University of Alberta
Course Guide SPH 501 Fall 2016 (Distance) DETERMINANTS OF HEALTH
Instructor: Email: Telephone:
Lori Baugh Littlejohns
[email protected] 250.688.0865
TA: Email: Telephone:
Krystyna Kongats
[email protected] 416.906.7797
TA: Email: Telephone:
Jacqueline Torti
[email protected] 780.667.2887
Table of Contents
Course Description ..................................................................................................................... 3 Course Competencies ................................................................................................................. 3 Course Readings .......................................................................................................................... 4 Course Evaluation ........................................................................................................................ 4 Student Evaluation ...................................................................................................................... 5 Academic Integrity ...................................................................................................................... 6 Course Calendar ......................................................................................................................... 7 Student Assignments .................................................................................................................. 8 Detailed Course Guide by Week.................................................................................................. 17
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
Page 2
Course Description
The conditions in which people are born, grow, live, work and age have a profound impact on health and are shaped by the distribution of money, power, and resources at the global, national and local levels. These social determinants of health shape health inequities, that is, the unfair and avoidable differences in health status seen between and within countries. Social and behavioural sciences in public health illuminate the relationship between social determinants and health inequities and explain the resulting impact on individual and population health over the life course. Research and practice in this area contributes to the development, administration, and evaluation of programs and policies in public health to ameliorate health inequities and promote health for all. Each week will comprise a combination of required readings, group discussion, and student presentations.
Course Competencies Critically analyze key conceptualizations of health and their implications for understanding population health and public health policy and practice. Identify key theories, concepts and models from a range of social and behavioural disciplines that are used to inform public health policy and practice. Explain and assess the social determinants of health and the pathways through which they impact individual and population health. Identify the role of social (and community) factors in both the onset and solution of health issues in different contexts. Define and apply appropriately the key concepts of diversity, equity, social justice, inequality, empowerment, power, system and social change. Describe/explain the principles of the socio-ecological model of health in the development of population health interventions. Communicate and disseminate data and information about health and well-being and/or stressors to health and well-being. Convey information clearly in reports and presentations appropriate to the recipient.
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Course Readings
Weekly required course readings are to be accessed through web links or e-journals via the University of Alberta Library. The University of Alberta library system’s website www.library.ualberta.ca details the range of services offered to students on and off campus. If you need further information or assistance, contact the Library's Electronic Reference Desk. Please note that students will need to access additional readings for the final paper (see Student Assignments: Final Paper below).
Recommended course pre-reading Lalonde, M. (1974). A new perspective on the health of Canadians. Ottawa: Department of Health and Welfare. http://www.phac-aspc.gc.ca/ph-sp/pdf/perspect-eng.pdf World Health Organization. (1986). Ottawa Charter for Health Promotion. http://www.who.int/healthpromotion/conferences/previous/ott awa/en/
Course Evaluation
Mid-Point Course Evaluation: We are continually looking for ways to improve the course and need to hear from students in order to do that well. Therefore, we will gather feedback and recommendations from students at the midpoint of the course. Instructions and timelines will be posted as an Announcement in eClass.
Final Course Evaluation: Following completion of the course, you will receive a standardized evaluation from the School of Public Health. We urge you to complete the questionnaire. Instructors receive a summary of the quantitative and qualitative data after grades have been submitted.
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Student Evaluation
The University of Alberta uses a letter grading system. Grades reflect judgments of student achievement made by Instructors. The following tables indicate the assignments from which students will be graded and how final letter grades will be assessed. Please see “Student Assignments” sections below for more information. Assignment Weekly posts to discussion groups
Marks /12
Student presentations of weekly topic summaries
/23
Newspaper article review (due Oct 26, 2016)
/25
Final paper (due December 6, 2016)
/40
/100
Final letter grades will be based upon the following: Letter Grade A+ A AB+ B BC+ C CD+ D F
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
Percentage Equivalent 95-100 89-94 82-88 78-81 74-77 70-73 66-69 62-65 58-61 54-57 50-53 <49
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Academic Integrity
The University of Alberta is committed to the highest standards of academic integrity and honesty. Students are expected to be familiar with these standards regarding academic honesty and to uphold the policies of the University in this respect. Students are particularly urged to familiarize themselves with the provisions of the Code of Student Behaviour and avoid any behaviour which could potentially result in suspicions of cheating, plagiarism, misrepresentation of facts and/or participation in an offence. Academic dishonesty is a serious offence and can result in suspension or expulsion from the University.
