Game Changer: Tackling Social Determinants of Health with The Last Straw
By Natasha Nurse-Clarke, RN, PhD, FAAN
Imagine you are an older senior living in a neighborhood with many high-rise apartment buildings. You’d like to spend more time with your neighbors. What do you do? Fear not!
Your group in the game, The Last Straw, has come up with several interventions to reduce isolation and has saved you from loneliness! This is an example of one of the scenarios players were faced with during a session at the most recent NASAGA Conference in St. Louis, MI. The Last Straw is a game that encourages not only learning but also empathy and innovation in the context of social determinants of health (SDOH).
Participants enjoyed the session's immersive nature, which transported them into the world of individuals at different stages of life, with various socioeconomic statuses, genders and races. The engaging nature of the game set the tone for a session filled with creativity, empathy, and problem-solving.
As the session unfolded, attendees actively immersed themselves in The Last Straw board game, engaging in discussions, decision-making, and collaborative interventions to combat issues related to the social determinants of health which encompasses the conditions in the environments where people live such as food, housing, socioeconomics and much more.
Following the gameplay, we all had a lively group discussion, where we shared insights and offered feedback on the game's educational effectiveness. While most players enjoyed the game, some who had overly traumatic experiences as a result of their status during the game expressed their feelings of sadness and hopelessness due to the conditions they were exposed to. For instance, roles with a disability lost “vitality points” during each turn, exponentially increasing the likelihood they would be eliminated from the game. Participants from lower socioeconomic backgrounds consistently lost more vitality points throughout the game and found it difficult to break out of this cycle.
While a subtle theme of despair was described, players also described some of the realistic experiences they encountered during the game. For instance, in the childhood phase, kids from lower socioeconomic backgrounds may not have been able to go outside and play because there was no safe area or park in their neighborhood. At the adolescent phase, issues such as bullying or racism affected players who were assigned a certain race or sexual orientation. As with most games, many of these consequences were exaggerated. However, the purpose of the game is ultimately achieved by making players think critically about current inequalities within our own societies due to their experiences during the game.
This game really demonstrated the potential that game-based learning has to better understand the world around us. By providing players with certain challenges and scenarios within a simulated environment, it can be easier to identify social issues and understand how real-world situations can have an effect on individuals of different backgrounds.
The session left a lasting impression on attendees, emphasizing the importance of addressing SDOH and sharing an innovative approach to do so. The Last Straw board game has successfully combined learning, empathy, and innovation, making it a standout experience at the NASAGA Conference in St. Louis, MI.
Natasha Nurse-Clarke is an Associate Professor of Nursing and Undergraduate Program Director at Lehman College, City University of New York. She is a current NASAGA Board member and an avid lover of gamification and game-based learning.