University of Alberta

Course Guide for SPH 501 Fall 2015 (Campus) Social Behavioural Foundations of Public Health Friday, 9:00-11:50 am ECHA 1-498 Discussion/ Break-out Rooms: 1-451 ECHA 1-457 ECHA 1-464 ECHA 1-468 ECHA Instructor: Jane Springett, PhD Phone: (780) 492-0289 Email: [email protected] Office: 3-289 ECHA

SPH501:2014

Teaching Assistants: Tadesse Alemayehu Belie Email : [email protected] Office : 4059 RTF Rachel Prowse Email: [email protected] Office: 4-347 ECHA Rosslyn Zulla Email: [email protected] Office: 3-035 ECHA;

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, the unfair and avoidable differences in health status seen between and within countries (WHO, 2012). 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. 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 session will comprise a combination of lectures and small group discussion. Class time and assignments are aimed at enhancing student understanding, critical analysis and theoretical application of key concepts and selected issues related to the course.

Objectives

Upon completion of this course, students will be able to: Overall Course Objectives: 1. To understand how conceptualizations of health and health action influences ways of promoting and enhancing health. 2. To apply knowledge of selected social determinants of health to multi-level interventions to improve health of individuals, communities, and populations. 3. To utilize an ecological approach to the analysis of health and the design of public health actions. 4. To apply key social science theories to the analysis of social determinants of health.

Competencies

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Define and apply appropriately the key concepts of diversity, equity, social justice, inequality, empowerment, power, system and social change 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. Identify key theories, concepts and models from a range of social and behavioural disciplines that are used to inform practice. Describe individual, organizational and community capacity (i.e., assets, resources) to bring about positive change in environments and health. Explain the principles of the socio-ecological model of health in the development of population health interventions. Listen well and encourage open exchange of information (facilitation) Convey information clearly in assignments and presentations appropriate

to the recipient. 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 at www.library.ualberta.ca/ereference/index.cfm or call 1-800-207-0172.

Teaching and Learning

This course requires students to read extensively. This includes not only the required reading ( see below ) but also more broadly. The approach taken in the course of combining practical exercises, reading and lectures together with the assignments is based well researched pedagogical principles about how different types of people learn. Your own learning style will determine how comfortable you feel with each of the different formats. Students without a background in the social sciences will initially find some of the material challenging but the course is structured to ease you into the concepts. There are no course texts per se.

Course Evaluation Mid-Point Course Evaluation: As is the case with all SPH instructors, we are interested in improving the course. We need to hear from you in order to do that well, so will gather feedback and recommendations from you at the mid-point of the course using a participative and reflective process. Final Course Evaluation: Following completion of the course, you will receive a standardized summative evaluation. The standard University of Alberta course evaluation procedure will be followed. This will involve a standard questionnaire with anonymous responses returned to the Student Services Coordinator.

Student Evaluation Assignment Percentage Date Classroom Participation (online, in discussion 20% Whole term groups in class exercises and Case Study) Short paper (5-8 pages) and peer critique (1-3 First draft of short paper due pages) 30% 9:00am October 9th 2014 Peer review due October 16th, 2014

9:00am

Short paper final draft due 9:00am October 23rd 2014 SPH501:2014

Term Paper (15-20 pages)

50%

4:00 pm December 18th 2014

Evaluation of Coursework Classroom Participation 20% Students are expected to participate in small-group discussions of the course material and in exercises set in class. Students may also draw on their own experiences to contextualize their comments. Classroom participation will occur in three ways 1) in four groups, which are each led by one instructor or TA. Groups will be assigned during the first week. In each group Students will be assigned to take the lead on a reading, provide a written summary of the key points of the reading to share with their group, including comments on the readings. These must be submitted via EClass on the Tuesday evening prior to the class, no later than 9 p.m. Based on on all the readings, all students will develop 1-2 comments or questions for discussion each week. These should be posted by Thursday, no later than 9pm. Students will draw on the discussion questions to explore issues raised in the lectures and other activities during their group session. 2) Additional activities, such as the application of classroom learning to real-world scenarios, can also be expected. 3) Each group will be working on a case study and will be asked to present their work in the final class. The Case Studies which will involve some role playing will be provided in class on October 23rd. For both online and face-to-face participation, quality is preferred over quantity of contribution, and participation should facilitate group, as well as individual learning. Participation grades will be assigned based on an assessment of your preparation and contributions, as well as attendance in class. Grading scheme ● ● ● ● ● ● ● ●

Attends regularly Submits quality comments and discussion questions regularly Comes prepared, having read the assigned readings and summaries May have done additional reading on the subject, or makes an effort to relate the required reading to previous learning and/or work experience. Contributes relevant comments, or asks questions during class/discussion groups. Does not dominate whole class or small group discussions. Allows others to participate in the discussion. Demonstrates an effort to apply the concepts and theories from lectures and readings to real life practice scenarios. Collaborates and works effectively with others as part of a team.

