Social Emergency Medicine

Dr Sarah Simons

Social Emergency Medicine is an emerging sub-specialty of Emergency Medicine relating to the interplay of social determinants such as housing, poverty and racial discrimination in the emergency setting.  Socially vulnerable people are more likely to present to an ED and are more likely to have significant physical and mental health issues with higher acuity. Many marginalised people have experienced significant adversity and trauma in their lifetime with long-reaching adverse implications on their health literacy and access to and compliance with healthcare.

“Trauma is [typically] car crashes & gunshots - but that’s not the trauma that sits in our ED waiting rooms, unacknowledged and often poorly managed”

ACEM President Dr Claire Skinner speaking at ICEM 2022

Social EM explores and addresses barriers within healthcare systems which affect how and why people with social vulnerabilities utilise emergency healthcare services differently from more affluent counterparts and why this  population is often further marginalised when seeking healthcare. Social EM incorporates social justice and advocacy into clinical practice from the front door and in the Australian context this also relates specifically to First Nations people and the cultural understanding of health and wellbeing in the context of colonialism and structural racism in the healthcare setting.

“Spend a few hours in any Emergency Department, from deep on a rural Indian reservation to the heart to the gritty city to the placid suburb in the grip of a methamphetamine epidemic, it will quickly become clear that this is where medicine and society meet, greet, and sometimes square off.” 

The Andrew Levitt Center for Social Emergency Medicine, California, USA

This page has a number of educational and practical resources for clinical practice in the ED to ensure that all vulnerable and marginalised patients receive the best possible care. Click on the below links for more.