Purpose
Social determinants of health (SDoH) play a significant role in shaping health outcomes, contributing to 30-55% of health disparities. The United States Healthy People 2030 guidelines emphasize creating environments that promote health equity. Medical school SDoH curricula often focus on knowledge acquisition rather than practical skills application for addressing SDoH in clinical settings. Most schools do not offer experiential teaching of SDoH, and the existing literature reveals that outcomes of teaching are mostly self-assessment or subjective reports. This study describes student clinical experiences with SDoHs at three US medical schools.

Methods
Pediatric clerkship students wrote patient reflection papers identifying CDC SDoH categories and at least one proposed intervention for SDoHs. Thematic inductive and deductive qualitative analysis of de-identified reflections was completed using Dedoose software. A socioecological theory framework was used for the analysis of proposed student interventions. IRB exemption was obtained at each institution.

Results
Our preliminary analysis includes 42 (11) % of the 374 student reflections. Economic stability (14/42; 33%) and healthcare access and quality (12/42; 28%) were the most identified SDoHs. The least discussed SDoHs were education quality and access and neighborhood and the built environment (each 4/42; 9.5%) Students cited intrapersonal (17/42; 40%) and community level (21/50; 42%) SDoH interventions most frequently. The least cited intervention was institutional level (7/42; 16%).

Conclusion
Educators are facing equity teaching restrictions in many locations. SDoH teaching allows use of a different lens in teaching health care equity. Our study highlights SDoH areas and levels of interventions not commonly encountered by medical students. We hope to have the entire sample analyzed fully for this conference. This information can be used to build more robust clinical curricula to improve health equity outcomes.