The University of North Carolina at Chapel Hill School of Social Work COURSE NUMBER: COURSE TITLE: SEMESTER AND YEAR: SOWO 836.001 and SOWO 836.002 Examining Health Access and Health Disparities Spring 2015 MEETING TIME/LOCATION: Mon (001) 9-10:20am Rm 135 / Tues (002) 9-10:20am Rm 300 INSTRUCTOR: Sarah Verbiest, DrPH, MSW, MPH Email: sarahv@med.unc.edu Phone: 919.843.2455 Office: Tate Turner Kuralt Building Room 419 OFFICE HOURS: By appointment (feel free to stop by my office anytime) AND 10 minutes before/after class COURSE DESCRIPTION: Examines disparities in health outcomes as a function of access to and quality of care for persons disadvantaged by income, ethnicity, sexual orientation, and other factors. Critically evaluates health and social policies related to exacerbation and resolution of health inequities. COURSE OBJECTIVES: The student who successfully completes this course should be able to: 1. Identify the principles, foundation and provisions of the primary social welfare programs that constitute the healthcare safety net in the United States. 2. Demonstrate the analytic, theoretical and value assessment skills that enable social workers to evaluate policies and apply change strategies. 3. Apply concepts and principles of human rights, social justice, and social work ethics to policy analysis, development and change strategies. 4. Describe major disparities in diagnosis, prognosis, and health outcomes in the United States for persons of varying gender, race and ethnicity, sexual orientation, and level of economic advantage. 5. Discuss the historical and political context of contemporary health disparities, including their roots in discriminatory systems and policies. 6. Describe the interrelationships among a range of economic and social factors that result in inadequate access to quality care. 7. Describe characteristics of healthcare systems and policies that inhibit the provision of highquality, culturally sensitive care. 8. Discuss ethical challenges for the social worker related to practicing in an environment that is structured in a way that promotes unequal access to and quality of care. 9. Evaluate a range of policy and intervention solutions that have been proposed in order to address and resolve health disparities. 10. Articulate strategies for the exercise of leadership and advocacy in successfully addressing health disparities. 1 TEACHING METHODS: This course will stimulate new ideas and insights related to health disparities and policy. During the course, students will agree and disagree with course content. Respectful discussion and debate is strongly encouraged. Students should feel free to relate the readings to broader policy, intervention, prevention, treatment, and systemic factors previously discussed and from experience in the field. Each session will include a combination of lecture, discussions, and classroom exercises. As the semester progresses, there will be allotted time for group and individual consultation to prepare for the final assignment. Depending on the week, guest speakers will be invited for a portion of the class to discuss relevant content. Adult learning methods will be utilized. Students are expected to complete all assigned readings before each class begins so they can contribute to discussion in meaningful ways. Not every article will be discussed in elaborate detail but should serve as a background for which the class topic is based. All students are expected to attend classes, participate in class discussion and activities, and make connections to class content in field and community contexts. POLICY FOR ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES: Students with disabilities that affect their participation in the course and who wish to have special accommodations should contact the University’s Disabilities Services http://disabilityservices.unc.edu. Students should discuss the specific accommodations they require directly with the professor. APA FORMATTING: Students are expected to correctly cite all of your material following the 6th ed. of the APA manual. Please refer to the APA manual and/or the School’s Writing Resources Page that includes an updated “APA Quick Reference Guide.”