Framing health inequalities in general practice education: a critical documentary analysis

BACKGROUND: Health inequalities represent a significant challenge for general practitioners (GPs) and how these inequalities are conceptualised in medical education may influence how GPs approach them in practise. AIM: This study used a critical constructionist approach to analyse how health inequalities are conceptualised within GP curriculum and practice documents to explore the implications for education and practise. METHODS: A qualitative, documentary analysis was undertaken, examining eleven texts from institutions involved in GP training and practise guidance. Documents were analysed using a blended inductive-deductive approach to identify dominant conceptual frameworks. RESULTS: Three main conceptualisations of health inequalities were identified: as social problems which can be changed, as variation without a cause, and as risk factors. While documents acknowledged inequalities as modifiable social issues, they often presented them without clear structural causes or political context, reducing complex sociopolitical issues to statistical variations or individual risk factors. CONCLUSION: Current framing of health inequalities in medical education documents may contribute to GP disempowerment by divorcing inequalities from their structural causes. We argue for incorporating more explicit political and structural understandings of health inequalities into medical education, enabling GPs to better navigate their role at the intersection of medicine and community advocacy.