Instructor
Lucinda (Cindy) Bryant, PhD MSHA MBA
Associate Professor, Departments of Community & Behavioral
Health and Health Systems, Management & Policy,
Colorado School of Public Health
Office: Building 500, 3 rd floor, Room E3340
E-mail: lucinda.bryant@ucdenver.edu
Phone: (303) 724-4394 (office)
(720) 982-1192 (cell)
Fax: (303) 724-4476
Office hours: Thursdays before class or by appointment
The purpose of this course is to introduce you to:
1. Factors across the social-ecological spectrum that affect population patterns of health, disease, and risk factors in older adults; and
2. Appropriate responses by public health, aging services and the research community to promote healthy aging.
Relevant components include both community and behavioral factors and health systems and policy issues such as health status; personal characteristics (including sociodemographic factors); physical, economic, social and policy environments; and the availability and use of health-related, often community-based services.
Course Objectives
By the end of the course students will be able to:
1. Identify the major issues concerning health and well being in an aging population
2. Describe the public health and aging services networks and their roles
3. Critically examine materials relevant to gerontological public health
4. Articulate how public health can address health issues in an aging population
To achieve these objectives, we will read and discuss relevant literature, conduct a fieldwork environmental audit of walkability and assess its potential impact on policy, and review and discuss public health issues important to older adult health.
The course is structured for participatory learning. Each class session usually will contain a didactic presentation, related to the current topics but not summarizing the readings, but we will spend much of our time exploring, analyzing, discussing, critiquing, and synthesizing. Students also will complete a hands-on fieldwork project.
I understand that life and business responsibilities exist, but I expect you (and me also, of course) to make every effort to attend class, be prepared, and actively participate in discussions. Please let me know in advance if you cannot attend a class, and we will determine how best to assure that you miss as little as possible. The advance notice of course does not apply to events beyond your control.
CBHS 6626 Syllabus (4/16/2020) page 1 of 22

Public Health Competencies
The
has established areas of competency expected of MPH graduates. This course will address the following subsets of these areas, especially as they relate to health promotion and delivery of services for older adults:
BASIC PUBLIC HEALTH SCIENCE SKILLS/CROSS-CUTTING COMPETENCIES
1. Define, assess and report on the physical and mental health status of populations, determinants of health and illness, and factors contributing to health promotion and disease prevention.
3. Identify relevant and appropriate data and information sources.
6. Communicate effectively both in writing and orally.
7. Effectively present accurate demographic, statistical, programmatic and scientific information for professional and lay audiences.
8. Identify and address ethical issues that arise in public health practice and research.
18. Analyze determinants of health and disease using an ecological framework.
CONCENTRATION-SPECIFIC CORE COMPETENCIES (expected of all MPH graduates)
CBHE3 Evaluate the social and community factors related to the health of communities, assess community health needs, and identify potential interventions that consider unique cultural settings.
CBHE4 Identify the causes of social and behavioral factors that affect health of individuals and populations.
EHOH3 Specify approaches for assessing, preventing and controlling environmental hazards that pose risks to human health and safety.
EPID3 Describe a public health problem in terms of magnitude, person, time and place.
EPID8 Draw appropriate inferences from epidemiologic data
HSMP2 Demonstrate an understanding of factors influencing access to and utilization of health services
HSMP4 Identify and interpret public health laws, regulations, and policies related to specific health programs and the delivery of health services.
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Journal readings and other materials will be made available to you on eCollege or occasionally handed out in class.
There are several books that you should own:
Prohaska T., Anderson, L.A., Binstock, R.H. (March
2012). Public Health for an Aging Society . Johns Hopkins University Press. ISBN
9781421404356 [when available]
Please note that this new version of an older text has not yet become available. The publisher (and editors) currently predict a March release (amazon.com has the paperback version available for preorder now). Drs. Prohaska and Anderson, colleagues in the CDC Healthy Aging Research Network, have kindly offered to supply us with material on a chapter-by-chapter basis while we wait.
Klinenberg, E. (2002). Heat wave: A social autopsy of disaster in Chicago . Chicago:
University of Chicago Press. ISBN 0226443221.
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A. Participation and discussion (20 points maximum)
We will devote substantial class time to discussion, interpretation, and debate of ideas presented in readings and lectures. The syllabus specifies some discussion topics; you are encouraged to develop additional relevant topics and questions in areas that interest you. Please assume that everyone has read the materials and therefore use our discussion time less to summarize the key content than to expand and explore perspectives.
Discussions should not focus on a regurgitation of the readings but concentrate on comparing and contrasting viewpoints expressed in the readings, integrating materials across the course, and exploring the readings’ applicability to your public health research and practice interests . You are expected to participate actively in discussions, debating issues and ideas with vigor (and back-up references) while treating individuals with respect.
B. Short assignments (20 points maximum total)
1) Description of “your” older adult (5 points maximum; due February 2). We will begin the course with an exploration into what people mean by
“aging.” To encourage you to think about your own perceptions, you will write a short paper (3 pages) for the second class in which you carefully and richly create a fictitious older person (age 70 or older), with details of his/her demographic, family and social, economic, and health and functional status characteristics as well as any other information about the person that seems relevant and interesting.
You may create an entirely fictitious person or base your description on someone you know or have known.
2) Changing demographics (5 points maximum; due February 16) . Details will be posted on eCollege.
3) Your older adult ’s benefits (5 points maximum; due February 23) . Calculate your older adult’s estimated Social Security benefits, and select
Medicare health and prescription plans for him/her.
Explore other available benefits. Details and suggested resources will be posted on eCollege.
4) Your older adult ’s budget (5 points maximum; also due February 23) . Create a budget for your older adult.
Details and suggested resources will be posted on eCollege.
CBHS 6626 Syllabus (4/16/2020) page 4 of 22