Short paper and peer critique 30% This assignment contains two components and students are required to pair off. Students are expected to draft a short 5-8 page paper (double-spaced) critically discussing a selection of course readings (see below for additional details). A complete first draft of the short paper must

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be completed and brought to class (two copies) on October 9th, 2015. Students will exchange their paper with their partner on this day and submit one copy to the instructors. Each student is then expected to read and draft a critical review of their partner’s paper (see below for additional details). This review is due in class (two copies) on October 16th, 2015 The student will submit one copy to the instructors and the second copy will be provided to their partner. After that, students will be expected to respond to the peer critique and incorporate edits and changes (as appropriate) into final draft of their papers, due in class on October 23rd , 2015. The evaluation of this assignment will take into account how well the student has incorporated the peer feedback into their paper. If they do not agree with the feedback (and this is certainly a possibility) students may append a brief explanation (one page) as to why they did not incorporate all of the suggested changes into their final version or why they felt the critique was not helpful. The instructors will take into account the quality of this explanation and the underlying rationale when evaluating the papers. The purpose of peer review is to replicate real world experience and enhance learning. Short 5-8 page paper You will be allocated one of the following Options: Option 1 Compare and Contrast the following two papers 1. Robertson, A., & Minkler, M. (1994). New Health Promotion Movement: A Critical Examination. Health Education & Behavior, 21(3), 295–312. 2. Evans, R. G., & Stoddart, G. L. (1990). Producing health, consuming health care. Social Science & Medicine (1982), 31(12), 1347–1363. These two papers each describe a different perspective within the field of public health: ‘health promotion’ and ‘population health.’ You are being asked to compare and contrast these two papers, critically analyze their underlying assumptions, and reflect on which perspective best represents your own approach to improving health for populations. Specifically, your paper should: 1) briefly define health promotion and population health and describe how these approaches differ in terms of their underlying assumptions (e.g. What do they take for granted?), activities, and core values. 2) Consider which perspective you align most closely with and explain why. Briefly analyze how your own past (work, life, learning) experiences and/or worldview may have shaped your preference for either the health promotion or population health perspective. Your arguments should be evidenced with appropriate quotes and citations from either paper (additional references are welcome but not required). Your paper should be referenced in APA format. Option 2 SPH501:2014

Compare and Contrast the following two papers 1. Lynch J. and Kaplan G. (2000). Socioeconomic status. In L. F. Berkman and I. Kawachi (Eds.) Social Epidemiology. Oxford University Press: Oxford. 2. Wilkinson, R. G. (1999). Health, hierarchy, and social anxiety. Annals of the New York Academy of Sciences, 896, 48–63. These two papers each advance a different explanation for how socioeconomic status impacts health, including why a persistent social gradient of health exists across populations (even amongst individuals occupying higher rungs on the socioeconomic ladder). You are being asked to compare and contrast these two papers, critically analyze their underlying assumptions and reflect on which perspective best represents your own interpretation of why SES and income inequality are such important determinants of population health. Specifically your paper should 1) briefly describe the ‘neomaterialist’ and ‘pyschosocial’ pathways and describe how these approaches differ in terms of their underlying assumptions (e.g. What do they take for granted?) and implicit statements on structure/agency. 2) Consider which paper advances a more credible explanation of the importance of SES/income equality for health and explain why. Briefly analyze how your own past (work, life, learning) experiences and/or world view may have shaped your preference for either the neomaterilaist or psychosocial pathway. Your arguments should be evidenced with appropriate quotes and citations from either paper (additional references are welcome but not required). Your paper should be referenced in APA format. Peer critique Each student is expected to write a critique of their partner’s short paper. The critique should be 1-3 pages long (double-spaced) and include your reflections on the substantive content of the paper. This includes a critique of how well the author has established his or her arguments, the quality of their analysis, whether he or she has addressed all aspects of the assignment, how clearly the paper is laid out and written, etc. Feedback should be constructive and suggest ways to improve the paper. Edits for grammar and spelling are acceptable but should not be the focus of the critique.

Grading Scheme (Guidance) Paper Body (critical discussion and responses to peer critique) Comprehension of papers and concepts; reflexivity Clarity, organization, punctuation, grammar, syntax and referencing Peer critique : Provides thoughtful and helpful commentary 5% Critique demonstrates knowledge of papers 10 % Critique demonstrates knowledge of concepts 5 %

Term Paper: 50% SPH501:2014

50 % 15% 15%

Students are required to submit a final paper 15-20 pages in length, excluding title page, table of contents, figures, tables, and references. The paper should be double spaced in a 12 point font and it should not include appendices. Drawing from course theory/material and your personal, professional, and volunteer experience, choose a public/population health issue that you have an interest in exploring. Demonstrate why this is an important health issue, for whom and in what context and the underlying social determinant(s) Devise a health promotion strategy to reduce the impact of the issue on population health status. Draw from your knowledge of the ecological approach and social theory to justify both your analysis of the issue and your course of action/strategies. You are expected to draw on literature beyond the provided readings. Your paper should include, at minimum, the following sections: 1) description and significance of the health issue, the populations/groups it affects and the underlying social determinant(s) 2) how different theories can be used to understand the underlying problem and its solution 3) Strategies for intervention (consider multiple ecological levels of action) including an assessment of their likely effectiveness and limitations Please discuss your plans with your group instructor as early as possible. Dr Springett will make available extra office hours for final clarifications. Grading Scheme: 1. Outline the problem: Discuss the health issue, the population/group affected, and the nature and extent of health problem in the population/group affected. Describe what part of the who you are focusing on in your paper (i.e., your target population) and why form a diversity and social justice perspective (10 %) 2. Discuss the social determinants you are focusing on in your paper (one or two maximum), using theory and research evidence to justify your choices. This section should include a description of why the social determinants you have selected are important for the health action and outcomes you are trying to achieve for your target population. This explanation should also describe the mechanisms that link the social determinants you have selected to the outcomes you are examining in this population with some theoretical justification. (30%) 3. Describe what has typically been done to deal with this health issue in your target population. This section should include a summary of the efforts made to address the problem in your target population, the underlying theoretical perspectives of these efforts, the ecological levels targeted, and how successful these efforts have been. (20%) 4. From a social determinants perspective, think about what remains to be done to promote health in your target population. Pick one or two of these ideas and describe how it could be carried out to benefit your target population. Demonstrate how it would be a realistic and effective strategy (you can use theoretical argument as well as research evidence or evidence from jurisdictions where it is already in place). Describe the ecological level(s) you are targeting and why. If nothing exists in the literature that shows a successful model of intervention, you may propose an intervention of your own. Be careful to discuss all of the above elements in your proposed plan as well as how you are going to SPH501:2014

