Course Descriptions Header

Public Health Issues and Interventions
in Communities of Color

 

EPID 615     Jack O. Lanier, MHA, DrPH, FACHE

Public Health Issues and Interventions in Communities of Color
Semester course; 3 lecture hours. 3 credits. This course is an overview of many critical psychological, social, cultural, demographic, biological, and other factors that influence lifestyle and disease susceptibility among minority status ethnic groups and other medically underserved populations in the United States. A lecture/discussion seminar format will be used, along with readings, student presentations and guest lecturers working in the field, to: (1) improve the students' understanding of the underpinnings of health status differences across communities; and (2) provide students with tools that can be used in developing effective interventions to address the misdistribution of health risk behavior and disease burden. Fall semester

 

COURSE SYLLABUS

 

EPID-615-901: PUBLIC HEALTH ISSUES AND

INTERVENTION STRATEGIES IN COMMUNITIES OF COLOR

FALL SEMESTER 2005

August 24- December 15, 2005

PROFESSOR: Jack O. Lanier, Dr. P.H., MHA, FACHE

Professor

Office: McGuire Annex, Room 324

Phone: 804-828-3258, Fax: 804-225-4096

Email: jolanier@vcu.edu

  

MPH PROGRAM MISSION STATEMENT

OUR MISSION

We are dedicated to promoting, preserving, and restoring health by training students to be effective practitioners of the skills, knowledge, and attitudes needed to:

 Assess the health needs of populations

The MPH program emphasizes community service for special population groups by working closely with local public and private organizations to advance and develop professional opportunities for program students and graduates. The Program is also designed to further the University’s Mission and the MCV School of Medicine’s Strategic Plan.

POLICIES AND PROCEDURES

Americans with Disabilities Act: The Americans with Disabilities Act of 1990 ( http://www.usdoj.gov/crt/ada/adahom1.htm) requires Virginia Commonwealth University to provide a “reasonable accommodation” to any individual who advises us of a physical or mental disability. Students seeking academic adjustments or accommodations must self-identify with the Coordinator of Services for Students with Disabilities on the appropriate campus (Velma Jackson-Williams is the Director of EEO/AA Services, 828-1347). After meeting with the Coordinator, students are encouraged to meet with their instructors to discuss their needs, and if applicable, any safety concerns related to their disabilities.

VCU Honor System: The class will follow the standards of academic integrity, the VCU Honor System, as covered in the current VCU Resource Guide. Any violation of the standards of academic integrity will result in appropriate disciplinary action. Information on the Honor System can be found at http://www.vcu.edu/safweb/rg/policies/rg7honor.html.

Religious Holidays: It is the policy of VCU to allow students, on an individual basis, the opportunity to observe their traditional religious holidays. Students desiring to observe religious holidays of special importance must provide advance written notification to each instructor by the end of the second week of classes.

Attendance : Attendance is defined as both being present for class and fully participating in scheduled assignments. Students are expected to arrive on time and be prepared to participate in discussions and classroom activities. Please consult the University’s policy on attendance: http://www/vcu.edu/artweb/CD/std_res/atten/htm

Assignments: Each student is expected to complete and submit all required assignments as specified in the syllabus. Any exception will require prior discussion with and permission of the instructor.

COURSE DESCRIPTION: This course provides an overview of critical public health issues and intervention strategies that may influence life and disease susceptibility among different ethnic or racially identified groups. Additionally, the course will include attention to certain medically underserved populations in the U.S.

EXPECTED OUTCOME :

To improve students’ knowledge and understanding of health status indicators

COURSE FOCUS :

1. Social Justice: Encompasses economic justice. Social justice is the virtue which guides us in creating those organized human interactions we call institutions. In turn, social institutions, when justly organized, provide us with access to what is good for the person, both individually and in our associations with others. Social justice also imposes on each of us a personal responsibility to work with others to design and continually perfect our institutions as tools for personal and social development. http://www.cesj.org/thirdway/economicjutice-defined.htm

2. Distributive Justice: Is the idea that health care consumption should occur on the basis of need rather than the ability to pay (Flood, 2000). This implies that the ill should not be discriminated against simply because of the inability to pay for required health care services. In some cases, this has also come to mean that the wealthy should not benefit from their wealth in obtaining health services (Selic, 1995; Boucher and Palda, 1996).

