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Effect of Social Determinants of Health Education on Recognition of Social Health Risks among Public Health Students in Nigeria

Abstract

Social determinants of health are important factors influencing health outcomes because the conditions in which people are born, grow, live, work, learn, and age can shape their exposure to health risks and their ability to access healthcare and other essential resources. Public health students require adequate knowledge of social determinants of health to identify how factors such as income, education, employment, housing, food security, social support, gender, transportation, environmental conditions, and access to healthcare contribute to health inequalities. However, limited practical understanding of these determinants may affect students' ability to recognize social and structural factors underlying health problems within communities. Social determinants of health education provides an opportunity to strengthen students' understanding of the relationship between social conditions and health outcomes and improve their ability to identify social health risks. Against this background, this study investigates the effect of social determinants of health education on recognition of social health risks among public health students in Nigeria. The study will be anchored on the Social Ecological Model, Fundamental Cause Theory, and Social Cognitive Theory. The Social Ecological Model explains how individual, interpersonal, community, institutional, and broader societal factors interact to influence health outcomes. Fundamental Cause Theory emphasizes how access to flexible resources such as income, knowledge, social connections, and power influences individuals' ability to avoid health risks and protect their health across different disease conditions. Social Cognitive Theory explains how observational learning, self-efficacy, environmental influences, and practical experiences may affect students' ability to understand and recognize social health risks. Collectively, these theoretical perspectives provide a suitable framework for explaining how social determinants of health education may influence recognition of social health risks among public health students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise undergraduate and postgraduate public health students enrolled in selected universities and other accredited tertiary institutions offering public health programmes in Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, institutions, public health departments, academic levels, and eligible students. Social determinants of health education will be assessed using indicators such as exposure to educational sessions, frequency and duration of training, knowledge of socioeconomic determinants, education and employment conditions, housing and living conditions, food security, transportation, access to healthcare, social support, gender and social inequalities, environmental conditions, community resources, health policies, and structural factors affecting health. Recognition of social health risks will be assessed using indicators such as ability to identify poverty-related health risks, recognize inadequate housing and overcrowding, identify food insecurity, recognize barriers to healthcare access, identify unemployment-related health risks, recognize educational inequalities, identify transportation barriers, recognize environmental and occupational risks, identify social exclusion and discrimination, recognize vulnerable populations, and distinguish immediate health outcomes from their underlying social and structural determinants. Data will be collected using structured questionnaires, social determinants of health knowledge assessment tools, case scenarios, community-health risk identification exercises, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize students' demographic and academic characteristics, previous community experience, exposure to social-determinants education, and baseline recognition of social health risks. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of social determinants of health education on recognition of social health risks. Where a quasi-experimental design is adopted, recognition scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the education programme. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that social determinants of health education has a significant positive effect on recognition of social health risks among public health students in Nigeria. Students exposed to structured and practical education are expected to demonstrate greater ability to identify the social, economic, environmental, and structural factors contributing to health problems than students without comparable exposure. Education may improve students' ability to recognize poverty, inadequate housing, food insecurity, unemployment, limited healthcare access, transportation barriers, environmental hazards, social exclusion, and other conditions that contribute to health inequalities. Case-based learning, community assessments, mapping exercises, and practical analysis of social conditions may further strengthen students' ability to connect social determinants with specific health outcomes and vulnerable populations. However, limited field exposure, inadequate community-level data, complex interactions among social determinants, insufficient teaching resources, and limited opportunities for practical application may reduce the effectiveness of education alone. The study therefore expects practical, context-specific, field-oriented, and competency-based social determinants of health education to contribute significantly to improved recognition of social health risks among public health students in Nigeria. The study is expected to contribute to the literature on social determinants of health, health inequalities, public health education, community health assessment, health equity, social epidemiology, health promotion, and public health practice in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, universities, schools of public health, public health departments, professional and accreditation bodies, community health organizations, development partners, public health practitioners, and policymakers regarding strategies for strengthening students' understanding of the social causes of health problems. The study will also provide evidence-based recommendations for integrating comprehensive social determinants of health education into public health curricula, expanding case-based and field-based learning, strengthening community assessment activities, improving students' ability to identify vulnerable populations and health inequalities, and developing competency-based training programmes that prepare public health students to recognize and address social health risks across Nigeria.

Keywords: Social determinants of health education, social health risks, public health students, health inequalities, health equity, social epidemiology, community health, health promotion, public health education, Nigeria.