(http://ssw.unc.edu/students/writing). You may also schedule an appointment with the SSW Writing Support Team: Diane Wyant, (dwyant@email.unc.edu) or Susan White, (sewhite@email.unc.edu). POLICY ON ACADEMIC DISHONESTY: Please refer to the APA Style Guide, The SSW Manual, and the SSW Writing Guide for information on attribution of quotes, plagiarism and appropriate use of assistance in preparing assignments. All written assignments should contain a signed pledge stating: "I have not given or received unauthorized aid in preparing this written work". In keeping with the UNC Honor Code, if reason exists to believe that academic dishonesty has occurred, a referral will be made to the Office of the Student Attorney General for investigation and further action as required. TEXTBOOKS AND OTHER READINGS: There is no required text for this course. All readings will be accessible through the UNC library system or posted on Sakai. If a reading has not uploaded or the link is broken please notify the instructor as soon as possible. ATTENDANCE AND PARTICIPATION: Student attendance at all class sessions is expected. If you will not be able to attend a class, notify the instructor as soon as possible. It is your responsibility to obtain handouts and information about class content from your classmates if you are unable to attend a class. In order to fully participate in and benefit from each session, students must complete required readings and come to class prepared and on time. Student who miss 2 or more classes without permission from the instructor, or who are continually late, will receive an “L”. 2 LATE ASSIGNMENTS: Late assignments are strongly discouraged. To obtain permission to submit an assignment after the deadline, the student must seek approval from the instructor before the due date. If permission for late submission is not granted before breaking a deadline, the grade will automatically be reduced 10% each day, including weekends. In case of an emergency, a late paper may be accepted without penalty at the discretion of the instructor. Avoid having last minute computer failures prevent you from turning papers in on time. Plan ahead! CELL PHONE AND COMPUTER POLICY: Cell phones are a disruption to the learning process. Please turn off cell phones during class. Laptops are allowed for class notes and also to look up information pertinent to class discussion. However, you are to refrain from email or any other off-topic computer/internet search while class is in session. Your participation grade will reflect non-compliance. GRADING SYSTEM: H = 94 and above P = 80 to 93 L = 70 to 79 F = 69 and below COURSE OVERVIEW WEEK 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 DATE (2016) Mon - 1/11 Tues - 1/12 MON - 1/18 Tues -1 /19 MON – 1/25 TUES – 1/26 MON –2/01 TUES – 2/02 MON – 2/08 TUES – 2/09 MON – 2/15 TUES – 2/16 MON – 2/22 TUES – 2/23 MON – 2/29 TUES – 3/1 MON – 3/07 TUES – 3/08 MON – 3/14 TUES – 3/15 MON – 3/21 TUES – 3/22 MON – 3/28 TUES – 3/29 MON – 4/04 TUES – 4/05 MON – 4/11 TUES -4/12 MON – 4/18 TUES – 4/19 MON – 4/25 TUES -4/26 TOPICS TO BE COVERED Course overview and patterns and causes of health disparities and inequity NO CLASS – MLK HOLIDAY Frameworks and theories to understand health equity issues Policy analysis frameworks and theory Effective communication about policy Return on Investment: The economics of health equity and making the case Frameworks and theories to understand health equity issues NO CLASS Overview of healthcare in the U.S: financing & policies Healthcare in the U.S: challenges and strategies for addressing disparities The role of social workers in advocacy and health equity / ethical principles SPRING BREAK How immigration, acculturation and national origin influence health Closing the gap from the start: strategies for addressing equity in birth outcomes Community approaches to improve health Final presentations & discussion Final presentations & discussion Leadership Revisited and Class Wrap Up 3 COURSE REQUIREMENTS OVERVIEW Requirement Points Date/Due Date Class Participation (attendance) Frameworks Reflection Policy Topic Communications “Share” 10 points 15 points 10 points Policy Analysis and Topic