COURSE NUMBER: COURSE TITLE: SEMESTER AND YEAR: MEETING TIME/LOCATION: INSTRUCTOR: THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF SOCIAL WORK SOWO 836.001 Examining Health Access and Health Disparities Spring 2014 Tuesday, 9-­‐10:20am; Room TBD Lisa de Saxe Zerden, MSW, PhD Email: lzerden@email.unc.edu Phone: 919.962-­‐6430 By appointment but feel free to stop by (Room 350) OFFICE HOURS: 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 high-­‐quality, 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) and provide documentation of their disability. Students should discuss the specific accommodations they require directly with the instructor. APA FORMATTING: Students are expected to correctly cite all of your material following the 5th ed. of the APA manual. If you are not familiar with this style, please refer to the APA manual and/or the School’s Writing Resources Page: (http://ssw.unc.edu/students/writing). This link provides access to an array of resources including the newly updated “APA Quick Reference Guide.” 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. If you are interested in a policy analysis text from which we will read certain chapters, this is recommended: O’Conner, M. K., & Netting, F. E.(2011). Analyzing social policy: Multiple perspectives for critically understanding and evaluating policy. Hoboken, NJ: John Wiley & Sons. 2 GRADING SYSTEM: H = 94 and above P = 80 to 93 L = 70 to 79 F = 69 and below 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”. 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. COURSE OVERVIEW: 1/14/14 Class 1: Course overview and patterns and causes of health disparities 1/21/14 Class 2: Frameworks and theories to understand health equity issues 1/28/14 Class 3: Policy analysis frameworks and theory 2/04/14 Class 4: How to effectively communicate about policy (Guest Speakers) 2/11/14 Class 5: Return on Investment: Interventions to reduce disparities 2/18/14 Class 6: Overview of healthcare in the U.S: financing & policies (Guest Speakers) 2/25/14 Class 7: Healthcare in the U.S. continued 3/04/14 Class 8: Examples and interventions of community approaches to improve health (Guest Speakers) 3/11/14 SPRING BREAK: NO CLASS 3/18/14 Class 9: How immigration, acculturation and national origin influence health 3/25/14 Class 10: Addressing inequities in birth outcomes – theory in action 4/01/14 Class 11: The role of social workers in advocacy and addressing health disparities (Guest Speakers) 4/08/14 Class 12: Final presentations & discussion 4/15/14 Class 13: Final presentations & discussion 4/22/14 Class 14: Class wrap up COURSE REQUIREMENTS OVERVIEW: 3 Requirement
Points
Date/Due Date
Class Participation (attendance)
Policy Communication Analysis
Midterm: Applying Policy Analysis Frameworks Final Paper: Policy Recommendations Final Health Disparity Presentation 10 points
15 points
30 points 30 points 15 points
Ongoing
Week 5 Week 6 Week 10 Week 12 & 13
COURSE READINGS AND COURSE OUTLINE: JAN 14, 2014 Week 1: Course overview and Patterns and causes of health disparities 1. Course overview and class introductions 2. Introduction to health disparities in diagnosis, prognosis, and health outcomes 3. Background history and patterns and causes of health disparities Readings: 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 (71-­‐84). New Brunswick: Rutgers University Press. 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 Recommended: Williams, D.R. (2006). Patterns & Causes of Disparities. In Mechanic, D., Rogurt, L.B., Colby, D.C. & Knickman, J.R. (Eds.), Policy Changes in Modern Health Care (115-­‐134). New Brunswick: Rutgers University Press. Epstein, H. (2003, October 12). Ghetto Miasma; Enough to make you sick? The New York Times. Available: http://www.nytimes.com/2003/10/12/magazine/ghetto-­‐miasma-­‐
enough-­‐to-­‐make-­‐you-­‐sick.html?pagewanted=all&src=pm JAN 21, 2014 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 Readings: Policy Link (2011). Why race and place matter (Executive Summary): Impacting health through a focus 4 on race and place. Start on page 16. Retrieved: http://www.policylink.org/atf/cf/%7B97c6d565-­‐bb43-­‐406d-­‐a6d5-­‐