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Course Calendar – at a glance Week 1 Sept 7-13
Topic and important dates Conceptualizations of health Sign up for Student Presentation of Weekly Topic Summaries Health inequality and health inequity Lifecourse epidemiology and early childhood development
2 3 4
Sept 14-20 Sept 21-27 Sept 28-Oct 4
5
Oct 5 -11
Social exclusion
6 7 8
Oct 12-18 Oct 19-25 Oct 26- Nov 1
9 10 11 12 13
Nov 2-8 Nov 9-15 Nov 16-22 Nov 23-29 Nov 30-Dec 6
Social capital and social support Socio-ecological models Individual level of analysis Newspaper Article Review (due 26 Oct 2016) Topic for Final Paper (due 1 Nov 2016) Community level of analysis Organizational level of analysis Societal level of analysis Systems thinking Final paper (due 6 Dec 2016)
14
Dec 7-13
Critical reflection on course learnings
SPH 501 (Fall 2016) Course Syllabus
Power, politics and ideology
University of Alberta
Page 7
Student Assignments 1. WEEKLY POSTS TO DISCUSSION GROUPS Small group discussion For each week of the course small groups are created in order to facilitate depth and breadth of discussion of course readings. Students are expected to complete course readings, answer guiding questions, and post responses to designated discussion groups. We have assigned each student to a discussion group and the list will be posted in eClass. Weekly schedule for reading and posting Each week of the course starts on a Wednesday and ends on a Tuesday. It is expected that students complete the course readings (at least some) by Friday. Please post two substantive contributions per week: - the first post by Saturday, - the second post must be completed by Tuesday night and this post should be extending the discussion of other students. It is strongly recommended that you write posts in a word document first and then copy and paste into the appropriate eClass discussion section. Postings have been lost due to technology problems and this is very frustrating and time consuming. Grading of weekly posts If students post two contributions to designated discussion groups in each of the 12 weeks (as per course calendar) then they will automatically receive 12 marks. One (1) mark will be deducted for each week that students do not post at all and ½ mark will be deducted for each week where only one post is contributed to the weekly discussion. Participation through weekly posting to discussion groups is a very important part of student and peer learning as this builds the vital knowledge (course content) and skill (writing) base for other assignments in the course. Therefore, while weekly postings account for 12% of a student’s grade, the marks should not be seen as insignificant.
Role of Instructor/TA in weekly posts to discussion groups The role of the Instructor/TA is primarily one of facilitation with respect to weekly posts. For example, Instructor/TA posts will offer areas for further discussion, seek clarification of posts, and ensure discussion is on the right track. Please pose questions to Instructors within your post if the course readings are unclear as this generates excellent discussion. We strive to provide a respectful (and safe) forum for discussion.
Substantive posts include the following: Sound interpretation of required readings, Appropriate and accurate citing/ referencing of literature: Author (date) format is good. Relevant/key information for in-depth exploration of guiding questions/issues, Identification of consistencies and/or inconsistencies within and across theories, Integration/synthesize of required readings throughout the course, A sound, logical position or argument, Clear articulation of thoughts and ideas, Provision of feedback to others in a constructive manner, and Respectful response to feedback, critique of ideas and suggestions for improvement.
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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2. STUDENT PRESENTATION OF WEEKLY TOPIC SUMMARIES In order to enhance student interaction, provide an opportunity for verbal presentation (as opposed to writing), and offer students a summary of key points covered each week, we have developed a strategy for students to interview one another. In Week 1 each student is asked to “Sign Up” for a week they are available to participate in conducting an interview with another student(s). The sign up list will be posted in eClass. Signing up will be on a first come first serve basis therefore a check of your calendar will be very important. We urge you to get your name on the list as soon as possible (sign up available on the first day of Week 1 at 8 AM Mountain time). The Instructor and TA will complete an interview for Week 1 to demonstrate this assignment therefore sign up will be for Weeks 2 through 12. If for some reason students need to change the week they signed up for, it will be students responsibility to request a change with another student.
Instructions for student presentations/interviews There will be 2 or 3 students signed up for each week to complete a presentation/interview. These students are not required to post to their discussion group in their designated week. These students will automatically receive participation marks for weekly posts if they complete the presentation/interview. Students are required to study all the week’s course readings and read all posts in all discussion groups by Sunday of their designated week (it is highly recommended to start early in the week). These students will then arrange to meet at a mutually convenient time in the eClass (instructions will be posted) on Sunday or Monday (at the very latest) of their designated week to •
identify and discuss key points and summarize answers to guiding questions (based upon course readings and all other students posts for the week),
•
decide who will be the Interviewer and who will be the interviewee (these roles do not have to be formal and strict as a dialogue type interview is much more interesting), and
•
conduct and record an interview no longer than 8 minutes.