Preview Final Paper Health Equity and Policy Presentation 20 points 30 points 15 points Ongoing Week 4 Ongoing – Complete by Week 12 Week 7 Week 11 Week 13 & 14 Assignments must be submitted by the start of class preferably via Sakai. Websites on Potential Policy Topics: NASW (Social Work Professional) - http://www.socialworkers.org/advocacy/default.asp American Public Health Association - http://www.apha.org/advocacy/ Progressive NC - http://www.ncjustice.org Conservative NC - http://www.johnlocke.org Heritage Foundation- http://www.heritage.org Kaiser Family Foundation- http://kff.org Policy Link - http://www.policylink.org/ Women AdvaNCe - http://www.womenadvancenc.org or Momsrising - http://www.momsrising.org National Council of La Raza - http://www.nclr.org The North Carolina Justice Center - http://www.ncjustice.org/ If you are in field check out your agency’s website and ask about their policy agenda COURSE READINGS AND OUTLINE JAN 11 & JAN 12, 2016 Week 1: Course overview and Patterns and causes of health disparities 1. Course overview and class introductions 2. Guidelines for dialogue 3. Introduction to health disparities in diagnosis, prognosis, and health outcomes 4. Background history and patterns and causes of health disparities Readings: Woolf, S.H., & Braveman, P. (2011). Where health disparities begin: The role of social and economic determinants and why current policies may make matters worse. Health Affairs, 30, 1852-1859 doi: 10.1377/hlthaff.2011.0685 Health Affairs Policy Brief (2011, October 6). Achieving health equity. Retrieved from http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_53.pdf Braveman, P. & Gurskin, S. (2003). Defining equity in health. J. Epidemiology and Community Health, 4 57, 254-258. (Optional) Link, B.G & Phelan, J.C. (2006). Fundamental Sources of Health Inequalities. In Mechanic, D., Rogurt, L.B., Colby, D.C. & Knickman, J.R. (Eds.), Policy Changes in Modern Health Care (7184). New Brunswick: Rutgers University Press. JAN 18 & JAN 19, 2016 Week 2: Frameworks and theories to understand health equity issues 1. Individual risk factors vs. social conditions (SES, neighborhood, employment) 2. Life Course theory 3. Historical trauma and population health 4. The Life Course Game Note: Section 836.001 on Monday will not meet. We will make up the class content in a few weeks, however, please watch the video and complete the readings on time as these concepts are important for the next several weeks. Readings: WATCH: The Impact of Racism on the Health and Well-Being of the Nation – Webinar 1 Naming and Addressing Racism: A Primer. Dr. Camara Jones (begin at minute 16:20 – will take 45 mins) https://www.apha.org/events-and-meetings/webinars/racism-and-health Policy Link (2011). Why race and place matter (Executive Summary): Impacting health through a focus on race and place. Start on page 16. Retrieved: http://www.policylink.org/atf/cf/%7B97c6d565-bb43-406d-a6d5eca3bbf35af0%7D/WPRM%20EXSUM%20(LORES).PDF Policy Link (2013). All-in Nation: An America that works for all (Executive Summary): http://allinnation.org/pdf/ExecSummary.pdf JAN 25 & JAN 26, 2016 Week 3: Policy analysis frameworks and theory 1. Understanding social policy analysis 2. Critical Theory Model for social welfare policy analysis 3. Rational vs. Non rational Policy analysis frameworks: themes and assumptions that guide policy analysis Readings: Segal, E. A. (2010). Social welfare policy and social programs: A values perspective. Belmont, CA: Cengage Learning. O’Conner, M. K., & Netting, F. E. (2011). Analyzing social policy: Multiple perspectives for critically understanding and evaluating policy. Hoboken, NJ: John Wiley & Sons. Chapter 4: Analyzing and researching social welfare policies (pp.80—113). Chapter 6: Applications in Nonrational Policy Analysis Case Study 5 FEB 1 & 2, 2016 Week 4: How to effectively communicate about health policy 1. How to effectively communicate a policy position, especially if controversial 2. Review and analyze sample policy briefs and position statements 3. Discuss framing ideas and messages 4. Lessons from the field: Guest TBD Frameworks Reflection is due today Readings: See Frameworks Reflection Assignment