address any issues of diversity and inclusion. Finally explore the ethical issues associated with your proposed action plan. (25%) 5. References, grammar and syntax. You are expected to use APA format for referencing your paper. (15 %) Final Mark:

Grade

Letter Grade

Descriptors

A+

Excellent

Grade Pt Value (assigned by U of A) 4.0

A

Excellent

4.0

A-

Excellent

3.7

B+

Good

3.3

B

Good

3.0

B-

Satisfactory

2.7

C+

Satisfactory

2.3

C

Failure

2.0

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Criteria

An exemplar and could be publicly presented by a leader in health promotion/public health . Key health promotion values and issues 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 strategies. Theoretical concepts are integrated and applied effectively and creatively to generate implications/applications for practice and/or research. The submission is organized, clear and concise – a good read/listen - and is free of errors in composition, formatting and referencing. Evidence of the above, but not as strong in one of the essential elements (e.g., synthesis and/or critical thinking) Evidence of the above, but not as strong in two of the essential elements (e.g., synthesis, critical thinking, implications) A leader in health promotion/public health 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 well, but further development would be required in at least one of the essential elements (e.g., HP values/issues, thorough treatment, critical thinking, integration, application). The submission is organized, clear and concise – a good read/listen - and is free of errors in composition, formatting and referencing. 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). Considerable revision would be required before this piece could be publicly presented by a leader in health promotion/public health . Some elements are addressed thoughtfully and appropriately, but several require further attention and development (e.g., HP values/issues, thorough treatment, critical thinking, integration, application, organization/presentation). Demonstrates graduate level thoughtfulness and organization, but requires further attention and development in several areas. The piece could not be publicly presented by a leader in health promotion/public health without major rethinking and reconstruction. Does not reflect a graduate level standard of research, thought and organization/presentation.

University of Alberta Calendar, Section 23.4 Regulations and Information for Students Evaluation Procedures and Grading System The University of Alberta uses a letter grading system with a four-point scale of numerical equivalents for calculating grade point averages. Grades reflect judgements of student achievement made by instructors. These judgements are based on a combination of absolute achievement and relative performance in a class. Some instructors assign grades as intervals during the course and others assign marks (e.g. percentages) throughout the term and then assign a letter grade at the end. Instructors must adapt their approaches to reflect the letter grading system. Grade distribution should reflect those shown in this document. (EXEC 03 FEB 2003) Grading in Graduate Courses Descriptor

Letter Grade

Grade Point Value

Excellent

A+ A AB+ B BC+ C CD+ D F

4.0 4.0 3.7 3.3 3.0 2.7 2.3 2.0 1.7 1.3 1.0 0.0

Good Satisfactory Failure

Academic Integrity

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Plagiarism is a serious offence. 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 (online at www.ualberta.ca/CodeofStudentBehaviour) 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. University of Alberta policy about course outline can be found in Section 23.4(2) of the University Calendar. (GFC 29 SEP 2003)

DETAILED COURSE OUTLINE BY WEEK STUDENTS ARE ADVISED THAT THIS COURSE REQUIRES YOU TO READ AROUND THE SUBJECT IN DEPTH. EACH WEEK HAS REQUIRED READING AND SUPPLEMENTARY READING. IT IS SUGGESTED THAT YOU DO NOT RESTRICT YOU READING TO THE REQUIRED READING. WEEK 1 (Sept. 13th) – Course Overview and definitions of health. Instructors: Jane Springett, Learning Objectives: 1. To become familiar with different concepts of health and its contested nature 2. To reflect on the implications of different perspectives on health for action for promoting and enhancing health. 3. To start to explore the social determinants of health 4. To reflect on the ethical implications of public health actions to promote health

Required Readings. There are no required readings this week. However students are urged to read some of the following: Supplementary Readings:  Williamson,DL & Carr,J (2009) Health as a resource for everyday life: advancing the conceptualization, Critical Public Health, 19:1, 107-122, DOI:10.1080/09581590802376234  Cameron E , Mathers J & Parry J (2006) ‘Health and wellbeing’:Questioning the use of health concepts in public health policy and practice, Critical Public Health, 16:4, 347354, DOI: 10.1080/09581590601128166  Labonte, R., Polanyi, M., Muhajarine, N., McIntosh, T., & Williams, A. (2005). Beyond the divides: Towards critical population health research. Critical Public Health, 15(1), 5– 17. ● Huber, M., Knottnerus, J. A., Green, L., Horst, H. v. d., Jadad, A. R., Kromhout, D., Leonard, B., et al. (2011). How should we define health? BMJ, 343(jul26 2), d4163– d4163. ● Raeburn, J. & Rootman, I. (2007). A new appraisal of the concept of health. In O’Neil, M., Pedersen, A., Dupere, S., & Rootman, I (Eds.) Health Promotion in Canada: Critical perspectives [2nd edition]. Toronto: Canadian Scholar’s Press. ● World Health Organization (1986). Ottawa Charter for Health Promotion. http://www.phac-aspc.gc.ca/ph-sp/phdd/pdf/charter.pdf ● Mikkonen, J. & Raphael, D. (2010). Social determinants of health: The Canadian facts. http://www.thecanadianfacts.org/ ● Brassolotto, J., Raphael, D., & Baldeo, N. (2014). Epistemological barriers to addressing the social determinants of health among public health professionals in Ontario, Canada: A qualitative inquiry. Critical Public Health, 24(3), 321-336.