Technical instructions will be posted in the eClass. It is strongly encouraged that you test your computer’s webcam and audio software (before the beginning of the course) to ensure successful completion of this assignment. If you have technical issues students will need to contact IT. SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Grading of student presentations/interviews If students complete this assignment as per instructions above they will automatically receive 23 marks. If students do not complete this assignment they will not receive any of the 23 marks. If a student is prevented from participating in this assignment due to unforeseen circumstances (e.g., illness) it is critical to email the other student, the Instructor or TA at the earliest possible moment. If a student does not participate as scheduled (for any reason) then the Instructor or TA will be available to substitute in for that student. This will ensure that students who are ready to participate will be able to complete this assignment. Discussion with the Instructor will be necessary to explore alternatives to make up for a missed assignment. Please note that this is highly discouraged and may not be possible. Please make sure that you have got the week/dates/days/etc on your calendar and be prepared to complete this assignment. If students forget to participate then no marks will be assigned.
3. NEWSPAPER ARTICLE REVIEW Due October 26, 2016 Noon Mountain Time The goal object of this assignment is to support the integration of student’s interests, current affairs, and course content. This is an opportunity to write about a topic of interest that is in the news and to identify how the determinants of health are/are not presented. Instructions Choose a newspaper article (please stay with a newspaper article) that resonates with you regarding the determinants of health. This should be an article published in September or October 2016 and can be an article about any topic that you believe you can effectively discuss in terms of the course content and readings so far. The Canadian Newsstand Complete database available through the University of Alberta Library may be a helpful starting place. Please use the following formatting: 8 page maximum, double space, Times New Roman 12 font, and 1” margins. Use APA style, however, please feel free to use first person for this assignment.
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Organize the review in the following manner and into one word document. Send to Instructor via email. Title Page Name, title of assignment, SPH 501, and date (one page). Introduction Indicate the purpose of the review in the first sentence, explain why you chose the article, and and tell the reader what points (insights) will be covered (one page). Discussion Discuss your 3-5 insights regarding the determinants of health and back up your discussion with appropriate references from course reading (5 pages). Conclusion Summarize how you think the article does/does not build upon the course readings regarding the determinants of health (2 pages). References Provide a list of course readings or references you have cited in the assignment (i.e., in the Introduction, Discussion, and Conclusion) Appendix Include a scanned copy of the newspaper article that you have reviewed.
Please email your assignment in a word document to the Instructor.
Grading of newspaper article review (next page)
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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The following will be used to grade this assignment (25 marks):
Newspaper Article Review Good 5 pts Article Selection
Fair 3 pts
Good - The source was a reliable website or newspaper. - The author and date of the article were cited. - The article was up-to-date, within the timeframe specified, and appended to the review.
Grammar, Punctuation & Spelling
Good - Rules of grammar, usage, and punctuation are followed; spelling is correct. - Language is clear and precise; sentences display consistently strong, varied structure.
Article Summary
Good - The summary exceeded the stated requirements. Relevant information was listed and elaborated upon. - Content and purpose of the writing are clear.
Opinion & Critical Evaluation
Good - Opinion is fully supported by course readings/references. - Review demonstrates outstanding level of critical evaluation and thinking about evidence presented in the article. - Evidence is well identified and evaluated.
Personal Reflection
Good - Critical thinking and connections were made between the information and more than one determinant of health. - Numerous connections were made to course material.
Poor 1 pts
Fair - The source was a reliable website or newspaper/magazine. - The information appeared to be recent, however, the date and/or author were not cited with in the paper. - Article was appended to the review.
Fair - For the most part, rules of grammar, usage, and punctuation are followed; spelling is correct. - Language is clear and precise.
Fair - The summary met all the stated requirements. - Major points are addressed and are well supported. - Content and purpose of the writing are clear.
Fair - Opinion on topic has some support. - Review demonstrates a good level of critical evaluation and thinking about evidence presented in the article. - Evidence is identified and evaluated.
Fair - Critical thinking and connections were made between the information and one determinant of health. - One clear connection was made in relation to course material.