C. Environmental audit project (30 points maximum)
Using a walkability audit tool and instructions that I will provide, you (in 2 or more groups depending on class size) will assess a Denver/Aurora neighborhood. You then will collaboratively prepare written and oral reports that describe your findings concerning characteristics of the physical and built environment that could affect older adults’ health and healthy behaviors and that suggest potential policy responses. We may have the opportunity to provide information and policy recommendations to the community. You may conduct your sections of the audit singly or in small groups to fit your schedules, but the analysis and written (10-15 pages) and oral reports must be collaborative efforts. More complete instructions for this project will be posted on eCollege, and we will devote class time to reviewing the tool and organizing the audit.
Your written reports will be due on May 3, and you will present and discuss them during class that day.
D. Final exam (30 points maximum)
The take-home exam, which will be posted on eCollege on May 10, will be due in the relevant eCollege dropbox by midnight May 17 (exam week).
The exam likely will ask you to identify a small number of issues addressed in the course and propose responses to them, so be thinking about your choice of topics during the semester.
E. Summary of assignments
Date Due Project continuous various
May 3
May 17
(midnight)
Total points
Participation
Description of older adult and related exercises; demographics exercise
Report (~ 10-15 pages written + oral presentation) based on environmental walkability audit, with potential policy responses
Final exam
Maximum Points
20
20
30
30
100
Assignments will be evaluated on a graduate-level grading scale:
90-100% (A/A+) good-to-excellent
80-89% (B+/B/B-) fair
70-79% (C+/C/C-) not graduate-level quality*
<70% failing
The rules for incomplete grades are complex; if they become an issue, let’s talk.
*Although the MPH program considers a grade of C or better passing for an elective course, if a
C brings your GPA below 3.0 you must do whatever it takes to raise your GPA to 3.0 or higher.
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Please use at least 11 point type with standard line spacing. Submit materials electronically to the eCollege dropbox that I will create for each written assignment and the final exam. I will respond electronically as well. You may want an additional hard copy to facilitate your in-class discussion. The quality of your writing matters, both in this course and in all succeeding academic and professional endeavors; consult with a good editor if you need that sort of help. The
Writing Center at UCD provides one-on-one assistance to students
( http://www.ucdenver.edu/academics/colleges/CLAS/Centers/writing/Pages/
TheWritingCenter.aspx) . I expect clear writing and careful proofreading and editing; egregious errors may affect your grade on a project. Assignments are due by the beginning of class on the specified dates. Extensions may be granted but only for truly unavoidable circumstances and (un)natural disasters.
All students are expected to abide by the honor codes of the Colorado School of Public Health.
Unless otherwise instructed, all of your work in this course should represent completely independent work. Students are expected to familiarize themselves with the Student Honor
Code that can be found in the Student Resources Section of the CSPH website at http://www.cudenver.edu/Academics/Colleges/PublicHealth/students/StudentAffairs/StudentRes ources/Documents/ColoradoSPH_StudentHonorCode.pdf
. Any student found to have committed acts of misconduct (including, but not limited to cheating, plagiarism, misconduct of research, and breach of confidentiality) will be subject to the procedures outlined in the CSPH
Honor Code.
In our field(s) we often refer to what others have done and written. That is not only acceptable but encouraged. Just be sure that you cite others’ contributions. In work for this class, if you are referring to an assigned text or article, a brief in-text citation (e.g., (Jones & Moon 1987) or
“Jones & Moon (1987) said”) is sufficient. If you draw on other materials (a good thing, especially as they relate to your areas of interest), then please provide a more complete reference including Web address if relevant. If you have any questions about what is or is not permitted, ask.
If you have special needs and wish to request accommodations, please contact the Office of
Disability Resources & Services (DRS) located in Building 500 of the Anschutz Medical
Campus, Room W1103 (West wing of the first floor, Room 1103). Their staff will assist in determining reasonable accommodations as well as coordinating the approved accommodations. Contact information:
Phone (303) 724-5640
Fax (303) 724-5641
Please also talk with me about any needs or concerns.
Computers and electronic notepads can reduce paper wastefulness and ease note-taking. Please, however, silence all electronic devices when you enter the classroom and refrain from unrelated Web surfing, email management, and other electronic activities during class.
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Overview : During this first unit we will set the stage for examining outcomes and risk factors associated with aging and beginning to define the role of public health. We first will “walk through” the course, briefly review the history and some theories of gerontology, and begin to build a toolkit of resources. We then will talk about aging (what it is and what it is not), what
“normal” and “usual/pathologic” aging look like, and how we talk about aging.
General topics

