas in order to improve and maximise their creative efforts

Brief description of the activity

In this activity, students will make community health diagnoses through community walks and a photovoice-like learning strategy. During the community walk, students will identify the aspects that potentially have a bearing upon the health of individuals of that community (social determinants of health such as buildings, services, green areas) and take pictures of these. In increasingly bigger groups, they will have to prioritise the pictures that make the best diagnosis of the health of that community using arguments based on (a) theories of the social determinants of health and (b) available health indicators of that community. This will result in 8-9 pictures approximately that summarise the health of a specific community. 

Activity plan: step by step

Before the activity

Choose the community where the walk will take place. The choice can be based on aspects such as location, availability of health indicators, existence of health inequalities, etc. Draw a route and think of stops within the route where students will have to watch and identify social determinants of health. Examples of these stops include hospitals or other health institutions, green areas or playgrounds, crowded traffic areas, etc.

During the activity

Step 1. The walk. Meet students in the community where you will go for a walk. Start walking and make them look at their environment in order to identify social determinants of health. In each of the stops that you previously thought about, ask them what they see that may have a bearing upon that community’s health status. At the end of the walk, make a final reflection of what they think the health of that community will be like. Then, make them go back to the places where they identified the most relevant social determinants of health for that community and take pictures of these. This part should take about 90 minutes (1 hour for the walk, half an hour for the pictures).

Step 2. Prioritisation. Build groups of 3 to 4 students and make them show to each the pictures that they took during the walk. They should choose 3 pictures that better represent the social determinants of health of that community. To do so, they can build on theories of the social determinants of health, as well as on health indicators of that community. Once they picked the 3 pictures, they should meet with two other groups. There should now be 9 to 12 people in each group. Within these bigger groups, they should choose 3 pictures from the 9 (3 per group) that they already picked. Finally, all groups of 9 to 12 students should show their 3 pictures to the whole class. A debate should follow in which students should argue which pictures make the best diagnosis of that community’s health status, again, making use of theories and health indicators. The debate should end with 8-9 pictures approximately that establish an accurate health diagnosis of that community. 

Optional. In each of the two previous steps, you can incorporate stakeholders of that community (e.g. health and social care workers, community associations). Their participation both in the walk and in the prioritisation steps can aid students understand deeper how what they saw has a bearing upon that community’s health status. Therefore, it will likely build student engagement. 

After the activity

After the activity, it’s time for self-reflection. Ask students to think about where they live and whether the social determinants of health of their own community are similar or divergent from those of the community that you analysed. You can also ask them to think about their own and their families’ health status, and think about how it relates to the social determinants of health that surround them. Finally, you could also make them think about what should be changed to improve the health of communities, as well as what their role should be as health or social work professionals. 

Evaluation tool

Transversal skills are difficult to evaluate, particularly among big groups of students. Therefore, in this section we propose a tool for students to self-assess the development of these skills. The tool is divided into three dimensions: suitability of the learning activity, level of achievement of learning outcomes, and transferability to professional settings. You can adapt the dimensions and/or indicators that you use according to your teaching-learning context and needs. 

Evaluation tool to self-assess the development of skills during the activity

For each of the following statements, select the best answer on a scale from 1 to 4, where 1 means “Not at all” and 4 indicates “Yes, totally”. N/A means “not applicable”.

Download evaluation tool in pdf here.