Missing/Unacceptable 0 pts
Poor - The validity of the source was questionable. - The date and author was not given. - Article was not appemded to the review.
Poor - Review contains some grammatical, punctuation and spelling errors. - Language lacks clarity and/or includes use of some jargon or conversational tone.
Poor - The summary recalled some information, but left out several important points. - Content is inconsistent with regard to purpose and clarity of thought.
Poor - Opinion has no support. - Review demonstrates a fair level of critical evaluation and thinking about the evidence presented in the article. - Evidence is either not identified or evaluated.
Poor - Critical thinking and the personal response to the article did not fully relate the information to any of the determinants of health. - Connections in relation to course material were unclear.
Missing/Unacceptable - There was no source cited within the review. - Article was not appended to the review. - Topic was inappropriate for this assignment.
Missing/Unacceptable - Review contains numerous grammatical, punctuation, and spelling errors. - Language uses jargon or conversational tone.
Missing/Unacceptable - The summary was inadequate and too brief. - Most of the information was left out or incomplete. - Points are unclear.
Missing/Unacceptable - Opinion is not stated. - Review demonstrates a poor level of critical evaluation and thinking about evidence presented in the article. - Evidence not identified or evaluated.
Missing/Unacceptable - Critical thinking with respect to the article was undeveloped or missing.
Organizing your ideas/insights for the newspaper article review The following template may help with organizing your ideas or insights for this assignment. Identify 3-5 key insights that you gleaned from the article and that you wish to discuss in the review. Identify the course reading or reference that gave you these insights. Please do not use other references other than course readings.
Topic Conceptualizations of health Health inequality and health inequity Lifecourse epidemiology and early childhood development Power, politics and ideology Social exclusion Social capital and social support Socio-ecological models
Insight(s)
Course Reading/ Reference to cite
4. FINAL PAPER Due December 6th, 2016 Noon Mountain Time Instructions Based upon your course learnings and your personal, professional, and/or volunteer experience choose a public health topic of your choice. Please send the Instructor your topic for feedback by November 1, 2016. It is highly recommended that you choose a topic or issue that you have had some previous experience for this paper (or a topic that you have a very keen interest in exploring). This is not a thesis: it is another opportunity to write on a topic of interest to you and integrate learnings from the course. The Public Health Agency of Canada identifies the following public health activities and these may help you select your topic (http://www.phac-aspc.gc.ca/cphorsphc-respcacsp/2008/frrc/cphorsphc-respcacsp05a-eng.php Health protection – Actions to ensure water, air and food are safe, a regulatory framework to control infectious diseases, protection from environmental threats, and expert advice to food and drug safety regulators. Health surveillance – The ongoing, systematic use of routinely collected health data for the purpose of tracking and forecasting health events or health determinants. Disease and injury prevention – Investigation, contact tracing, preventive measures to reduce the risk of infectious disease emergence and outbreaks, and activities to promote safe, healthy lifestyles to reduce preventable illness and injuries. Population health assessment – Understanding the health of communities or specific populations, as well as the factors that underlie good health or pose potential risks, to produce better policies and services. Health promotion – Preventing disease, encouraging safe behaviours and improving health through public policy, community-based interventions, active public participation, and advocacy or action on environmental and socio-economic determinants of health. Emergency Preparedness and Response – Planning for both natural disasters (e.g. floods, earthquakes, fires, dangerous infectious diseases) and man-made disasters (e.g. those involving explosives, chemicals, radioactive substances or biological threats) to minimize serious illness, overall deaths and social disruption.