Getting acquainted: What is your interest in aging?

Introduction to course: rules & regs, structure, requirements, course outline

A brief history of gerontology and some aging theories
Activity/Discussion #1: Think of people you think are aging/did age well or poorly.
What characteristics of those people contribute to your perceptions?
Lecture #1: Introduction to the course
Lecture #2: Brief history of gerontology, aging theories
Activity #2: Intro to environmental audit
Next week:

Short paper (basis also for subsequent activities): create and write a short paper about a fictitious older person.
See “Course Requirements” and eCollege for details.
Assignment due : Short paper
General topics
 What do we mean by “aging” and by “being old”?

Demographics of aging in the United States

How do we talk about aging?
Discussion #1: What do we mean by aging, by being old? How do you know that someone is old? What characteristics make you think so? Why?
Lecture #1: The demography and biology of aging: Who is aging and how?
Lecture #2: How do we talk about aging?
Discussion #2: First impressions of “Heat Wave”
Readings
Required readings
Gawande, A. (2007). The way we age now [Annals of Medicine]. The New Yorker , April
30, 2007, 50-9.
Klinenberg, E. (2002). The spectacular city: news organizations and the representation of catastrophe. In Heat wave: A social autopsy of disaster in Chicago . Chicago:
University of Chicago Press, Chapter 5, 185-224. [ Probably a good idea to read through the book, then go back to specific chapters as assigned .]
Journalists Exhange on Aging. Survey on Style (Summer 2007 ). Age Beat 24. Available at: http://www.medinaassociates.com/agebeatsurvey.pdf.
CBHS 6626 Syllabus (4/16/2020) page 7 of 22