eca3bbf35af0%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 Halfon, N. (2009). Life Course Health Development: A New Approach for Addressing Upstream Determinants of Health and Spending. Policy Brief (Available on Sakai). Recommended: Jones, C.P. (2000). Levels of Racism: A Theoretic Framework and a Gardener’s Tale. American Journal of Public Health, 90(8), 1212-­‐1215. The John D. and Catherine T. MacArthur Foundation Research Network on Socio-­‐economic Status and Health (2008). Reaching for a healthier life: Facts on Socio-­‐economic status and health in the U.S. Available on Sakai. JAN 28, 2014 Week 3: Policy analysis frameworks and theory 1. Understanding social policy analysis 2. Critical Theory Model for social welfare policy analysis 3. Rational vs. Nonrational Policy analysis frameworks: themes and assumptions that guide policy analysis Readings: Segal, E. A. (2013). Social welfare policy and social programs: A values perspective. (Chapter 4). 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. (available on sakai) • Chapter 4: Analyzing and researching social welfare policies (pp.80—113). • Chapter 6: Applications in Nonrational Policy Analysis • Case Study FEB 4, 2014 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. Lessons from the field: Paige Johnson, Planned Parenthood Readings: 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-­‐policy-­‐
brief.pdf Blog posting by Melinda Lewis, LCSW: “What makes a good policy brief” 5 http://melindaklewis.com/2009/09/30/what-­‐makes-­‐a-­‐good-­‐policy-­‐brief/ Recommended: 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 FEB 11, 2014 WEEK 5: Interventions to reduce disparities in an age of scare resources 1. Policy recommendations/efforts to address health disparities 2. Return on Investment: Using cost benefit ratios to understand why prevention matters http://www.cdc.gov/dhdsp/programs/nhdsp_program/economic_evaluation/Module_IV/Podcast_IV.pdf 3. Case examples: tobacco policy, obesity epidemic, and HIV/AIDS in the U.S., poverty and children’s health 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-­‐114). New Brunswick: Rutgers University Press. 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 18, 2014 WEEK 6: Overview of Healthcare in the U.S.—How the system is financed and related policies Guest lecture from Alice Pollard, MSW/MPH q Midterm paper due today 1. Affordable Care Act 2. Federal financing of health care in the US 3. Private sector health care and reform 4. Role of social workers in health care settings Readings: Consumer Reports on the Affordable Care Act: http://www.consumerreports.org/health/resources/pdf/ncqa/The_Affordable_Care_Act-­‐
You_and_Your_Family.pdf Andrews, C. M., Darnelb, J. S., McBride, T.D., & Gehlert, S., (2013). Social work and implementation of 6 the Affordable Care Act (editorial). Health and Social Work, 38(2), 67-­‐74. (also available here: http://www.sswr.org/ACA%20Editorial-­‐Health%20and%20Social%20Work%20%201-­‐27.pdf Silberman, P. (2013). Implementing the Affordable Care Act in North Carolina: The rubber hits the road. North Carolina Medical Journal, 74(4), 298-­‐307. Recommended: Holahan, J., & Garrett, B. (2009). Rising Unemployment, Medicaid and the Uninsured: January 2009. Available at: http://www.kff.org/uninsured/upload/7850.pdf Andrulis, D.P., & Siddiqui, N.J. (2011). Health reform holds both risks and rewards for safety-­‐net providers and racially and ethnically diverse patients. Health Affairs, 30, 1830-­‐1836. Web resources to review: 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/fs191/1110472552145/archive/1115333192782.html http://archive.constantcontact.com/fs191/1110472552145/archive/1114996602364.html Raising Women’s Voices website has good information about enrollment, advocacy, stories and links. http://www.raisingwomensvoices.net The source of information: www.Healthcare.gov This includes information about the 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 FEB 25, 2014 WEEK 7: Overview of Healthcare in the U.S (cont.); ACA, Improving access and quality 1. Ideological and cultural issues to tackle 2. Brief history of health Insurance in the U.S. 3. Health reform and role of social work 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. Golden, R.L. (2011). Coordination, integration, and collaboration: A clear path for social work in health care reform. Health & Social Work, 36(3): 227-­‐228. Zabora, J.R. (2011). How can social work affect health care reform? Health & Social Work, 36(3): 231-­‐ 232. 