COURSE OBJECTIVES: Upon completion of this course, the student will be able to:

  1. Describe and provide a socio-demographic picture of the U.S., based on race, ethnicity, socioeconomic status, and other pertinent characteristics of selected population groups.
  2. Identify and discuss certain political, social, cultural , economic and psychological obstacles facing certain population groups in communities of color in the U.S.
  3. Identify and assess selected health problems found to be more prevalent in communities of color.
  4. Present examples of best practices and intervention strategies designed to mitigate the consequences of health disparities among different population groups.
  5. Describe key health indicators as measures of disease and health outcomes in communities of color.
  6. Identify and discuss the impact of cultural myths that may pose a barrier to improved health status.
  7. Identify and describe selected issues that may characterize the politics of health.

REQUIRED TEXT : The primary textbook is available at the MCV Campus Bookstore or through VCU Libraries as an e-book at http://www.netLibrary.com/urlapi.asp?action=summary&v=1&bookid=57149.

Ronald L. Braithwaite and Sandra E. Taylor, Eds. Health Issues in the Black Community. 2 nd ed. San Francisco: Jossey-Bass, Inc. 2001

SUPPLEMENTAL REFERENCE DOCUMENTS INCLUDE :

EXPECTATIONS OF STUDENTS:

ASSIGNMENTS:

1. Class presentations. Each student will be responsible for leading assigned discussions during the semester. Discussions will focus on major health issues and factors that may impact particular ethnic or racial groups. Students will be expected to discuss the history and evolution of a particular health issue, its impact, and recommendations for addressing the problem. Students will also focus on a major public health-related policy enacted or presently being considered. Students will be expected to discuss the history of the policy, the perspective of various constituencies, and present an assessment of the policy considering the aims of public health and the interests of the community. For each assignment and presentation, the student is expected to conduct a thorough review of the relevant scholarly literature and various positions pertaining to the issue.

2. Exams. A midterm exam and a final exam will be given. The exams may include a combination of essays, multiple choice, true-false and short definitions. The midterm may given in class (please, write legibly) on October 6, 2005. The final may be a take home exam that will be due on December 8, 2005. Dates are subject to change with as much prior notification as possible, should unplanned circumstances or unforeseen events occur.

 

3. Research Proposal and Presentation. Each student will identify an issue of importance to the health of at least one special population group, develop and present an intervention strategy. Each student will identify and report on a funding source for the proposal using the guidelines provided. Students should contact the instructor for approval each research proposal before proceeding. A date for each presentation, based upon your proposal, will be assigned not later than Thursday, November 10, 2005.

4. Grading: Student’s final grade will be based upon the following criteria:

Class attendance and participation 10%

Midterm Exam 25%

Research Proposal/Paper 40%

Final Exam 25%

A grade of ‘A’ (92 and above) is earned when an assignment meets all requirements. This grade demonstrates exceptional insight, creativity and originality. The assignment will be well conceptualized, demonstrate a comprehensive grasp of the literature, issues and impact. The effort should include a thoughtful analysis. The student’s work must be well organized, well written and properly edited (proofed and spell-checked), or well articulated (in the case of oral presentations - you will keep the interest of the audience and discuss your topic in a systematic and engaging manner), and follow proper formatting.

A grade of ‘B’ (82-91) is earned when an assignment meets all requirements. The student’s work will be well-organized, properly edited and meets presentation guidelines.

A grade of ‘C’ (70-81) is earned when an assignment fails to meet part of the assignment and demonstrates an average grasp of related concepts, issues and scholarship.

A grade of ‘D’ (Below 70) is earned when an assignment fails to meet several parts of the assignment and does not demonstrate a grasp of the issue, and is poorly written or presented.

Please speak with the instructor immediately should you have any questions or concerns about any assignment or course requirement.


WEEKLY READINGS AND AGENDA

SECTION I: PUBLIC HEALTH ISSUES IN COMMUNITIES OF COLOR

 

WEEK 1 Course Introduction - August 25

Assignment Objectives:

  1. Provide an overview of the course
  2. Discuss course goals and objectives
  3. Discuss core public health functions:
    • Policy development
    • Assessment
    • Assurance
  4. Review and discuss social determinants of health
  5. Discuss general definitions
    • Race
    • Racial profiling
    • Ethnicity
    • Minority
    • Diversity
    • Socio-economic status
    • Uninsured
    • Disadvantaged
    • Affirmative action
    • Health outcomes
  6. Identify two (2) course-related public health issues that impact persons of color for class next week. References should be scholarly, informative, and relevant to the of the focus of the course.
  7. Identify and present a topic of special interest to a population group for possible in-depth research. The issue should be related to the general focus of the course.
  8. Read Braithwaite, Chapter 1; Hogue, Chapter 1
  9. Review Healthy People 2010, Volume 1
  10. Be prepared to discuss special handouts in class
  11. Define and discuss terms attached to syllabus (page 13)

WEEK 2 Overview of Public Health Issues in Virginia - Part I

Sept. 1

Assignment Objectives:  

1. Identify and review ethnic demographics, key health indicators, and health disparities among special population groups.

