​IHI Open School Change Agent Network (I-CAN) Learning Activities

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Fifteen-year-old “Isaiah” was writhing in pain on an exam table the first time Dr. Don Berwick met him.
It was leukemia, which Dr. Berwick had the tools to cure. But there were other problems that medicine couldn’t fix. There was his drug problem; Isaiah had smoked his first dope at age 5. There was violence in his neighborhood. He’d dropped out of school, so he had no skills to find legitimate work. At age 37, Isaiah died on a street corner, brain-dead from complications of uncontrolled diabetes. What killed him? Dr. Berwick blames social forces such as poverty, violence, trauma, racism, inadequate education — social conditions he was born into. 
The World Health Organization calls these conditions the “social determinants of health.” They’re the circumstances that people are born into and live in, and they’re created by the distribution of money, power, and resources at global, national, and local levels. While clinical providers don’t always have the expertise and resources to address these needs, they can play a critical role in identifying them when their patients most need help. They can also collaborate with other members of the care team, such as social workers, to get patients that help. And this can make a big difference — according to one model, social and economic factors are responsible for as much as 40 percent of population health.
Explore our list of IHI Open School resources and activities below to start learning more about issues facing communities as they relate to the social determinants of health. This list is by no means comprehensive, there are many things we can and should do to improve these influential factors, but this should get you started on the road to improving health and may even serve as ideas for leading change.
To become a change agent and lead change, click here to learn more about I-CAN projects.
​Topic Ac​tivities & Resources Potential I-CAN Projects
  • Incorporate the Health Leads preventative care model into your local work. Create and distribute a community asset map to  doctors so they can refer services and address patients' needs.
  • ​Use electronic medical record systems to facilitate linkage, coordination, and care management for people living with HIV/AIDS.
  • Promote routine, voluntary HIV screening—including, where appropriate, rapid testing.
  • Support the mobilization of faith communities, businesses, schools, health care providers, community-based organizations, social gathering sites, and all types of media outlets to support people living with HIV and high risk communities to reduce stigma.
Community Safety and Violence Prevention
  • Introduce the trauma-informed care model and trainings into your local clinic.
  • Take action to prevent gun violence by visiting Doctors for America to sign their pledge, submit a medical student blog, or take action.
Social Disruption/ Housing
​Finished the activities and ready to do more? Here are five things you can do to improve the health of your community:
  1. Share your pledge to improve population health.
  2. Make your support visible: Share this with colleagues and friends through your networks and conversations, post on social media (@IHIOpenSchool), and invite others to pledge to take action with us.
  3. Lead and become an agent for change by conducting a project through the I-CAN course.
  4. Amplify efforts locally by joining an existing I-CAN project or by connecting with your community. Contact us to link up!