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Week 2 Social Change for Health: Using social theory to understand health and its promotion. Guest speaker: Elaine Hyshka 1. Understand what ‘social theory’ is, and why it is useful for public health research and practice. 2. Critically examine how the central tension between structure and agency informs understandings of health and strategies for improving it. 3. Understand various theoretical approaches employed in public health and health promotion. Required readings ● Frohlich, K. L., Mykhalovskiy, E., Miller, F., & Daniel, M. (2004). Advancing the population health agenda: Encouraging the integration of social theory into population health research and practice (Commentary). Can J Public Health, 95(5), 392–95. ● Wills, J (2012) Understanding and using theories and models Chapter 6 in Jones and Douglas (2012) Public Health: Building Innovative practice Sage. ● Cockerham, W. C. (2013). Bourdieu and an Update of Health Lifestyle Theory. In Cockerham, W.C. (Ed.) Medical Sociology on the Move. Springer: Netherlands. ● Krieger, N. (2001). Theories for social epidemiology in the 21st century: an ecosocial perspective. International Journal of Epidemiology, 30(4), 668–677. doi:10.1093/ije/30.4.668 Supplementary readings    

Marx, K. (1887). Capital: A Critical Analysis of Capitalist Production. S. Sonnenschein, Lowrey, & Company. Foucault, M. (1991). Governmentality. In Burchell, G., Gordon, C., & Miller, P. (Eds.). The Foucault Effect: Studies in Governmentality (1 edition.). Chicago: University Of Chicago Press. Bourdieu, P. (2005). Habitus. In Hillier, J., & Rooksby, E. (Eds.). Habitus: a sense of place (2nd ed.). Aldershot, Hants, England ; Burlington, VT: Ashgate. Krieger, N. (2011). Epidemiology and the People’s Health: Theory and Context. Oxford University Press: Online.

WEEK 3 Social Injustice Kills: income inequality, health and globalisation Instructor: Jane Springett. Learning Objectives: 1. Understand income as the keystone of health and the graded relationship between socioeconomic status (SES) and health. 2. Understand the impacts of income inequality (i.e., the importance of relative rather than absolute deprivation) and where Canada sits on the income inequality gradient comparatively to other countries.

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3. Understand the relationship between social history and health with particular reference to aboriginal health 4. Understand the drivers of globalization, the relationship with health, and policy implications. Required Readings: All students should look at :  Loppie, C and Wien, F ( 2009). Health Inequalities and Social determinants of Aboriginal People’s Health. National Collaborating Centre for Aboriginal Health. http://www.nccah-ccnsa.ca/docs/social%20determinates/NCCAH-loppieWien_report.pdf Other: ● Frohlich, K. L., Ross, N., Richmond, C. (2006). Health disparities in Canada today: Some evidence and a theoretical framework. Health Policy, 79, 132–143. ● Raphael, D. (2011). A discourse analysis of the social determinants of health. Critical Public Health, 21(2), 221-236. ● ●

Pickett, K. E., & Wilkinson, R. G. (2015). Income inequality and health: a causal review. Social Science & Medicine, 128, 316-326. Chaufan, C., Yeh, J., Ross, L., & Fox, P. (2015). You can’t walk or bike yourself out of the health effects of poverty: active school transport, child obesity, and blind spots in the public health literature. Critical Public Health,25(1), 32-47.

Supplementary Readings: ● Popay, J., Whitehead, M., & Hunter, D. J. (2010). Injustice is killing people on a large scale—but what is to be done about it?. Journal of Public Health, fdq029. ● Marmot, M., & Bell, R. (2012). Fair society, healthy lives. Public Health, 126, S4-S10. ● Mikkonen, J. & Raphael, D. (2010). Social determinants of health: The Canadian facts. http://www.thecanadianfacts.org/ ● Braveman, P. (2006). Health disparities and health equity: Concepts and Measurement. Annual Review of Public Health, 27(1), 167–194. ● Navarro, V. & Shi L. (2001). The political context of social inequalities and health. Social Science and Medicine, 52(3), 481-491 ● Popay, J., Williams, G., Thomas, C., & Gatrell, T. (1998). Theorising Inequalities in Health: The Place of Lay Knowledge. Sociology of Health & Illness, 20(5), 619–644. ● Gore, D Kothari A (2013) Getting to the Root of the Problem: Health Promotion Strategies to address the Social Determinants of Health Canadian Journal of Public Health 104(1) -54 ● Ruckert, A., & Labonté, R. (2012). The global financial crisis and health equity: toward a conceptual framework. Critical Public Health, 22(3), 267–279.