Blog posting by Melinda Lewis, LCSW: “What makes a good policy brief” http://melindaklewis.com/2009/09/30/what-makes-a-good-policy-brief/ IDRC Toolkit for Health Researchers: How to Write a Policy Brief http://www.idrc.ca/EN/Resources/Tools_and_Training/Documents/how-to-write-a-policybrief.pdf Resources: Grantmakers in Health (2007). Communicating for Policy Change: Issue Brief No. 29. Washington, D.C. Retrieved from: http://www.gih.org/usr_doc/communicating_for_policy_change_final.pdf Jones, N., & Walsh, C. (2008). Policy briefs as a communication tool for development research: Background note. Retrieved from: http://www.odi.org.uk/sites/odi.org.uk/files/odiassets/publications-opinion-files/594.pdf (review Table 1 on page 4). Global HIV/AIDS Initiatives Network, Guidelines for Writing Policy Briefs http://communicationresources.wikispaces.com/file/view/Guidelines+for+writing+policybriefs.pdf FEB 8 & 9, 2016 WEEK 5: Interventions to reduce disparities in an age of scare resources 1. The economics of health equity – making the case 2. Return on Investment: Using cost benefit ratios to understand why prevention matters 3. Case examples: tobacco policy, obesity, HIV/AIDS in the U.S., poverty and children’s health 4. Guest speaker - TBD Readings: Warner, K.E. (2006). Tobacco Policy in the U.S.: Lessons for the Obesity Epidemic. In Mechanic, D., Rogurt, L.B., Colby, D.C. & Knickman, J.R. (Eds.), Policy Changes in Modern Health Care (99-116). New Brunswick: Rutgers University Press. 6 Marlatt, A.G., & Witkiewitz, K. (2010). Update on harm-reduction policy and intervention research. Annual Review of clinical Psychology, 6, 591–606. Wolfe, B. L. (2009). Reducing disparities by targeting mothers and children. Pathways (winter), 1-4. Videos to view in class: Public Health is ROI: Saves lives, saves money http://www.youtube.com/watch?v=B5M9JefYxJI FEB 15 & 16, 2016 WEEK 6: FRAMEWORKS AND THEORIES TO UNDERSTAND HEALTH EQUITY ISSUES (REPEAT) Section 836.002 on Tuesday will not meet. Section 836.001 on Monday will meet to cover content missed over MLK Holiday. FEB 22 & 23, 2016 WEEK 7: Overview of Healthcare in the U.S.: financing and policies Policy analysis and topic preview paper due today 1. 2. 3. 4. 5. Affordable Care Act Federal financing of health care in the US Private sector health care and reform Role of social workers in health care settings Guest speaker: TBD Readings: WATCH: Health Insurance Explained by Youtoons at http://kff.org/health-reform/video/healthinsurance-explained-youtoons/ TAKE: The Health Insurance Quiz at http://kff.org/quiz/health-insurance-quiz/ REVIEW: Information on Disparities Policy at http://kff.org/disparities-policy/ Silberman, P. (2013). Implementing the Affordable Care Act in North Carolina: The rubber hits the road. North Carolina Medical Journal, 74(4), 298-307. Additional Resources: The Henry J. Kaiser Family Foundation - http://kff.org/understanding-health-insurance/ THE source of information: www.Healthcare.gov Raising Women’s Voices website has good information about enrollment, advocacy, stories and links. http://www.raisingwomensvoices.net 7 NC Campaign for Better Care – this links to a video that is a good sample story: http://www.ncjustice.org/?q=health/health-access-coalition-nc-campaign-better-care Consumer Reports on the Affordable Care Act: http://www.consumerreports.org/health/resources/pdf/ncqa/The_Affordable_Care_ActYou_and_Your_Family.pdf Every Woman Southeast Coalition – October and November 2013 newsletters – Both have a variety of resources and links to current information on health care reform. http://archive.constantcontact.com/fs191/1110472552165/archive/1115333192782.html http://archive.constantcontact.com/fs191/1110472552165/archive/1116996602364.html FEB 29 & MARCH 1, 2016 WEEK 8: Overview of Healthcare in the U.S (cont.); ACA, Improving access and quality 1. Ideological and cultural issues to tackle 2. Health reform and role of social work 3. Strategies for addressing health disparities in health care Readings: Jansson, B. S. (2011). Embedding advocacy in the U.S. health system. In Improving healthcare through advocacy: A guide for the health and helping professions (1-13). Hoboken, N.J.: John Wiley & Sons. Hall, W.J. et al (2015). Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. American Journal of Public Health, 105(12): 2588Golden, R.L. (2011). Coordination, integration, and collaboration: A clear path for social work in health care reform. Health & Social Work, 36(3): 227-228. Institute of Medicine. (2002). Unequal treatment: What healthcare system administrators need to know about racial and ethnic disparities in healthcare. http://www.iom.edu/~/media/Files/Report%20Files/2003/Unequal-Treatment-Confronting-Racialand-Ethnic-Disparities-in-Health-Care/DisparitiesAdmin8pg.pdf Kaiser Family Foundation. (2009). National health insurance—a brief history of reform efforts in the U.S. Available: http://www.kff.org/healthreform/upload/7871.pdf MAR 7 & 8, 2016 WEEK 9: The role of social workers in advocacy and addressing health disparities / Ethics 1. Role of social workers in addressing health disparities and improving access: local and national efforts 2. Policy practice and legislative action 3. Advocacy and its place in micro and macro practice 4. Guest Speakers: TBD 8 Readings: Jansson, B (2014). In Becoming an Effective Policy Advocate. Chapter 2 pp 33-51, Belmont, CA: Brooks/Cole, Cengage Learning. Bobo, K, Kendall, J, Max, S (2010). In Organizing for Social Change Midwest Academy Manual for Activists. Chapter 2 pp 6-19, Santa Ana, CA, The Forum Press, Inc. Bobo, K, Kendall, J, Max, S (2010). In Organizing for Social Change Midwest Academy Manual for Activists. Chapter 3 pp 21-27, Santa Ana, CA, The Forum Press, Inc. Poindexter, C.C. (1999). Promises in the Plague: The Ryan White CARE Act as a Case Study for Legislative Action. Health and Social Work, 24, 35-41. McDonough-Figueira, J. (1993). Policy Practice: The Neglected Side of Social Work Intervention. Social Work, 38(2), 179-188. Moniz, C. (2010). Social work and the social determinants of health perspective: A good fit. Health & Social Work, 35(4): 310-313. Praxis Project (2005). Advocating for Better Policies. Available: http://www.unnaturalcauses.org/assets/uploads/file/UC_PolicyAdvocacy.pdf (*This will be a helpful tool to consider as you plan your final presentation). MAR 14 & 15, 2016 NO CLASS, ENJOY YOUR SPRING BREAK MAR 21 & 22, 2016 WEEK 10: How immigration, acculturation and national origin influence health 1. Effects of immigration and acculturation on health 2. The Latino Health Paradox 3. Guest speaker: TBD 4. Video: Unnatural Causes-- Becoming American (view in class) Readings: DeRose, K. P., Escarce, J. J., & Lurie, N. (2007). Immigrants & health care: Sources of vulnerability. Health Affairs, 26(5), 1258-1268. Zambrana, R.E., Carter-Pokras, O. (2010) Role of acculturation research in advancing science and practice in reducing health care disparities among Latinos. American Journal of Public Health, 100(1), 18-23. Galarneau, C. (2011). Still Missing: Undocumented immigrants in health care reform. Journal of Health Care for the Poor and Underserved, 22: 422–428. 9 MAR 24, 2016 WEEK 11: Closing the gap from the start: strategies for addressing equity in birth outcomes – theory in action 1. Effects of birth outcomes on health equity and visa versa 2. Strategies for change Final paper due today Readings: Hogan, V. K., Rowley, D., Bennett, T., Taylor, K. D. (2012). 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, 1163-1150. Hogan, V.K., et al (2013). The impact of social disadvantage on preconception health, illness, and well-being: an intersectional analysis. American Journal of Health Promotion, 27 (3), eS32-42. Verbiest, S., Malin, C.K., Drummonds, M., & Kotelchuck, M. (2016). Catalyzing a reproductive health and social justice movement. Maternal and Child Health Journal, IN PRESS. MARCH 31, 2016 WEEK 12: Examples and interventions of community based approaches to improve health 1. Impact of social injustice on the health of marginalized populations 1. Addressing racial inequality in healthcare through civil rights 2. Guest speakers - INVITED Policy Topic Communication “Share” must have been done by today Readings: Gehlert, S., Coleman, R. (2010). Using community-based participatory research to ameliorate cancer disparities. Health & Social Work, 35(4): 