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 7 Institute of Medicine. (2002). Unequal treatment: What healthcare system administrators need to know about racial and ethnic disparities in healthcare. Retrieved: http://www.iom.edu/~/media/Files/Report%20Files/2003/Unequal-­‐Treatment-­‐Confronting-­‐
Racial-­‐and-­‐Ethnic-­‐Disparities-­‐in-­‐Health-­‐Care/DisparitiesAdmin8pg.pdf Recommended: Ofosu, A. (2011). Implication of healthcare reform. Health & Social Work, 36(3), 229-­‐230. Golden, R.L. (2011). Coordination, integration, and collaboration: A clear path for social work in health care reform. Health & Social Work, 36(3): 227-­‐228. MAR 4, 2014 WEEK 8: Examples and interventions of community based approaches to improve health 1. Impact of social injustice on the health of marginalized populations 2. Addressing racial inequality in healthcare through civil rights 3. Guest speakers: East Durham Initiative (http://edci.org) 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): 301-­‐304. 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 Recommended: Gamble, V. N. (1997). Under the shadow of Tuskegee: African Americans and health care. American Journal of Public Health, 87, 1773-­‐8. MAR 11, 2014 NO CLASS, ENJOY YOUR SPRING BREAK MAR 18, 2014 WEEK 9: How immigration, acculturation and national origin influence health 1. Effects of immigration and acculturation on health 2. The Latino Health Paradox 3. Case example: Latino injection drug users 4. Video: Unnatural Causes-­‐-­‐ Becoming American (view in class) Readings: DeRose, K. P., Escarce, J. J., & Lurie, N. (2007). Immigrants & health care: Sources of 8 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. Recommended: Vega, W.A., & Amaro, H. Latino outlook: Good health, uncertain Prognosis. (2002). In T.A. LaVeist (Ed.), Race, Ethnicity, and Health—A public health reader (47-­‐75). San Francisco: Jossey-­‐Bass. Sherrill, W., Crew, L., Mayo, R., Mayo, W., Rogers, B., & Haynes, D. (2005). Educational and health services innovation to improve care for rural Hispanic communities in the US. Education for Health: Change in Learning & Practice, 18(3), 356-­‐367. MAR 25, 2014 WEEK 10: Addressing inequities in birth outcomes – theory in action 1. Effects of birth outcomes on health equity and visa versa 2. Strategies for change q 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, 1143-­‐1150. Verbiest, S., & Holliday, J. (2009). Preconception care: Building the foundation for healthy women, babies, and communities. Community. North Carolina Medical Journal, 70(5), 417-­‐427. APR 1, 2014 WEEK 11: The role of social workers in advocacy and addressing health disparities 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: Bebe Smith Readings: 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 9 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). Recommended: Shaw-­‐Ridley, M., & Ridley, C.R. (2010). The health disparities industry: Is it an ethical conundrum? Health Promotion & Practice,11: 454-­‐464. Gamble, V., & Stone, D. (2006). U.S. policy on health inequities: The interplay of politics and research. Journal of Health Politics, Policy & Law, 31(1), 93-­‐126. APR 8, 2014 WEEK 12: Final presentations and discussion APR 15, 2014 WEEK 13: Final presentations and discussion APR 22, 2014 WEEK 14: 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 SOW0 836, HEALTH ACCESS & DISPARITIES 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 – VIDEO AND COMMENTS: (15 POINTS) Due: Week 5 Watch both of these short videos (10 minutes total). Select one and respond to the questions below in 1-­‐2 pages (no references needed). Respond based on your current knowledge and understanding of the video. 