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WEEK 4 Using models to make sense of the social determinants of health: the socioecological model of health and the settings approach. Instructor: Kim Raine Learning Objectives 1. Understand the different socio ecological models and their use in public health and health promotion 2. Critically examine the relationship between socio-ecological models and the social determinants of health 3. Identify how different social dimensions interact to impact on health 4. Critically evaluate the use of models in a practical setting Required reading  Shareck, M., Frohlich, K. L., & Poland, B. (2013). Reducing social inequities in health through settings-related interventions—a conceptual framework. Global health promotion, 20(2), 39-52  Dooris, M. (2013). Expert voices for change: Bridging the silos—towards healthy and sustainable settings for the 21st century. Health & Place, 20, 39-50  Jackson, Suzanne F., Birn, Anne-Emanuelle, Fawcett, Stephen B., Poland, Blake, & Schultz, Jerry A.. (2013). Synergy for health equity: integrating health promotion and social determinants of health approaches in and beyond the Americas. Revista Panamericana de Salud Pública, 34(6), 473-480. Retrieved August 15, 2014, from http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S102049892013001200015&lng=en&tlng=en. .  Golden, S. D., McLeroy, K. R., Green, L. W., Earp, J. A. L., & Lieberman, L. D. (2015). Upending the Social Ecological Model to Guide Health Promotion Efforts Toward Policy and Environmental Change. Health Education & Behavior, 42(1 suppl), 8S-14S. Supplementary reading  Daniel Stokols (1996) Translating Social Ecological Theory into Guidelines for Community Health Promotion. American Journal of Health Promotion: March/April 1996, Vol. 10, No. 4, pp. 282-298.  Poland, B., Krupa, G., & McCall, D. (2009). Settings for health promotion: an analytic framework to guide intervention design and implementation. Health Promotion Practice, 10(4), 505–516.  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), 307–26.  Poland, B., & Dooris, M. (2010). A green and healthy future: the settings approach to building health, equity and sustainability. Critical Public Health, 20(3), 281–298.  Veugelers, P.V. & Fitzgerald, A.L.. (2005). Effectiveness of School Programs in Preventing Childhood Obesity: A Multilevel Comparison. American Journal of Public Health, 95, 3, 432-435.  http://www.phecanada.ca/programs/health-promoting-schools  Whitehead, M., & Dahlgren, G. (1991). What can be done about inequalities in health?. The lancet, 338(8774), 1059-1063. SPH501:2014

WEEK 5 Determinants of Health: Early Childhood development Instructor: Jane Springett Guest speaker: Line Perron

Learning Objectives 1. Understand the role of life course influences on the development of health inequality 2. Understand the impact of early childhood on mental health and health outcomes 3. Critically examine policies and programmes for early childhood development Required Readings/video    

Raphael, D. (2011). Poverty in childhood and adverse health outcomes in adulthood. Maturitas, 69(1), 22–26. Video (30 min): Unnatural Causes see link in e class. Braverman P and Barclay, C ( 2009) Health Disparities beginning in Childhood: a life course perspective Pedriatrics 124 Supplement 3 5163-5175 Halfon, N., Larson, K., Lu, M., Tullis, E., & Russ, S. (2014). Lifecourse health development: past, present and future. Maternal and child health journal, 18(2), 344-365.

Supplementary Readings  Ku, D., et al (2003). Life course epidemiology. J Epidemiol Community Health, 57, 778783.  Lu. M. C., et al (2003). Racial and ethnic disparities in birth outcomes: A life course perspective. Maternal and Child Health Journal, 7(1), 13-30.  Hogan, V. K., Rowley, D., Bennett, T., & Taylor, K. D. (2011). Life Course, Social Determinants, and Health Inequities: Toward a National Plan for Achieving Health Equity for African American Infants—a Concept Paper. Maternal and Child Health Journal, 16(6), 1143–1150.  Marmot, M ( 2010) A Fair Society, Healthy Lives, The Marmot Review http://www.instituteofhealthequity.org/Content/FileManager/pdf/fairsocietyhealthylives.p df

Week 6 (October 16th) Thinking Clearly About Health Behaviour Guest: Cam Wild Learning objectives 1. Understand the key behaviours that influence health. 2. Understand the antecedents of these behaviours (i.e., dynamic interactions between the individual and the social environment). 3. Understand how behaviours modify relationships between social determinants and health outcomes. Required readings:

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● Bauer, U.E., Briss, P.A., Goodman, R.A., & Bowman, B.A. (2014). Prevention of chronic disease in the 21st century: Elimination of the leading preventable causes of premature death and disability in the USA. Lancet, 384(9937), 5-11. http://www.sciencedirect.com.login.ezproxy.library.ualberta.ca/science/article/pii/S0140673614606486

● Jeffery, R.W. (1989). Risk behaviors and health: Contrasting individual and population perspectives. American Psychologist, 44(9), 1194-1202. http://ovidsp.tx.ovid.com.login.ezproxy.library.ualberta.ca/sp3.13.1a/ovidweb.cgi?&S=HLGBFPBKHFDDAJJGNCLKHCJCNOLMAA00&Link+Set=S.sh.18.19.23.27%7c3%7csl_10

● Bandura, A. (2005). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143-164. http://heb.sagepub.com.login.ezproxy.library.ualberta.ca/content/31/2/143

● 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.