2. Identify and describe key risk factors and determinants of health..

3. Review and discuss “Health People 2010”

4. Review and discuss Robert Wood Johnson-Funded Project document: Youth Matters (“Three Challenges”)

5. Read and discuss in class Braithwaite, Part One Chapters, 1- 5

6. Read and discuss in class Braithwaite, Part Four, Chapters 6-9

WEEK 3 Distributive Justice in Health Care (Powerpoint Presentation)

Sept. 8

Assignment Objectives:

  1. Describe and discuss unequal treatment and health disparities among certain ethic and racial groups.
  2. Identify and describe selected vulnerable population groups
  3. Discuss the costs and consequences of uninsurance (Reference: “The Costs and Consequences of Uninsurance: A Virginia State Planning Grant Technical Briefing Paper (Draft), Center for Health Policy, Research and Ethics, George Mason University, August 15, 2005).
    • Background of Insurance coverage
    • Erosion of employee sponsored coverage
    • Rising insurance costs
    • Personal consequences of uninsurance
      • Adverse health outcomes
      • Insurance coverage and health of Virginians
      • Adverse economic effects
    • Societal consequences of uninsurance
      • Costs to employers and employees
      • Costs to the healthcare system
      • Costs to the general public
      • Medicaid as a safety net
  4. Read and discuss in class Braithwaite, Part Three, Chapters 10-12
  5. Read and discuss in class Special Handouts

WEEK 4 Overview of Public Health Issues in Virginia - Part 2

Sept. 15

Assignment Objectives:  

  1. Identify and describe the demographics and characteristics of the working poor.
  2. Identify and discuss key characteristics of the health workforce in Virginia.
  3. Describe known health disparities among identifiable racial and ethnic population groups in Virginia.
  4. Read and discuss the research findings of Hogue, Hargraves and Collins: “Minority Health in America.”
  5. Read and discuss in class Braithwaite, Part Four, Chapters 16-21

WEEK 5 Barriers to Health Care for Communities of Color

Sept. 22 VCUHS Powerpoint Presentation

Assignment Objectives:

  1. Review social, financial, economic and cultural barriers to health care
  2. Identify customs, attitudes of certain ethnic groups toward health care.
  3. Identify and describe utilization patterns among certain population groups.:.
  4. Review and discuss “Healthy People 2010”
  5. Review and discuss identified section of the “ Institute of Medicine Report – 2003”
  6. Discuss in class the Kellogg Foundation Report on Diversity in Health Care
  7. Review and discuss special handouts in class

WEEK 6 Barriers to Health Care for Communities of Color (continued)

Sept. 29

Assignment Objectives:

  1. Introduce and present special Guest Speaker and midterm review. Review and discuss the seven (7) course objectives.
  2. Review and discuss course objectives.
  3. Review and discuss all previous course assignments.
  4. Identify and discuss public policy pertaining to vulnerable population groups.
WEEK 7 Midterm Exam

Oct. 6

Assignment Objectives:

1. Administer and collect midterm exam

 

SECTION II: INTERVENTION STRATEGIES IN COMMUNITIES OF COLOR

 

WEEK 8 Closing the Gap: Eliminating Health Disparities

Oct. 13

Assignment Objectives:

 
  1. Identify and Discuss the health needs of special population groups:
    • children,
    • elderly,
    • homeless,
    • handicapped and disabled,
    • uninsured
    • unemployed
  2. Read and discuss in class Braithwaite, Part Five, Chapters 22-26
  3. Read and discuss “The 1985 Report of the Secretary’s Task Force on Black and Minority Health, U.S. Department of Health and Human Services (DHHS), 1985.”
  4. Read and report on “President Clinton’s campaign titled “One America in the Twenty-First Century: The President’s Initiative on Race”
  5. Review for background discussion Healthy People 2010

WEEK 9 Policy Formulation: Ethical, Political, and Ecological Issues

Oct. 20

Assignment Objectives:

  1. Discuss the organization, funding and delivery of health services in the U.S.
  2. Discribe and discuss the association between health services. and social
  3. Discuss the efficacy of public-private partnerships.
  4. Discuss grassroots advocacy.
  5. Discuss coalitions as a change agents.
  6. Describe and discuss the role of the Executive, Legislative and Judicial Branches of Government in the policy formulation process.
  7. Read and discuss Braithwaite, Part Five, Chapters 24 and 26
  8. Read and discuss “The 1985 Report of the Secretary’s Task Force on Black and Minority Health (U.S. Department of Health and Human Services [DHHS], 1985)”.

