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 2006
August 24-December 14, 2006

DAY/TIME LOCATION: Thursdays, 5:00-7:50 PM

Grant House, Room 314

1008 East Clay Street

Richmond, VA

CREDITS: 3 credit hours

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

Professor of Public Health Policy

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:

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
Virginia Commonwealth University recognizes that honesty, truth, and
integrity are values central to its mission as an institution of higher
education.  The Honor Code is built on the idea that a person's honor is
his/her most cherished attribute.  A foundation of honor is essential to a
community devoted to learning.  Within this community, respect and harmony
must coexist.  The honor code is the policy of VCU that defines the highest
standards of conduct in academic affairs.

The Honor System in its entirety can be reviewed at the following website
address: http://www.students.vcu.edu/rg/policies/honor.html
or it can be found in the 2006-07 VCU Resource Guide.

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 assigned 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 or as stipulated by the instructor. Any exception will require prior discussion with and permission of the instructor.

COURSE DESCRIPTION: This course provides an overview of critical public health-related issues and intervention strategies that may influence life’s chances 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.

  1. A lecture/discussion seminar format will be used.
  2. Selected current event materials and special assigned readings will complement basic text.
  3. An individual student research project with an in-class power point presentation is required.
  4. Guest lecturers will be engaged periodically to provide subject matter expertise.
  5. Special field trips to selected community-based sites will be conducted.

COURSE EMPHASIS:

  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, students will be able to:

  1. Describe and provide a socio-economic picture of the U.S. population to include race, ethnicity, and cultural attributes.
  2. Identify and describe certain political, social, cultural and economic barriers facing some population groups in communities of color in the U.S.
  3. Present examples of best practices and intervention strategies designed to mitigate the consequences of health disparities among different ethnic groups.
  4. Describe key health indicators as measures of disease burden and health outcomes in communities of color.
  5. Identify and discuss the impact of cultural myths that may pose a barrier to improved health status.
  6. Identify and describe key components of the health policymaking process in the U.S.

EXPECTED OUTCOME To:

  1. Improve students’ knowledge and understanding of health status indicators.
  2. Equip students with the ability to distinguish the cause and effects of health status differences among identified ethnic groups.
  3. Provide students with the requisite analytic tools essential to conduct a community-based research project.
  4. Describe the impact of social, cultural, demographic and political aspects that frame the core functions of public health.
  5. Equip students with the ability to recognize and describe the burden of disease caused by certain practices exhibited by individuals of color.
  6. Identify and describe determinants of health and health status.
  7. Describe selected health policies and their impact on health outcomes.

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.

David Satcher, MD, PhD and Rubens J. Pamies, MD, “Multicultural Medicine and Health Disparities.” New York. McGraw-Hill. 2005.

SUPPLEMENTAL REFERENCES:

  1. Attached Bibliography
  2. Suggested Community Service Sites Directory (July 2001)
  3. Guide to the MPH Research Project (Updated 06/06/05)
  4. Cultural, Ethnic and Racial Terminology Compendium

EXPECTATIONS OF STUDENTS:

  1. Continually review course syllabus throughout the semester.
  2. Complete all assignments timely as required.
  3. In-class participation is an essential part of the student’s evaluation.
  4. Outside readings and individual research are required.
  5. Always be prepared.
  6. Consult with the instructor timely for any assistance required.

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 present 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 to include its likely impact on a targeted ethnic group. For each assignment and presentation, the student is expected to conduct a thorough review of the relevant scholarly literature and present 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 on October 5, 2006. The final may be a take home exam that will be due on December 7, 2006. 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 of their research proposal before proceeding. A date for each presentation, based upon your proposal, will be assigned not later than Thursday, November 9, 2006.
  4. Grading: Student’s final grade will be based upon the following criteria:
    Class attendance and participation 10%
    Midterm Exam 25%
    Research Proposal/Paper Presentation 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), 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 specified guidelines..

A grade of ‘B’ (82-91) is earned when an assignment meets all requirements but fails to demonstrate exceptional insight, creativity and originality. 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 questions or concerns about any assignment or course requirements.


AGENDA AND WEEKLY ASSIGNMENTS

SECTION I: PUBLIC HEALTH ISSUES IN COMMUNITIES OF COLOR

WEEK 1 Course Introduction

August 24

Objectives:

  1. Provide an overview of the course
  2. Discuss history-based health disparities
  3. Discuss core public health functions:
    ◦ Policy development
    ◦ Assessment
    ◦ Assurance
  4. Review and discuss social determinants of health
  5. Discuss general definitions and terminology (List attached)
  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. Review and discuss special video: “Always With Us,” Padro Jose Greer, M.D., Keynote Address, 2006 Catholic Health Assembly, Orlando, Fl.

WEEK 2 Overview of Public Health Issues (Cont’d)

August 31

Objectives:

  1. Review and discuss “Racial and Ethnic Disparities in Healthcare:
    A Background and History,” W. Michael Byrd, M.D., MPH; Linda A.
    Clayton, M.D., MPH, Division of Public Health Practice, Harvard School of Public Health.
  2. Identify and discuss key health indicators and health disparities among special population groups.
  3. Identify and describe determinants of health.
  4. Review and discuss the focus of “Health People 2010”
  5. Review and discuss the ten-year Robert Wood Johnson-Funded Initiative: “Youth Matters” (The Three Challenges).
  6. Read and discuss in class Satcher-Pamies, Chapters 1-6

WEEK 3 Distributive Justice in Health Care (Powerpoint Presentation)

Sept. 7

Objectives:

  1. Describe and discuss unequal treatment and health disparities among certain ethnic and racial groups.
  2. Identify and describe selected vulnerable population groups
  3. Discuss the consequences of being uninsured (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 being uninsured
      • Adverse health outcomes
      • Insurance coverage and health of Virginians
      • Adverse economic effects
    • Societal consequences of being uninsured
      • Cost to employers and employees
      • Cost to the healthcare system
      • Cost to the general public
      • Safety net options
  4. Read and discuss in class Satcher-Pamies, Chapters 7-12

WEEK 4 Public Health Issues (cont’d)

Sept. 14

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 Satcher-Pamies, Chapters 13-20.

