THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF SOCIAL WORK
COURSE NUMBER:
COURSE TITLE:
SEMESTER AND YEAR:
MEETING TIME/LOCATION:
INSTRUCTOR:
OFFICE HOURS:
SOWO 836.002 (Monday) SOWO836.001 (Tuesday)
Examining Health Access and Health Disparities
Spring 2015
Mon: 9-10:20am or Tue: 9-10:20am; Rooms 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)
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.
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
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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 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 can also make
an appointment with Diane Wyant, (dwyant@email.unc.edu) or Susan White,
(sewhite@email.unc.edu), the SSW Writing Support Team.
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 check with a
friend and then notify the professor as soon as possible. If you are interested in a policy analysis
text from which we will read certain chapters, O’Conner, M. K., & Netting, F. E. (2011). Analyzing
social policy: Multiple perspectives for critically understanding and evaluating policy. Hoboken,
NJ: John Wiley & Sons is recommended.
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
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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.
GRADING SYSTEM:
H = 94 and above
P = 80 to 93
L = 70 to 79
F = 69 and below
COURSE OVERVIEW:
CLASS
Class 1:
Class 2:
Class 3:
Class 4:
Class 5:
Class 6:
Class 7:
Class 8:
Class 9:
Class 10:
Class 11:
Class 12:
Class 13:
Class 14:
DATE (2015)
Mon- Jan 12
Tue- Jan 13
Mon- Jan 26
Tue- Jan 20
Mon- Feb 2
Tue- Jan 27
Mon- Feb 9
Tue- Feb 3
Mon- Feb 16
Tue- Feb 10
Mon-Feb 23
Tue- Feb 17
Mon- Mar 2
Tue- Feb 24
Mon- Mar 16
Tue-Mar 3
Mon- Mar 23
Tue- Mar 17
Mon- Mar 30
Tue- Mar 24
Mon- Apr 6
Tue- Mar 31
Mon- Apr 13
Tue- Apr 7
Mon- Apr 20
Tue- Apr 14
Mon- Apr 27
Tue- Apr 21
TOPICS TO BE COVERED
Course overview and patterns and causes of health disparities
Frameworks and theories to understand health equity issues
Policy analysis frameworks and theory
How to effectively communicate about policy (Guest Speakers)
Return on Investment: Interventions to reduce disparities
Overview of healthcare in the U.S: financing & policies (Guest Speakers)
Healthcare in the U.S. continued
Ex. and interventions of community approaches to improve health (Guest Speakers)
How immigration, acculturation and national origin influence health
Addressing inequities in birth outcomes – theory in action
The role of SW in advocacy and addressing health disparities (Guest Speakers)
Final presentations & discussion
Final presentations & discussion
Class wrap up and concluding thoughts
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COURSE REQUIREMENTS OVERVIEW:
Requirement
Class Participation (attendance)
Policy Communication Analysis
Midterm: Applying Policy Analysis Frameworks
Final Paper: Policy Recommendations
Final Health Disparity Presentation
Points
Date/Due Date
10 points
10 points
35 points
30 points
15 points
Ongoing
Week 5
Week 6
Week 10
Week 12 & 13
COURSE READINGS AND COURSE OUTLINE:
Week 1: Course overview and Patterns and causes of health disparities
Monday- January 12, 2015
Tuesday-January 13, 2015
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 (7184). 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, NJ: 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-miasmaenough-to-make-you-sick.html?pagewanted=all&src=pm
Week 2: Frameworks and theories to understand health equity issues
Monday- January 26, 2015
Tuesday- January 20, 2015
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:
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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
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.
Week 3: Policy analysis frameworks and theory
Monday- February 2, 2015
Tue- January 27, 2015
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
Week 4: How to effectively communicate about health policy
Monday- February 9, 2015
Tuesday- February 3, 2015
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-policy5
brief.pdf
Blog posting by Melinda Lewis, LCSW: “What makes a good policy brief”
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
WEEK 5: Interventions to reduce disparities in an age of scare resources
Monday- February 16, 2015
Tuesday- February 10, 2015
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
WEEK 6: Overview of Healthcare in the U.S.—How the system is financed and related policies
Guest lecture from Alice Pollard, MSW/MPH
Monday-February 23, 2015
Tuesday- February 17, 2015
 Midterm paper due today
1.
2.
3.
4.
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
Readings:
Consumer Reports on the Affordable Care Act:
http://www.consumerreports.org/health/resources/pdf/ncqa/The_Affordable_Care_ActYou_and_Your_Family.pdf
Andrews, C. M., Darnelb, J. S., McBride, T.D., & Gehlert, S., (2013). Social work and implementation of
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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-campaignbetter-care
WEEK 7: Overview of Healthcare in the U.S (cont.); ACA, Improving access and quality
Monday- March 2, 2015
Tuesday- February 24, 2015
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): 231232.
Kaiser Family Foundation. (2009). National health insurance—a brief history of reform efforts in the
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U.S. Available: http://www.kff.org/healthreform/upload/7871.pdf
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-ConfrontingRacial-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.
WEEK 8: Examples and interventions of community based approaches to improve health
Monday- March 16, 2015
Tuesday-March 3, 2015
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, 19651973. 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.
MARCH 9—15, 2015: NO CLASS, ENJOY YOUR SPRING BREAK
WEEK 9: How immigration, acculturation and national origin influence health
Monday- March 23, 2015
Tuesday- March 17, 2015
1.
2.
3.
4.
Effects of immigration and acculturation on health
The Latino Health Paradox
Case example: Latino injection drug users
Video: Unnatural Causes-- Becoming American (view in class)
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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.
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.
WEEK 10: Addressing inequities in birth outcomes – Theory in action
Monday- March 30, 2015
Tuesday- March 24, 2015
 Final paper due today
1. Effects of birth outcomes on health equity and visa versa
2. Strategies for change
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.
WEEK 11: The role of social workers in advocacy and addressing health disparities
Monday- April 6, 2015
Tuesday- March 31, 2015
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
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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
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.
WEEK 12: Final presentations and discussion
Monday- April 13, 2015
Tuesday- April 7, 2015
WEEK 13: Final presentations and discussion
Monday- April 20, 2015
Tuesday- April 14, 2015
WEEK 14: Class wrap up and review
Monday- April 27, 2015
Tuesday- April 21, 2015
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.
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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.
 “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 (35 POINTS)
Due: Week 6
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 46 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
1. Jansson’s Six-Step Policy Analysis
Framework
2. Huttman’s Policy Analysis Model
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
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3. Holcomb & Nightingale’s Implementation
Analysis Model
4. Segal & Bruzuzy’s Questions for Social
Welfare Policy Analysis
4. Guba’s Policy-in-Action Policy Type
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
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
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FINAL HEALTH DISPARITY POLICY PRESENTATION (15 POINTS)
Due: Week 12 or 13
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
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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-for2014-an-early-look-at-branding-and-marketing.pdf
http://kaiserfamilyfoundation.files.wordpress.com/2013/09/8480-getting-into-gearinsights-from-three-states.pdf
Substance Abuse and Mental Health:
Mechanic, D. (2007). Mental health services then and now. Health Affairs, 26(6): 15481550.
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: 973975.
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
available. Search by health topic (for instance: asthma, diabetes) or by strategy (for
instance: pay for performance, nurse-led interventions).
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(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.
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