WEEK 10 The Politics of Health

Oct. 27

Assignment Objectives:

  1. Describe and discuss the role of advocacy groups.
  2. Review and discuss Van Horn’s Policy Domains.
  3. Read and discuss Braithwaite, Chapter 24 and 26.
  4. Discuss “Politics and Public Policy:” Carl E. Vanhorn, Donald C. Baumer, and William T. Gormley, Jr.
  5. Read and discuss in class Special Handouts

WEEK 11 Closing the Gap: Intervention Strategies that Work

Nov. 3

Assignments Objectives:

  1.   Review and discuss the “2003 Institute of Medicine (IOM) Report.”
  2. Discuss selected section of VDH’s Strategic Plan.
  3. Discuss the Kellogg Foundation Initiative, “Strategies for Increasing Diversity in the U.S. Physician Workforce,” (July 2001).
  4. Describe and discuss examples of best practices.

WEEK 12 Intervention Strategies that Work

Nov. 10

Assignment Objectives:

  1. Guest speaker from the Virginia Department of Health Office of Minority.
  2. Review and discuss VDH’s Strategic Plan.
  3. Student-led discussion of a selected public health research issue impacting persons of color.
  4. Review and discuss special handouts.

WEEK 13 Intervention Strategies that Work

Nov. 17

Assignment Objectives:

  1. Student-led research project
  2. Identify, review and discuss community-based best practices
  3. A community leader discusses the role of advocacy for vulnerable population groups
  4. Review and discuss powerpoint presentation: “Where Does Virginia Stand?”: 2003 Report

WEEK 14 HOLIDAY: No Class

Nov. 24

 

WEEK 15 Student-led Research Presentation and Guest Speaker

Dec. 1

Assignment Objectives:

  1. Review and discuss student research papers
  2. Student-led critique and evaluation of community-based field experience

WEEK 16 Course summary and evaluation

Dec. 8

Assignment Objectives:

1. Review and discuss all previous course assignments

2. Class discuss and critique course content

3. Class complete end-of-course evaluation

WEEK 17 Final Exam

Dec. 15

Assignment Objective:

1. Administer end-of-course exam

Critical Issues in Research Initiatives

TERMINOLOGY

  1. Etiology
  2. Incidence
  3. Prevalence
  4. Morbidity
  5. Mortality
  6. Environmental factors
  7. Geographic patterns
  8. Access and organizational issues
  9. Financial Issues: Insurance coverage; employment status
  10. Policy implications

Bibliography

A. Required Text

  1. Braithwaite, Ronald L., and Taylor, Sandra E., editors: “Health Issues in the Black Community.” San Francisco, California: Jossey-Bass Publishers, 2001.

B. Supplemental References

  1. Byrd, Michael, and Clayton, Linda A. : An American Health Dilemma: Race, Medicine, and Health Care in the United States, New York, NY: Routledge, 2002.
  2. Collins, Karen S., M.D., M.P.H., and Hargraves, Martha A., Ph.D., M.P.H., and Hogue, Carol J. R., Ph.D., M.P.H., editors: Minortiy Health in America: Findings and Policy Implications from The Commonwealth Fund Minority Health Survey. Baltimore, Maryland: The Johns Hopkins University Press, 2000.
  3. Curtis, James L. M.D.: Affirmative Action in Medicine: Improving Health Care for Everyone. Ann Arbor, Michigan: The University of Michigan Press, 2004.
  4. Guinier, Lani, and Torres, Gerald: The Miner’s Canary: Enlisting Race, Resisting Power, Transforming Democracy , Cambridge, Massachusetts: Harvard University Press, 2002.
  5. United States Department of Health and Human Services: (2001). Mental Health: Culture, Race, and Ethnicity - A Supplement to Mental Health: A Report of the Surgeon General, Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services
  6. United States Department of Health and Human Services: (2001). Mental Health: Culture, Race, and Ethnicity - A Supplement to Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.
  7. U.S. Department of Health and Human Services: November 2000. “ Healthy People 2010, Volume I: Understanding and Improving Health.”
  8. American Journal of Public Health (AJPH): April 2002. “Future Health Needs of Women of Color.”
  9. VanHorn, Carl E., Baumer, Donald C., and Gormley, Jr., William T.: Politics & Public Policy, Washington, D.C.: CQ Press, A Dimision of Congressional Quarterly Inc.

 

 

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