WEEK 5 Barriers to Health Care for Communities of Color

Sept. 21 VCUHS Powerpoint Presentation

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. Read and discuss in class Satcher-Pamies, Chapters 21-25.

WEEK 6 Barriers to Health Care for Communities of Color (cont’d)

Sept. 28

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.
  5. Read and discuss in class Satcher-Pamies, Chapters 26-31

WEEK 7 Midterm Exam

Oct. 5

Objectives:

  1. Administer, collect and grade midterm exam

SECTION II: INTERVENTION STRATEGIES IN COMMUNITIES OF COLOR

WEEK 8 Closing the Gap: Eliminating Health Disparities

Oct. 12

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 Satcher-Pamies, Chapters 33-34
  3. “Health Care for Everyone: Obstacles Old and New Prevent Significant. change from taking shape.” Efforts to reform healthcare system. (PowerPoint presentation).
  4. Review and discuss purpose of Healthy People 2010

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

Oct. 19

Objectives:

  1. Describe the organization, funding and delivery components of the U.S. health care system.
  2. Identify and discuss the role of grassroots advocacy.
  3. Discuss coalitions and partnerships as an agent of change.
  4. Describe the role of Government in the policy formulation process.
  5. Discuss the role of Government in Minority Health: Chapter 34, Satcher-Pamies.

WEEK 10 The Politics of Health and Health Policy

Oct. 26

Objectives:

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

WEEK 11 Closing the Gap: Intervention Strategies that Work

Nov. 2

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. 9

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. 16

Objectives:

  1. Student-led research project.
  2. Identify, review and discuss community-based best practices.
  3. Describe the role of advocacy for socio-economically disadvantaged population groups.
  4. Review and discuss power point presentation: “Where Does Virginia Stand?”: 2003 Report.

WEEK 14 HOLIDAY: No Class

Nov. 23

WEEK 15 Student-led Research Presentations

Nov. 30

Objectives:

  1. Present and discuss student-led community-based field experience.
  2. Assess the application of student community-based research to improving health outcomes for targeted population groups.

WEEK 16 Course Summary and Evaluation

Dec. 7

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. 14

Objective:

  1. Administer end-of-course examCritical Issues in Research Initiatives

DEFINITIONS AND TERMINOLOGY

  1. Access to health services
  2. Advocacy and activism
  3. Affirmative action
  4. At-Risk population groups
  5. Culture and cultural-related issues
  6. Disadvantaged
  7. Distributive Justice
  8. Diversity
  9. Environment and Environmental-related issues
  10. Ethnicity
  11. Etiology
  12. Financial barriers to health care
  13. Geographic patterns
  14. Health Outcomes
  15. Health Status
  16. Heritage
  17. Incidence
  18. Minority Health
  19. Morbidity
  20. Mortality
  21. Pedigree
  22. Policy
  23. Politics
  24. Race
  25. Racial profiling
  26. Social Justice
  27. Socio-economic status
  28. Underserved population groups

Bibliography

A. Required Text:

  1. Satcher, MD, PhD, David; and Pamies, MD, Rubens J., “Multicultural Medicine and Health Disparities.” New York, McGraw-Hill Medical Publishing Division, 2005.

B. Supplemental References:

  1. American Journal of Public Health (AJPH): April 2002. “Future Health
    Needs of Women of Color.”
  2. Braithwaite, Ronald L., and Taylor, Sandra E., editors: “Health Issues in the
    Black Community.” San Francisco, California: Jossey-Bass Publishers, 2001.
  3. Byrd, Michael, and Clayton, Linda A.: An American Health Dilemma: Race,
    Medicine, and Health Care in the United States, New York, NY: Routledge,
    2002.
  4. 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: University Press, 2000.
  5. Curtis, James L. M.D.: Affirmative Action in Medicine: Improving Health Care for Everyone. Ann Arbor, Michigan: The University of Michigan Press, 2004.
  6. Guinier, Lani, and Torres, Gerald: The Miner’s Canary: Enlisting Race,
    Resisting Power, Transforming Democracy , Cambridge, Massachusetts:
    Harvard University Press, 2002.
  7. King, Jr., Talmadge E., and Wheeler, Margaret B., “Medical Management of Vulnerable and Underserved Patients. Principles, Practice, and Populations,” New York, NY, McGraw Hill, 2007.
  8. 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.
  9. U.S. Department of Health and Human Services: November 2000. “Healthy
    People 2010, Volume I: Understanding and Improving Health.”
  10. 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.
  11. “Unequal Treatment: Confronting Racial and Ethnic Disparities In Health
    Care,” Institute of Medicine of the National Academies of Sciences, 2002.
    Brian D. Smedley, Adrienne Y. Stith, and Alan R. Nelson, Editors.

Other:

  1. Department of Epidemiology and Community Health “Suggested Community Service Sites,” May 2006. (Attached)
VCU logo
School of Medicine
Department of Epidemiology & Community Health
1000 East Clay Street
P.O. Box 980212
Richmond, Virginia 23298-0212
Phone: (804) 828-9785
Fax: (804) 828-9773
E-mail: webmaster

Updated:Annually