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Select 5 peer reviewed journal articles beyond course readings on the topic of your choice. The selection criteria is not of greatest importance for this paper and simply selecting the most current articles would be suitable. However, it is recommended that students include an article that broadly reviews the literature on the topic and if possible an article that includes discussion of the determinants of health. The main goal of the paper is to critically review how your chosen issue is presented in the selected articles from the perspective of the determinants of health. Please follow these technical instructions: 12 page maximum, excluding title page and references APA format (does not normally allow first person) Double spacing, Times New Roman, 12 font, and 1” margins Please email your paper in a word document to the Instructor. Organization of the final paper Please use the following to title your paper: Critical review of selected literature regarding [public health topic of your choice] from a determinants of health perspective. Organize your paper with the following sections: Introduction, Methods, Results, and Conclusion In the Introduction section be very explicit in terms of the purpose of the paper, the topic you are covering, and the points you discuss in the paper. In the Methods section, you are expected to articulate your inclusion criteria for the articles you selected. That is, how and why you chose the articles. We want to learn how you chose your articles. However, please note that we will not mark on the rigor of your inclusion criteria as this is not a literature review. The purpose of the paper is to analyze how the authors integrated and discussed the determinants of health in relation to your topic. The following questions are a good starting point for the Results section: How do the articles conceptualize ‘health’? Do they focus on an individual and/or social responsibility for health? What determinants of health are addressed in the articles? (This is a critically important question to answer well). At what level(s) within an ecological approach is the issue discussed? What course readings best back up your critical review or arguments? The following questions are a good starting point for the Conclusion section: What are the strengths and weaknesses that you see in the reviewed articles? Are important linkages made between key determinants of health? Are some determinants of health missing in the presentation of the topic? Are there ways that you would recommend for a more comprehensive approach to presenting the topic (e.g., perhaps authors could have included a specific determinants of health? taken a more ecological approach?) SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Grading criteria for Final Paper Grade/40 38 -40
Description An exemplar and could be publicly presented by a leader in public health/health promotion. Key determinants of health are considered, and the complexity of the field is reflected as appropriate. Critical thinking is evident throughout. Literature review is appropriately thorough. Clear evidence of thoughtful analysis and synthesis (i.e., not just summary) of concepts and implications. Theoretical concepts are integrated and applied effectively and creatively to generate implications/applications for practice and/or research. The paper is organized, clear and concise – a good read - and is free of errors in composition, formatting and referencing.
36-37
Evidence of the above, but not as strong in one of the essential elements (e.g., synthesis and/or critical thinking).
34-35
Evidence of the above, but not as strong in two of the essential elements (e.g., synthesis and/or critical thinking) A leader in public health/health promotion could publicly present the piece after revision according to comments and further thought in some areas. The majority of the elements described above are addressed, but further development would be required in at least one of the essential elements (e.g., determinants of health, population health, thorough treatment, critical thinking, integration, application). The submission is organized, clear and concise – a good read - and is free of errors in composition, formatting and referencing.
32-33
30-31
Many elements are done well, but further development would be required in at least two major areas (e.g., HP values/issues, thorough treatment, critical thinking, integration, application).
28-29
Considerable revision would be required before this piece could be publicly presented by a leader in public health/health promotion. Some elements are addressed thoughtfully and appropriately, but several require further attention and development (e.g., determinants of health, population health, thorough treatment, critical thinking, integration, application, organization/presentation).
26-27
Demonstrates graduate level thoughtfulness and organization, but requires further attention and development in numerous areas.
25 and <
The piece could not be publicly presented by a leader in public health/health promotion without major rethinking and reconstruction. Does not reflect a graduate level standard of research, thought and organization/presentation.
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Detailed Course Guide by Week Course readings are accessible through the University of Alberta library. Hyperlinks to all readings for each module will be made available in eClass a few weeks in advance.
Week 1 – Conceptualizations of health Objective Examine the underlying assumptions regarding different conceptualizations of health and implications for supporting personal and/or social responsibility for health. Required Readings Antonovsky, A. (1996). The salutogenic model as a theory to guide health promotion. Health Promotion International. Vol 11, No. 1, 11-18 Blaxter, M. (1997). Whose fault is it? People’s own conceptions of the reasons for health inequalities. Social Science & Medicine, Vol 44, 6, p747-756. Huber, M., Knottnerus, J. A., Green, L., Horst, H., Jadad, A. R., Kromhout, D., Leonard, B., et al. (2011). How should we define health? BMJ, 343(jul26 2), d4163–d4163. Larson, J. (1999). The conceptualization of health. Medical Care Research & Review, 56. Schwartz, M., & Brownell, K. (2007). Actions necessary to prevent childhood obesity: creating the climate for change. Journal of Law, Medicine & Ethic, Spring 2007, 78-89.
Guiding Question What are the main conceptual approaches to ‘health’ that are presented? What factors do you think influence whether people favour a more individual (biomedical and/or clinical) or a more social model to conceptualize health? Discuss the readings in terms of personal and/or social responsibility for health.
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 2 – Health inequality and health inequity Objective Increase understanding of the concepts of health inequality and health inequity. Required Readings Braveman, P. & Gruskin, S. (2003). Defining equity in health. Journal of Epidemiology and Community Health. 57, 254-258. CSDH. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. World Health Organization. (Chapters 1-4) Frohlich, K. L., & Potvin, L. (2008). The inequality paradox: The populations approach and vulnerable populations. American Journal of Public Health, 98(2), 216-221. Marmot, M. & Allen, J. (2014). Social deteminants of health inequity. American Journal of Public Health. Supplement 4, Vol 104, No. S4, S517-19
Guiding Question How has your understanding of ‘health inequity’ been enhanced in the course so far? Why is it so important to understand the determinants of health in terms of both disadvantaged populations and the social gradient in health outcomes?
