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.
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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”.
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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:
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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,
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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
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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.
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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
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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
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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.
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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.
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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
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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:
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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
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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.
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