10 • “Choice Project”: http://www.choiceproject.wustl.edu/ • “Get ready for Obamacare” (KFF): http://www.youtube.com/watch?v=JZkk6ueZt-­‐U • Questions to discuss: o What do these videos communicate? What is the message/framing? o How are the issues framed despite the fact that they are contentious in mainstream discourse? o What are the strengths of the message? o How could opponents critique the messages conveyed in either video? The following policy analysis assignments can be done individually or in pairs MIDTERM: POLICY ANALYSIS FRAMEWORK (30 POINTS) Due: Week 6 (February, 18, 2014) 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. Your task for the midterm policy assignment is to choose a health-­‐related policy of your choice, at the local, state or national level and analyze it using either a rational or nonrational framework. This purpose of this assignment is to allow you to think critically about a selected policy analysis approach and answer the main points regarding your policy topic. The final product will be 4-­‐6 pages and includes two parts: Part A: In this section you will briefly answer the key questions/points for your selected theory (options below) as they are written in the text chapters. Part B: After you have analyzed the policy and responded to the key points outlined in the chapter, please respond to question one and either question two or three: 1. Why did you pick the policy framework you did? 2. What are the merits and challenges of framework you outlined to understand your policy issue? 3. Given the analysis you conducted, identify who are the stakeholders involved – who are the policy beneficiaries and victims (think back to Schenider and Ingram’s 1993 social construction article from SoWo530). The table below summarizes the frameworks to choose from (you only need to choose one!). 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 Nonrational Policy Analysis Theories to Consider 1. Jansson’s Six-­‐Step Policy Analysis 1. Stone’s Policy Paradox Approach Framework 2. Kindgon’s Policy Primeval Soup Approach 2. Huttman’s Policy Analysis Model 3. Prigmore & Atherton’s Policy Analysis 3. Holcomb & Nightingale’s Implementation 4. Guba’s Policy-­‐in-­‐Action Policy Type 11 Analysis Model 4. Segal & Bruzuzy’s Questions for Social Welfare Policy Analysis Taxonomy 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 Note: The final assignment will focus more closely on specific actions (e.g. advocacy activities, research, legislative change, organizational modification, etc.) that can be taken to improve health equity for the population(s) impacted by the policy. Your midterm assignment is the groundwork for which these action/change-­‐oriented steps will be crafted. FINAL HEALTH DISPARITY POLICY STATEMENT: IMPACT OF POLICY (30 POINTS) Due: Week 10 (March, 25, 2014) In your midterm assignment, you analyzed a health-­‐related policy using a specific theoretical framework. The midterm assignments asked you to think about a specific policy and who is impacted, and how the policy issue is framed. Now you have an opportunity to advocate for a policy response using your own voice and knowledge of the issue. Please explain your recommendation and what specific action steps are necessary to see this recommendation implemented (2-­‐3 pages). Directions on writing a policy brief are provided within the syllabus, class examples and also consider the following elements: • Clear purpose that is expressed early in the text • Cohesive argument that persuades the reader of the importance of the recommendations • Quality of evidence • Messenger (individual or organization) has credibility in the eyes of the policy-­‐maker • Addresses specific content • Addresses needs of target audience • Recommendations must be actionable • Clear and feasible recommendations on policy steps to be taken • Presentation of author’s own views about policy implications of research findings • But clear identification of argument components that are opinion-­‐based • Easily understood by educated, non-­‐specialist • Simple and to the point, keeping in mind only what matters to the reader • Concise – where every word is used as efficiently as possible • Visually engaging • Presentation of information through clearly labeled charts, graphs, photos • White space, sub-­‐headings, lists, fonts and other means of making the reading easier 12 •