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 3 – Lifecourse epidemiology and early childhood development Objective Understand the importance of lifecourse epidemiology and early childhood development. Required Readings Kuh, D., Ben-Shlomo, Y., Lynch, J., Hallqvist, J., & Power, C. (2003). Life course epidemiology. Journal of Epidemiology & Community Health. 57(10), 778-783. The Chief Public Health Officer’s Report on the State of Public Health in Canada, 2009: Growing Up Well - Priorities for a Healthy Future (Ottawa). CSDH. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. World Health Organization. Chapter 5 Gilbert L., Breiding M., Merrick M., Parks S., Thompson, W., Ford, D., Dhingra S., & Parks, S. Childhood adversity and adult chronic disease: An update from ten states and the District of Columbia, 2010. Am J Prev Med. 2010;48(3):345-9. Kanopy streaming. Cavalcade Productions. The ACE study 1: childhood trauma and adult health https://ualberta-kanopystreaming-com.login.ezproxy.library.ualberta.ca/video/ace-study-ichildhood-trauma-and-adult-health
Other recommended reading/viewing Keon, W. J. & Pépin, L. (2009). A Healthy Productive Canada: A Determinant of Health Approach. (Ottawa: Standing Committee on Social Affairs, Science and Technology). How brains are built: the core story of brain development http://www.albertafamilywellness.org/resources/video/how-brains-are-built-core-story-braindevelopment Guiding Question How would you summarize the critical aspects of early childhood development in relation to a) lifecourse epidemiology (e.g., health outcomes) and b) other social determinants of health (e.g., the social gradient, disadvantaged populations, education, income, physical environments, social justice, economics)?
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University of Alberta
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Week 4:
Power, politics and ideology
Objective Increase understanding of the role of power, politics and ideology in addressing health equity. Required Readings Bambra, C., Fox, D., & Scott-Samuel, A. (2005). Towards a politics of health. Health Promotion International, 20(2), 193-193. CSDH. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. World Health Organization. Chapter 10. Mackenbach, J.P. (2009). Policy is nothing but medicine at a larger scale: Reflections on public health’s biggest idea. J Epidemiol Community Health, 63, 181-184. Navarro, V., & Shi, L. (2001). The political context of social inequalities and health. Social Science & Medicine, 52(3), 481-491. Raphael, D. (2011). A discourse analysis of the social determinants of health. Critical Public Health, 21(2), 221-236.
Guiding Question What is your most important learning about power, politics and ideology in relations to health equity? What surprised you? What made you pause because of your experience and background? Are there ideas in the readings that you do not agree with?
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 5:
Social Exclusion
Objective Understand the implications of social exclusion in terms of race, class and gender as determinants of health. Required Readings Dahlgren, G., & Whitehead, M. (2006). European strategies for tackling social inequities in health: Levelling up Part 2. Copenhagen: World Health Organization. Denton, M., Prus, S., & Walters, V. (2004). Gender differences in health: A Canadian study of the psychosocial, structural and behavioural determinants of health. Social Science & Medicine. Vol 59, 2585-2600 Frohlich, K. L., Ross, N., Richmond, C. (2006). Health disparities in Canada today: Some evidence and a theoretical framework. Health Policy, 79, 132–143 WHO SEKN. (2008). Understanding and tackling social exclusion. World Health Organization. http://www.who.int/social_determinants/knowledge_networks/final_reports/sekn_final%20report _042008.pdf
Guiding Question Describe your understanding of social exclusion in terms of class, race, place and gender as determinants of health. Explain how social exclusion is seen to be a pathway to health inequity. Discuss how we might use this understanding for improving population health.
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 6: Social relationships: social capital and social support Objective Understand social capital and social support as key determinants of health. Required Readings Berkman, L., Glass, T., Brissette, I., & Seeman, T. (2000). From social integration to health: Durkeim in the new millennium. Social Science & Medicine. Vol 51, 843-857. Underson, D Crosnoe, R Corrine, R (2010) Social Relations and Behaviour across the lifecourse. Annual Review of Sociology 36 131-157 Hawe, P., & Shiell, A. (2000). Social capital and health promotion: a review. Social Science & Medicine, 51(6), 871–885. D’Hombres, B Rocco, L., Suhrcke M and McKee, M. (2010). Does social capital determine health? Evidence from eight transition countries, Health Economics 19 56-74
Guiding question Discuss the concepts of social capital and social support as determinants of health. Discuss implications for population health outcomes and how we might use these concepts for improving population health.