302-309. Wiechelt, S.A., Gryczynski, J., Jeannette, L., (2009). Designing HIV prevention interventions for urban American Indians: Evolutions of the ‘Don’t Forget Us’ program. Health & Social Work, 34(4): 301304. Sequist, T.D., Cullen, T., & Acton, K. (2011). Indian Health Service innovations have helped reduce health disparities affecting American Indian and Alaska Native people. Health Affairs, 30, 1965-1973. doi: 10.1377/hlthaff.2011.0630 APR 11 & 12, 2016 WEEK 13: Final presentations and discussion Note: Students will score and comment on each other’s presentations. Class attendance is very important. APR 18 & 19, 2016 WEEK 14: Presentations and discussion Note: Students will score and comment on each other’s presentations. Class attendance is very important. 10 APR 25 & 26, 2016 WEEK 15: Class wrap up and review 1. Resources and tools for future use (references on Civil Discourse, Adaptive Leadership, Policy development and Crucial Conversations - The Crucial Conversations people have a blog & weekly newsletter: http://www.crucialskills.com/ 2. Moving from class to community 3. Class evaluation & lingering questions Readings: Gooden, S (2014). In Race and Social Equity A Nervous Area of Government. Chapter 1 pp 3-20, Armonk, NY: M.E. Sharpe, Inc. CLASS ASSIGNMENTS CLASS PARTICIPATION: (10 POINTS) Due: Ongoing All students are expected to attend class, complete the readings and to participate in class discussions. Active and constructive participation matters; be on time and be prepared to be called on. POLICY COMMUNICATION – FRAMEWORKS REFLECTION: (15 POINTS) Due: Week 4 (2/1 & 2/2) The Frameworks Institute conducts research on how the general population “hears” messages on important issues and responds accordingly. They suggest that the way a message or issue is framed can significantly impact how advocates are able to move policy forward. For this assignment, please review one of the three pieces below and skim over information related to at least one topic of interest (ideally an area you may be considering for your policy paper). Then share your reflections about the messages, approach and findings. What did you find interesting? Relevant and true? Not clear? How might this impact your presentation at the end of the semester? No citations are required. The paper shouldn’t be more than 2 pages, 1.5 spaced with 1 inch margins and at least 11 point font. Resources are below and also on Sakai. A rubric will be posted on Sakai by Week 2. Don't Think About Elephants http://www.frameworksinstitute.org/assets/files/eZines/Avoid_this_Communications_trap.pdf The Storytelling Power of Numbers http://www.frameworksinstitute.org/assets/files/eZines/Storytelling_power_of_numbers.pdf Framing on Your Feet (Humans Services) http://www.frameworksinstitute.org/toolkits/humanservices/elements/pdfs/nsha_faq.pdf Examples of the different messages and frames people have different issues (a sample – there are many examples on the website – look at whatever seems interesting) http://frameworksinstitute.org/toolkits/foodfitness/resources/pdf/CommunityHealth_Toolkit_swamp.pdf http://www.frameworksinstitute.org/toolkits/bt/resources/pdf/Budgets_and_Taxes_Toolkit_swamp.pdf 11 http://www.frameworksinstitute.org/budgets-and-taxes-video.html http://www.frameworksinstitute.org/assets/files/aging_ffa_final_090215.pdf http://www.frameworksinstitute.org/assets/files/PDF_race/cognitive_media_analysis.pdf http://frameworksinstitute.org/assets/files/PDF/ezine_framing_food&fitness.pdf POLICY COMMUNICATION – MEDIA “SHARE”: (10 POINTS) Due: By Week 12 (4/4 & 4/5) Each student will post a class message via sakai with a blog, video, website, radio story, article etc., relating to his/her policy topic, population of focus or of relevance to a particular class discussion. The student should include a few sentences to describe the resource and why it is being shared. Below is an example of something in the media that is relevant to our class – particularly Week 9. EXAMPLE: NPR – Lack of Diversity in Clinical Trials Presents Possible Health Consequences (12/15/15) http://www.npr.org/2015/12/15/459871070/lack-of-diversity-in-clinical-trials-presents-possible-health-consequences The