Supplmentary readings: ● Emmons, K. M. (2002). Health behaviors in a social context. In L. F. Berkman, & I. Kawachi (Eds.), Social epidemiology (pp. 243-266). Oxford: Oxford University Press. ● Crawford, R. (2005). You are dangerous to your health: The ideology and politics of victim blaming. In N. Krieger (Ed.), Embodying inequality: Epidemiologic perspectives (pp. 79-98). New York: Baywood Publishing Company. ● Brunner, E. & Marmot, M. (2006). Social organization, stress and health. In M. Marmot, & R. G. Wilkinson (Eds.), Social Determinants of Health, 2nd Ed., (pp. 6-30). Oxford: Oxford University Press.

WEEK 7(Oct. 24) – Social Relationships and health: Instructor : Jane Springett Learning Objectives 1. Understand how the nature social relationships support health 2. Differentiate between social support and social capital. 3. Explain how the notion of intersectionality helps us understand how social dimensions interact Required Readings: ● Emery, M. E., & Bregendahl, C. (2014). Relationship building: the art, craft, and context for mobilizing the social capital necessary for systems change. Community Development, 1-14.. ● Abel, T., & Frohlich, K. L. (2012). Capitals and capabilities: Linking structure and agency to reduce health inequalities. Social science & medicine, 74(2), 236-244 ● .Hawe, P., & Shiell, A. (2000). Social capital and health promotion: a review. Social Science & Medicine, 51(6), 871–885. ● Egolf, B., et al. (1992). The Roseto effect: A 50-year comparison of mortality rates. American Journal of Public Health, 82(8), 1089-1092

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Supplementary Reading: ● Perry, M., Williams, R. L., Wallerstein, N., & Waitzkin, H. (2008). Social Capital and Health Care Experiences Among Low-Income Individuals. American Journal of Public Health, 98(2), 330–336. ● Berkman, L. F., Glass, T., Brissette, I., Seema, T. E. (2000). From social integration to health: Durkheim in the new Millennium, Social Science & Medicine, 51 (2000) 843-857 ● Wakefield, S. E., & Poland, B. (2005). Family, friend or foe? Critical reflections on the relevance and role of social capital in health promotion and community development. Social Science & Medicine, 60(12), 2819-2832.. ● Underson, D Crosnoe, R Corrine, R ( 2010) Social Relations and Behaviour across the lifecourse Annual Review of Sociology 36 131-157 ● 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 ● Tampubolon, G., Subramanian, S. V., & Kawachi, I. (2013). Neighbourhood Social Capital And Individual Self‐Rated Health In Wales. Health economics,22(1), 14-21.

WEEK 8 (October 30th ) Participatory practice for health : community engagement and social activism, its role in social change Learning Objectives 1. To explore the centrality of community engagement for action at the local level in public health. 2. To examine the nature of participatory action research and its role in enabling people to act on the determinants of health 3. To understand the nature of empowerment as a concept and tool for change 4. To identify the factors which contribute to effective engagement 5. To explore the notion of health activism and consider some of the ethical challenges associated with public health advocacy, community organizing and activism.

Required Readings:  

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Laverack, G. (2013). Health activism: the way forward to improve health in difficult times. Global Health Promotion, 20(3), 49–52. Martinson, M. & Su, C. (2012). Contrasting organizing approaches: The ‘Alinsky Tradition’ and Freirian Organziing Approaches (pp.59-77). In Minkler, M. (Ed.). Community organizing and community building for health and welfare (3rd ed.). New Brunswick, N.J: Rutgers University Press. South, J. (2014). Health promotion by communities and in communities: Current issues for research and practice. Scandinavian journal of public health,42(15 suppl), 82-87. Chiu LF (2008) Engaging communities in health intervention research/ practice, Critical Public Health, 18:2, 151-159, DOI: 10.1080/09581590701771725

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Trapence, G., Collins, C., Avrett, S., Carr, R., Sanchez, H., Ayala, G. Baral, S. D. (2012). From personal survival to public health: community leadership by men who have sex with men in the response to HIV. The Lancet, 380(9839), 400–410. Supplementary Readings ● Laverack, G., & Keshavarz Mohammadi, N. (2011). What remains for the future: strengthening community actions to become an integral part of health promotion practice. Health Promotion International, 26(suppl 2), ii258–ii262. ● Minkler, M., Pies, C., and Hyde, C.A. (2012). Ethical issues in community building and community organizing. In Minkler, M. (Ed.). Community organizing and community building for health and welfare (3rd ed.). New Brunswick, N.J: Rutgers University Press. ● Ledwith M and Springett J ( 2010) Participatory Practice. Community based action for transformative change Policy Press ● Toomey, A. H. (2011). Empowerment and disempowerment in community development practice: eight roles practitioners play. Community Development Journal, 46(2), 181-195. ● Mohajer, N., & Earnest, J. (2009). Youth empowerment for the most vulnerable: A model based on the pedagogy of Freire and experiences in the field. Health Education, 109(5), 424-438. ● Jung, D and Ali, SI (2010) Measuring Empowerment? Ask them SIDA Studies in Evaluation 2010(1)

November 6th READING WEEK

WEEK 9 (14 Nov ) - Politics, power and Health. Learning Objectives 1. Understand the role of power and politics in creating health inequity 2. Examine theories of power 3. To understand the role of health in all policies 4. To identify the barriers to and opportunities for change Required Readings  Raphael, D. (2015). Beyond policy analysis: the raw politics behind opposition to healthy 

public policy. Health promotion international, 30(2), 380-396.