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 7: Socio-ecological models Objective Understand socio- ecological models in terms of population health. Required Readings (recommended order of reading) Bronfenbrenner, U. (1977). Toward an Experimental Ecology of Human Development. American Psychologist, 32(7), 513 Green, l. Richard, L. & Potvin, L. (1996). Ecological foundations of health promotion. American Journal of Health Promotion. March/April, Vol 10, No 4, 270. Kreiger, N. (2001). Theories for social epidemiology in the 21st century: an ecosocial perspective. International Journal of Epidemiology, 30, 668-67 Richard, L., Gauvin, L., & Raine, K. (2011). Ecological Models Revisited: Their Uses and Evolution in Health Promotion Over Two Decades. Annual Review of Public Health, 32(1), 307326. Canadian Council on Social Determinants of Health. (2015). A review of frameworks on the determinants of health. (accessed 10 Aug 2016: http://ccsdh.ca/images/uploads/Frameworks_Report_English.pdf)
Guiding Question Discuss why ecological models are important to understanding population health. Which models reviewed by the Canadian Council on Social Determinants of Health do you think better advance understanding of socio-ecological models?
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 8: Individual level of analysis Newspaper Article Review Due October 26, 2016 Noon Mountain Standard Time Objective Examine the determinants of health from multiple levels of analysis. Required Readings Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31, 143-164. Burke, N., Joseph, G., Pasick , R.& Barker, J. (2009). Theorizing social context: Rethinking behavioral theory. Health Education & Behavior. Vol 36, 5, 55S-70S. Cohen, D., Scribner, R., & Farley. T. (2000). A structural model of health behavior: A pragmatic approach to explain and influence health behaviors at the population level. Preventive Medicine. 30, 146-154. Munro, S., Lewin, S., Swart, T. & Volmink, J. (2007). A review of health behavior theories: How useful are these for developing interventions to promote long-term medication adherence for TB and HIV/AIDS? BMC Public Health. 7, 104 Rose, G. (1985). Sick individuals and sick populations. International Journal of Epidemiology. 14:32-38. Reiteration in International Journal of Epidemiology, 2001; 30; 427-432. Other recommended reading Baum, F. & Fisher, M. (2014). Why behavioural health promotion endures despite its failure to reduce health inequities. Sociology of Health & Illness, 36(2), 213-225.
Guiding Question Discuss the individual and behavioral theoretical perspectives that are articulated in the articles specifically demonstrating your understanding of micro level influences on the determinants of health. What contribution did Rose (1985) offer to your understanding of individual and population health?
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 9: Community level of analysis Objective Examine the determinants of health from multiple levels. Required Reading Evans, G., Jones-Rounds, M., Belojevic, G., & Vermerlen, F. (2012). Family income and childhood obesity in eight European cities: The mediating roles of neighborhood characteristics and physical activity. Social Science & Medicine, 75, 477-481. Hancock, T. (1993). Health, human development and the community exosystem: three ecological models. Health Promotion International, 8(1) , 41-47 CSDH. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. World Health Organization. Chapter 6 Laverack, G. (2006). Improving health outcomes through community empowerment: a review of the literature. Journal of Health, Population and Nutrition, 24 (1) March; 113-120. Smith, N., Baugh Littlejohns, L., & Thompson, D. (2001). Shaking out the cobwebs: insights into community capacity and its relation to health outcomes. Community Development Journal, 36 (1) January, 30-41. Recommended viewing Dr. Clyde Hertzman: Presentation to WHO, 1 of 3 http://www.youtube.com/watch?v=EJvxNO4ET1U&feature=related Dr. Clyde Hertzman: Presentation to WHO, 2 of 3 http://www.youtube.com/watch?v=XBva4F4rti8&feature=relmfu Dr. Clyde Hertzman: Presentation to WHO, 3 of 3 http://www.youtube.com/watch?v=73iz_5Qx51w&feature=relmfu
Guiding Question What is your most significant learning regarding the ‘community’ as a determinant of health? How does this understanding relate to socio-ecological approaches to population health? From your experience, what community level determinants of health resonant with you most? SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 10: Organizational level of analysis Objective Examine the determinants of health from multiple levels. Required Readings Bond, L., Glover, S., Godfrey, C., Butler, H., & Patton, G.C. (2001). Building capacity for system-level change in schools: Lessons from the Gatehouse project. Health Education & Behavior, 28, 368-383. Karasek, R. (2004). An analysis of 19 international case studies of stress prevention through work reorganization using the demand/control model. Bulletin of Science, Technology & Society, Vol 24, 5, 2446-456. Shain, M., & Kramer, D.M. (2004). Health promotion in the workplace: framing the concept; reviewing the evidence. Occupational and Environmental Medicine, 61 (7), 643-648. Dooris, M., Wills, J., & Newton, J. (2014). Theorizing healthy settings: a critical discussion with reference to Healthy Universities. Scandinavian Journal of Public Health, 42 (15 suppl), 7-16. Guiding Question Discuss the organizational (or institutional) theoretical perspectives that are articulated in the readings. Specifically demonstrate your understanding of the importance of settings and systems with respect to their influence on the determinants of health. What resonated with you the most with respect to the organizational or institutional level of analysis? Why?
