COURSE SYLLABUS
“Cultural Factors in Public Health Policy”
Course #280.375
3 Credits
Spring Semester 2004
Friday 12:30-1:50
Instructor: Thomas A. LaVeist, Ph.D.
Department of Health Policy and Management
Bloomberg School of Public Health
Hampton House (East Baltimore Campus)
COURSE DESCRIPTION
The objective of this course is to familiarize students with the aspects of culture that influence health status, the development of public health policy, and the management and practice of health care. The course will be taught in both lecture and seminar format. Each week there will be readings from the medical, social science and public health literature that will discuss various aspects of cultural influences in public health. Among the aspects of U.S. culture that will be discussed are: race, ethnicity, gender, social class, and nationality. These cultural factors impact patient-provider interaction, health and illness behavior, health care provider decision-making; all of which ultimately effects health status. Additionally, there will be periodic guest speakers from among the health care providers, health care managers and policy-makers in the Baltimore area to discuss ways in which they have addressed cultural issues in their careers.
COURSE FORMAT
The course will be conducted as a combination of lectures and seminar (class group discussions of readings). In addition there will be occasional films and guest lecturers.
COURSE REQUIREMENTS
Students will be expected to attend all class sessions, complete all readings, complete a 10 page research paper on a health related topic incorporating the concepts learned in the course, students will be required to write two brief (2 page) essays on and complete one in-class final exam.
COURSE READINGS
Course readings will be on reserve at the Milton S. Eisenhower Library accessible through the library’s web site.
COURSE GRADING
Attendance will be recorded each week. All students are required to attend all classes. Students are also expected to complete all readings and participate in the class discussions. Grades will be determined by the following formula: attendance - 10%, policy memo 25%, group project 50%, seminar participation and required reading - 15%.
RESEARCH PAPER
The ten page (double spaced) research paper will consist of the following sections: (1) Background (Epidemiology of the problem, outlining race/ethnic differences if any), (2) List published theories explaining why race/ethic differences exist, (3) evaluation of the theories, (4) Annotated Bibliography of 10 articles in academic journals or books (no web sites, newspapers or magazines), (5) Five Discussion Questions for class discussion.
COURSE SCHEDULE
SESSION 1 – January 28, 2004
Introduction and Course Overview
Administration of questionnaire on the Health Social Status of the US Population
SESSION 2 – January 30, 2004
Questionnaire results
The Epidemiology and Demography of Minority Health
Readings:
Chapter 1 “Introduction: Why we should study race, ethnicity and health”
SESSION 3 – February 4, 2004
Historical Issues in Minority Health 1
Readings:
Chapter 2 Shades of Difference: Theoretical underpinnings of the medical controversy on Black-White differences in the United States, 1830-1870” Nancy Krieger
SESSION 4 – February 6, 2004
Historical Issues in Minority Health 2
Readings:
Chapter 3 “Under the Shadow of Tuskegee: African Americans and Health Care” Vanessa Northington Gamble
Film:
“Bad Blood: The Tuskegee Syphilis Study”
SESSION 5 – February 11, 2004
Conceptual Issues in the study of race, ethnicity and health
Readings:
Chapter 6 “A Note on the biological concept of race and its application in epidemiologic research” Richard Cooper
Chapter 7 “Beyond dummy variables and sample selection: What health services researchers ought to know about race as a variable” Thomas A. LaVeist
SESSION 6 – February 13, 2004
Disparities in Healthcare 1
SESSION 7 – February 18, 2004
Disparities in Healthcare 2
Organization of Group Assignment
SESSION 8 – February 20, 2004
Discussion session on health status and healthcare disparities
Readings:
Chapter 10 “Racial and ethnic differences in access to medical care” Robert Mayberry, Fatima Mili, and Elizabeth Ofili
Chapter 11 “Disparities in health care by race, ethnicity and language among the insured: Findings from a national Sample” Kevin Fiscella, Peter Franks, Mark P. Doescher, Barry G. Saver
SESSION 9 – February 25, 2004
Class will convene for the Center for Health Disparities Solutions Lecture Series.
Location to be announced.
SESSION 10 – February 27, 2004
Issues in Minority Mental Health
Guest Lecture: Dr. Duane Thomas, Johns Hopkins University, Center for Health Disparities Solutions
Readings:
Readings to be distributed in class
SESSION 11 – March 3, 2004
Theories: Why health disparities exist 1: Socioeconomic Status, Risk Exposure, and Resource Deprivation
Readings:
Chapter 21 “Racial residential segregation: A fundamental cause of racial disparities in health” David R. Williams and Chiquita Collins
Chapter 26 “Solid waste sites and the Black Houston Community” Robert D. Bullard
Chapter 28 “Probing the meaning of racial/ethnic group comparisons in crack cocaine smoking” Marsha Lillie-Blanton, James A. Anthony, and Charles R. Schister
Chapter 24 “Neighborhood characteristics associated with the location of food stores and food service places” Kimberly Morland, Steve Wing, Ana Diez Roux, Charles Poole
SESSION 12 – March 5, 2004
Theories: Why health disparities exist 1: Weathering Hypothesis, John Henryism, Assimilation and Integration, Discrimination, and Biogenetic differences
Readings:
Chapter 12 “Black-white differences in the relationship of maternal age to birthweight: A population-based test of the Weathering Hypothesis” Arline T. Geronimus
Chapter 20 “John Henryism and the health of African Americans” Sherman James
Chapter 15 “adverse pregnancy outcomes: Differences between U.S. and Foreign-born women in major U.S. racial and ethnic groups” Gopal K. Singh and Stella M. Yu
Chapter 17 “Levels of Racism: A theoretic framework and a gardener’s tale” Camara P. Jones
“Do races exist” Scientific American December 2003
SESSION 13 – March 10, 2004
Class Cancelled
SESSION 14 – March 24, 2004
No Class: Midterm paper due by 4:00
SPRING BREAK MARCH 16-19
SESSION 15 – March 26, 2004
Community Health
Readings:
Chapter 27 “Health risk and inequitable distribution of liquor stores in African American neighborhoods” Thomas A. LaVeist and John M. Wallace
SESSION 16 – March 31, 2004
Risk Factors for Community Health
Guest Lecture: Dr. Shanni Harris Peterson, Johns Hopkins University, Center for Health Disparities Solutions
Readings:
Readings to be distributed in class
SESSION 17 – April 2, 2004
Health Behavior and Minority Health
Readings:
Readings to be distributed in class
SESSION 18 – April 7, 2004
Chronic Conditions and Minority Health
Guest Lecture: Dr. Sharon Smith, Johns Hopkins University, Center for Health Disparities Solutions
Readings:
Readings to be distributed in class
SESSION 19 – April 9, 2004
Gerontology: Aging and Minority Health
Readings:
Readings to be distributed in class
SESSION 20 – April 14, 2004
Groups Presentations
SESSION 21 – April 16, 2004
Group Presentations
SESSION 22 – April 21, 2004
Group Presentations
SESSION 23 – April 23, 2004
Group Presentations
SESSION 24 – April 28, 2004
No Class
SESSION 25 – April 30, 2004
Group Presentations
SESSION 26 – May 5, 2004
Final Paper Due
1