Greer, S. L., & Lillvis, D. F. (2014). Beyond leadership: Political strategies for coordination in health policies. Health Policy, 116(1), 12-17.  Navarro, V. (2008). Politics and health: a neglected area of research. The European Journal of Public Health, 18(4), 354–355.  Wismar, M., McQueen, D., Lin, V., Jones, C. M., & Davies, M. (2013). Rethinking the politics and implementation of health in all policies. Israel journal of health policy research, 2(1), 17. Supplementary Readings

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Gaventa, J Power after Lukes : An overview of theories of power since Lukes and their application to development found at : http://www.powercube.net/wpcontent/uploads/2009/11/power_after_lukes.pdf Fridkin, A. J. (2012). Addressing Health Inequities Through Indigenous Involvement in Health-Policy Discourses. CJNR (Canadian Journal of Nursing Research), 44(2), 108– 122. Shannon, K., Kerr, T., Allinott, S., Chettiar, J., Shoveller, J., & Tyndall, M. W. (2008). Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work. Social Science & Medicine (2008), 66(4), 911–921. Wallerstein N (2006). What is the evidence on effectiveness of empowerment to improve health? Copenhagen, WHO Regional Office for Europe. Health Evidence Network report; www.euro.who.int/document/e88086.pdf. Bambra, C., Fox, D., & Scott-Samuel, A. (2007). A Politics of Health Glossary. Journal of Epidemiology and Community Health, 61(7), 571–574.

Week 10 (Nov 20th.) The importance of place: Neighbourhood environment and health inequities. Case Study : Built Environment and Health Guest Speaker : Candace Nykiforuk Learning Objectives 1. Understand impact of neighbourhood environment on health 2. Critically examine various theoretical approaches to understanding the relationship between neighbourhood and health. 3. Identify aspects of the built environment that promote health. 4. Consider methodological challenges associated with measuring neighborhood impacts on health Required Readings  

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Bernard, P., Charafeddine, R., Frohlich, K. L., Daniel, M., Kestens, Y., & Potvin, L. (2007). Health inequalities and place: A theoretical conception of neighbourhood. Social Science & Medicine, 65(9), 1839–1852. Masuda, J. R., Teelucksingh, C., Zupancic, T., Crabtree, A., Haber, R., Skinner, E., Poland, B., Frankish, J., and Fridell, M. (2012). Out of our inner city backyards: Rescaling urban environmental health inequity assessment. Social Science & Medicine, 75(7), 1244–1253. Schaefer-McDaniel, N., O’Brien Caughy, M., O’Campo, P., & Gearey, W. (2010). Examining methodological details of neighbourhood observations and the relationship to health: A literature review. Social Science & Medicine, 70(2), 277–292. Belon, A. P., Nieuwendyk, L. M., Vallianatos, H., & Nykiforuk, C. I. J. (2014). How community environment shapes physical activity: Perceptions revealed through the PhotoVoice method. Social Science & Medicine, 116, 10–21.

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Supplementary Readings  Frohlich, K. L., & Abel, T. (2014). Environmental justice and health practices: understanding how health inequities arise at the local level. Sociology of health & illness, 36(2), 199-212. WEEK 12 (Nov.27th ) –Tackling health issues at the institutional and organsiational level level through intersectoral action. Lessons from Europe . Instructor: Jane Springett Learning Objectives 1. To explore the roles of organizations and institutions in promoting health. 2. To understand the strengths and limitations of organizational and institutional action on influencing determinants of health 3. To understand the challenges and constraints on intersctoral action . Required Readings: ● Berkeley, D., & Springett, J. (2006). From rhetoric to reality: Barriers faced by Health For All initiatives. Social Science & Medicine, 63(1), 179–188. ● Berkeley, D., & Springett, J. (2006). From rhetoric to reality: A systemic approach to understanding the constraints faced by Health For All initiatives in England. Social Science & Medicine, 63(11), 2877–2889. ● Chircop, A., Bassett, R., & Taylor, E. (2015). Evidence on how to practice intersectoral collaboration for health equity: A scoping review. Critical Public Health, 25(2), 178-191. Supplementary Readings ● Doherty, S., Cawood, J., & Dooris, M. (2011). Applying the whole-system settings approach to food within universities. Perspectives in Public Health, 131(5), 217–224. doi:10.1177/1757913911413344 ● Sallis, J.F., Cervero, R.B., Ascher, W., Henderson, K.A., Kraft, M.K., & Kerr J. (2006). An ecological approach to creating active living communities. Annu. Rev. Public Health, 27, 297–322. ● http://creatinghealthyorganizations.a/Videos.php ● WHO synthesis report from case studies :Health Equity through intersectoral action Geneva,2011 http://www.who.int/social_determinants/publications/publications_case_studies_isa/en/in dex

Week12 December 4th . Tackling Health issues at the policy level: the example of the Alberta Policy Coalition : Guest : Dr Kim Raine.