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 11: Societal level of analysis Objective Examine the determinants of health from multiple levels. Required Readings Alvaro, C., Jackson, L, Kirk, S., McHugh, T., Hughes, J., Chircop, A., & Lyons, R. (2011). Moving Canadian governmental policies beyond a focus on individual lifestyle: Some insights from complexity and critical theories. Health Promotion International, 26(1), 91-99. Ruckert, A., & Labonté, R. (2012). The global financial crisis and health equity: toward a conceptual framework. Critical Public Health, 22(3), 267–279. World Health Organization (2013). The Helsinki Statement on Health in All Policies. CPHA. (2015). Global change and public health: Addressing the ecological determinants of health. http://www.cpha.ca/uploads/policy/edh-discussion_e.pdf CSDH. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. World Health Organization. Chapter 10 Other recommended reading Baum, F., Lawless, A., Delany, T., Macdougall, C., Williams, C., Broderick, D., Wildgoose, D., Kickbush, I., Popay, J., & Marmot, M. (2014) Evaluation of Health in All Policies: concert, theory and application. Health Promotion International, 29 (S1). i130-i141
Guiding Question Discuss the societal theoretical perspectives that are articulated in the articles, specifically demonstrating your understanding of system influences on the determinants of health. How do these articles relate to power, politics and ideology?
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 12:
Systems thinking
Objective: Understand foundational concepts in systems thinking as they relate to determinants of health and health promotion. Required reading Best, A. (2011). Systems thinking and health promotion. American Journal of Health Promotion. Vol 25 (4), eix-ex. Finegood, D. (2012). The importance of systems thinking to address obesity. Obesity Treatment and Prevention: New Directions. Vol 73, 123-137. Luke, D. & Stamatakis, K. (2012). Systems science methods in public health: dynamics, networks, and agents. Annual Review of Public Health. 33, 357-376. Trochim, W., Cabrera, D., Milstein, B., Gallagher, R., & Leischow, S. (2006). Practical challenges of systems thinking and modeling in public health. American Journal of Public Health, 96(3), 538-546. Jayasinghe, S. (2011). Conceptualizing population health: from mechanisitc thinking to complexity science. Emerging themes in epidemiology, 8(2). Other recommended reading Foresight Tackling Obesities: Future Choices – Project report https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/287937/07-1184xtackling-obesities-future-choices-report.pdf Meadows, D. (1999). Leverage points: Places to intervene in a system. Norwich, Vermont, Donella Meadows Institute (Accessed 10 Aug 2016: http://donellameadows.org/archives/leverage-points-places-tointervene-in-a-system/ ) Guiding question What concepts resonated with you most and why when applying systems thinking to the study of the determinants of health (e.g., holism, relationships, interactions, feedback mechanisms, emergence)?
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 13: Final papers No readings or postings this week … time for finishing papers.
Due December 6th, 2016 Noon Mountain Standard Time
SPH 501 (Fall 2016) Course Syllabus
University of Alberta
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Week 14: Critical Reflections Objective Following completion of final papers, critically reflect on key learnings from the course. We ask all students to please post and answer the following question.
Guiding Question What are the highlights, key learnings and/or personal insights most relevant for you related to the ideas, concepts and perspectives examined in this course?
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University of Alberta
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