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FINAL HEALTH DISPARITY POLICY PRESENTATION (15 POINTS) Due: Week 12 or 13 (April 8, 2014 or April 15, 2014) 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 well-­‐though 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 10 will be accepted. SUPPLEMENTAL READING LIST: Braithwaite, K. (2008). Health is a human right, right? American Journal of Public Health, 98, 5-­‐7. Healthy People 2020. Retrieved http://healthypeople.gov/2020/LHI/default.aspx (Review the 2020 list of Leading Health Indicators [LHIs] on the left side of the website to see stats and figures about identified health areas to improve by 2020, i.e. Access to Health Services, Clinical Preventative Services, Physical Activity, Oral Health, etc.) Health Equity and Framing: National Association of City and County Health Officials. The Roots of Health Inequity access at: www.rootsofhealthinequity.org National Partnership to End Health Disparities. National Stakeholder Strategy for Achieving Health Equity access at http://minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=33&ID=286 Izlar, A.C. (2011). The corporate role in reducing disparities: Initiatives under way at Verizon. Health Affairs, 30(10): 1992-­‐1996. Weinick, R.M., and Hasnain-­‐Wynia, R. (2011). Quality improvement efforts under health reform: how to ensure that they help reduce disparities – not increase them. Health Affairs, 30(10): 1837-­‐1843. Affordable Care Act: Kaiser brief on women and Medicaid http://www.kff.org/womenshealth/7213.cfm 13 Commonwealth report by Kay Johnson http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2012/Au
g/1620_Johnson_addressing_womens_htl_needs_improving_birth_ib.pdf Commonwealth women and ACA brief updated http://www.commonwealthfund.org/News/News-­‐Releases/2012/Jul/Oceans-­‐Apart.aspx Federal factsheet for families with children http://www.healthcare.gov/news/factsheets/2011/08/families.html Coverage for young adults http://www.dol.gov/ebsa/faqs/faq-­‐dependentcoverage.html White House brief on ACA and women http://www.whitehouse.gov/files/documents/health_reform_for_women.pdf HHS women's preventive services guidelines http://www.hrsa.gov/womensguidelines/ Insights from MD, Nevada and Oregon, 3 states leading the way in preparing for outreach and ACA enrollment which examines the lessons, challenges and successes in preparing for the ACA coverage expansions; http://kaiserfamilyfoundation.files.wordpress.com/2013/09/8481-­‐getting-­‐into-­‐gear-­‐for-­‐
2014-­‐an-­‐early-­‐look-­‐at-­‐branding-­‐and-­‐marketing.pdf http://kaiserfamilyfoundation.files.wordpress.com/2013/09/8480-­‐getting-­‐into-­‐gear-­‐
insights-­‐from-­‐three-­‐states.pdf Substance Abuse and Mental Health: Mechanic, D. (2007). Mental health services then and now. Health Affairs, 26(6): 1548-­‐ 1550. Barry, C.L. & Huskamp, H.A., (2011). Moving beyond Parity: Mental health and addiction care under the Affordable Care Act. New England Journal of Medicine; 365: 973-­‐ 975. McGuire, T.G., & Miranda, J. (2008). New evidence regarding racial and ethnic disparities in mental health: Policy Implications. Health Affairs, 27(2): 393-­‐403. doi:10.1377/hlthaff.27.2.393 Additional Websites: The FAIR Database (http://www.solvingdisparities.org/fair) Finding Answers’ FAIR database is one of the most comprehensive collections of summaries and systematic reviews of racial and ethnic health disparities intervention literature 14 available. Search by health topic (for instance: asthma, diabetes) or by strategy (for instance: pay for performance, nurse-­‐led interventions). (http://www.solvingdisparities.org/tools/roadmap) This section is a guide for healthcare organizations to improve minority health and foster health equity. Lessons learned from the results of other projects and literature is available and may be an invaluable resource for your final project. 15