Learning Objectives 1. Understand the role of public policy in promoting health SPH501:2014

2. Critically examine through case studies how public policy advocacy can create environmental change to promote health 3. Required Reading 

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Shelley D. Golden, Kenneth R. McLeroy, Lawrence W. Green, Jo Anne L. Earp, and Lisa D. Lieberman Upending the Social Ecological Model to Guide Health Promotion Efforts Toward Policy and Environmental Change Health Education & Behavior, April 2015; vol. 42: pp. 8S-4S http://heb.sagepub.com/content/42/1_suppl/8S.full.pdf+html Raine K, Lobstein T, Landon J, Potvin Kent M, Pellerin S, Caulfield T, Finegood D, Mongeau L, Neary N*, and Spence J. Restricting Marketing to Children: Consensus on Policy Interventions to Address Obesity. Journal of Public Health Policy 2013; 34 (2): 239-253, doi:10.1057/jphp.2013.9. Nykiforuk CI, Wild TC, Raine KD. Cancer beliefs and prevention policies: comparing Canadian decision-maker and general population views. Cancer Causes & Control, 2014; 25(12): 1683-1696. Raine KD, Nykiforuk CI, Vu‐Nguyen K, Nieuwendyk LM, VanSpronsen E, Reed S, Wild TC. Understanding key influencers' attitudes and beliefs about healthy public policy change for obesity prevention. Obesity. 2014; 22(11): 2426-2433.

WEEK 13 ( December 4th ) Tackling Wicked problems: Ecological models, Systems Thinking and Public Health Approaches. Instructor: Jane Springett Learning Objectives 1. Understand the nature of systems theory and its implications for public health action 2. Explore the role of settings as a concept for working from a systems perspective 3. Examine how research , learning and action can be integrated in a systems approach to change Required Readings ● Lorenc, T., Clayton, S., Neary, D., Whitehead, M., Petticrew, M., Thomson, H., Cummins, S., et al. (2012). Crime, fear of crime, environment, and mental health and wellbeing: Mapping review of theories and causal pathways. Health & Place, 18(4), 757– 765. ● Leischow, S. J., Best, A., Trochim, W. M., Clark, P. I., Gallagher, R. S., Marcus, S. E., & Matthews, E. (2008). Systems thinking to improve the public’s health. American Journal of Preventive Medicine, 35(2 Suppl), S196–203. ● Keshavarz, N., Nutbeam, D., Rowling, L., & Khavarpour, F. (2010). Schools as social complex adaptive systems: a new way to understand the challenges of introducing the health promoting schools concept. Social science & medicine,70(10), 1467-1474. ● Naaldenberg, J., Vaandrager, L., Koelen, M., Wagemakers, A. M., Saan, H., & de Hoog, K. (2009). Elaborating on systems thinking in health promotion practice. Global health promotion, 16(1), 39-47. SPH501:2014

Supplementary Readings ● Diez Roux, A. V. (2011). Complex systems thinking and current impasses in health disparities research. American Journal of Public Health, 101(9), 1627–1634. ● Chapman, R., Howden-Chapman, P., Capon, A., & Ahao, P. (2012). Cities as systems: Implications for sustainability and health. Wellington, NZ: New Zealand Centre for Sustainable Cities. Available from http://sustainablecities.org.nz/2012/03/cities-assystems-implications-for-sustainability-and-health-2/ ● Hummelbrunner, R. (2006). Systemic evaluation in the field of regional development. In Williams, B. and Imam, I. (Eds.) Systems concepts in evaluation: An expert anthology. Point Reys, CA: American Evaluation Association. ● Burns, D. (2007). Evaluation in Complex Governance Arenas: the Potential of Large System Action Research Available from: http://hls.uwe.ac.uk/research/Data/Sites/1/docs/SOLAR/EvaluationinComplexGovernanc eArenas.pdfShankardass, K. (2012). Place-based stress and chronic disease: A systems view of environmental determinants. In O’Campo, P. & Dunn, J.R. (Eds.), Rethinking social epidemiology: Towards a science of change. Springer Science and Business Media.

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Date Sept 11th Sept 18

Sept 25

Oct 2

Topic Course overview Introduction to the social determinants of health Social Change for Health: Using social theory to understand health and its promotion

Instructor Jane Springett

Assignment

Elaine Hyshka

Discussion of Assignment and allocation of pairs

Social Injustice Kills: The impact of inequality and globalisation on health and wellbeing Case study: aboriginal health Using models to make sense of the Social determinants of health: the socio-ecological model of health and the settings approach

Jane Springett

Oct 9

Early Childhood Development and health: impact on life course Using theory and research data to inform practice : the ECMAP project

Oct 16

Thinking clearly about health behaviour

Oct 23rd

Social relationships and health: social support and social capital Case Study: Lay health workers and health literacy Participatory practice for health

Oct 30 Nov 6th Nov 13

Kim Raine

Jane First draft of short paper due in class (2 copies) Springett Guest Discussion of peer critique speaker- Line assignment Perron Guest Peer critique due in class (2 copies) speaker: Cam Wild Jane Short paper final draft due Springett Discussion of final paper

Jane Springett

Introduction to Case Studies

Jane Springett

Group Work on Case Studies

Jane Springett Guest speaker: Candace Nykiforuk Jane Springett

Group Work on Case Studies

Reading Week Power, politics and health

Nov 20

Tackling health issues at the Community level Case study :Built Environment and Health

Nov. 27

Tackling Health issues at the institutional and Organisational

SPH501:2014

Group Work on Case Studies

Level : intersectoral collaboration Dec 4th Dec 11th

Tackling health issues at the Policy level Tackling Wicked Problems: from ecological models to systems thinking and back.

Dec 18th

SPH501:2014

Kim Raine Jane Springett

Group work on Case Studies Presentation of Case Studies in Class Final paper due