following 3 assignments can be done individually or in pairs POLICY ANALYSIS AND TOPIC PREVIEW (20 POINTS) Due: Week 7 (2/22 & 2/23) Your task for this policy assignment is to first select a health-related policy of your choice (local, state or national level). Then, begin to think critically about policy analysis frameworks and to describe your policy topic and priority population. Your paper should be 2-4 pages, 1.5 spaced with 1 inch margins and 11 or 12 point font. Citations should follow APA style. Please include the following in your paper: Describe the particular health disparity issue and population that will be impacted by this policy Describe the policy Identify the stakeholders involved – who are the policy beneficiaries and “victims” What policy framework do you think would be best to use to analyze this policy? What are the merits and challenges of framework you outlined to understand your policy issue? Resources: The O’Conner & Netting (2011) chapters outline two overarching approaches to help understand common themes, assumptions and theories of policy: rational policy analysis and nonrational policy analysis. The table below summarizes the frameworks from which to choose. Lecture notes and reading for class will offer greater detail about the specific questions and elements of each framework. Rational Policy Analysis Theories to Consider 1. Jansson’s Six-Step Policy Analysis Framework 2. Huttman’s Policy Analysis Model 3. Holcomb & Nightingale’s Implementation Analysis Model 4. Segal & Bruzuzy’s Questions for Social Welfare Policy Analysis Nonrational Policy Analysis Theories to Consider 1. Stone’s Policy Paradox Approach 2. Kindgon’s Policy Primeval Soup Approach 3. Prigmore & Atherton’s Policy Analysis 4. Guba’s Policy-in-Action Policy Type Taxonomy 12 FINAL: HEALTH DISPARITY POLICY PAPER (30 POINTS) Due: Week 11 (3/28 & 3/29) This final paper follows a very general policy analysis framework. Your paper should include the following elements: Background: Policy name and description, importance of the policy, stakeholders (beneficiaries and losers) summary of historical, social, political or economic factors that clarify why this policy merits consideration for addressing health disparities Ethics: What ethical principles are promoted or thwarted by the policy, what are the inherent dilemmas, if any, about how the policy operates to promote social justice or leads to oppression Evidence: What analyses have been done on the efficacy and effectiveness of the policy/program? What is the quality of the research? Are findings generalizable to relevant populations? What is the return on investment? Advocacy: What partners, agencies or stakeholders are best suited to act on this policy issue? Who are they trying to influence? The paper should be between 8-10 pages, 1.5 spaced with 1 inch margins and 11 or 12 point font. Citations should follow APA style. HEALTH DISPARITY POLICY PRESENTATION (15 POINTS) Due: Week 13 or 14 (4/11 & 4/12 or 4/18 & 4/19) In a brief (5-7 minutes**) presentation, students will offer a brief overview summarizing the main points of their policy analysis and recommendations. While this cannot be an exhaustive review of the health disparity and related policy analyzed, students are responsible for informing their classmates on the following presentation points: a. Topic and prevalence of issue: who is affected and what is the disparity? b. What is the related policy? c. What policy interventions or programmatic changes do your recommend taking to address the disparity or problems identified above? d. What might be some unintended or indirect costs and benefits of your policy recommendations? e. Based on your research, what was the most surprising or startling aspect of what you learned? The timing of this presentation will depend on how many solo versus group projects the class ends up with; details will be worked out as the semester gets underway. Your presentations need to be concise and wellthought out—practice these as sticking to the time limit is part of your final grade. Power point slides are not required but if you do use these, no more than 8 will be accepted. Students will use a rubric to score each other. 13