Additional readings and references
Centers for Disease Control and Prevention and the Merck Company Foundation. The
State of Aging and Health in America. Interactive version available at: http://apps.nccd.cdc.gov/SAHA/Default/Default.aspx
National Institute on Aging. Growing Older in America: The Health and Retirement
Study . [NIH Publication No. 07-5757], 2007. Available at: http://www.nia.nih.gov/health/publication/growing-older-america-health-andretirement-study
Luo, Y., Xu, J., Granberg, E., Wentworth, W.M. (2011). A longitudinal study of social status, perceived discrimination, and physical and emotional health among older adults. Research on Aging xx(x), 1-27. Published online before print December 14,
2011, doi: 10.1177/0164027511426151.
Resource materials
Centers for Disease Control and Prevention. The State of Mental Health and Aging in
America.
Available at: http://apps.nccd.cdc.gov/MAHA/MahaHome.aspx
World Health Organization. Webpage on Aging.
Available at: http://www.who.int/topics/ageing/en/
Trends in health and aging. National Center for Health Statistics.
Available at: http://www.cdc.gov/nchs/ppt/aging/aging_english.ppt
Aging in the Americas Conference Series . Available at: http://www.utexas.edu/lbj/caa/index.php
Administration on Aging. National Center on Elder Abuse. Ageism webpage. Available at: http://www.ncea.aoa.gov/main_site/library/cane/CANE_Series/CANE_agesism.aspx
National Institute on Aging (2008). Making your printed health materials senior friendly.
Available at: http://nacanet.nia.nih.gov/HealthInformation/Publications/srfriendly.htm
Next week:

Discussion of “compression” theories
Overview : The second section of the course will examine risk factors associated with aging healthily or not, using the social-ecological framework to organize the material. We will identify the issues and discuss the role of public health. During one week’s class we will prepare and train for environmental audit fieldwork.
General topics

Social-ecological framework

Epidemiology of aging

Chronic diseases and conditions

Function and disability
Lecture #1: What factors affect aging? A social-ecological framework
Lecture #2: Chronic disease, disability and modifiable risk
Discussion #1: Compression of morbidity/mortality/disability
 What does “compression of morbidity” mean?

What supports the concept?

What contradicts the concept?
CBHS 6626 Syllabus (4/16/2020) page 8 of 22


What effect might compression of morbidity/mortality/disability have at different social-ecological levels (individual, economic, community, etc.)?
Readings
Required readings
Satariano, W.A. (2006). Aging, health, and the environment: an ecological model. In
Satariano, W.A. Epidemiology of Aging . Sudbury MA: Jones and Bartlett Publishers,
Chapter 2, 39-84.
Link, B.G., Phelan, J. (1995). Social conditions as fundamental causes of disease.
Journal of Health & Social Behavior (extra issue), 80-94.
Branch, L.G., Meng, H., Guralnik, J.M. (2011). Disability and functional status. In T.R.
Prohaska, L.A. Anderson, R.H. Binstock (eds). Public Health for an Aging Society .
Baltimore MD: Johns Hopkins University Press, Chapter 6.
Hughes, S.L., Ory, M.G., Seymour, R.B. (2011). Behavioral risk factors and evidencebased interventions. In T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds). Public
Health for an Aging Society . Baltimore MD: Johns Hopkins University Press, Chapter
7.
Discussion topic readings
Fries, J.M. (2005). Frailty, heart disease, and stroke: the compression of morbidity paradigm. American Journal of Preventive Medicine 29(5S1):164 –168.
Kinsella, K.G. (2005). Future longevity – demographic concerns and consequences.
Journal of the American Geriatrics Society 53:S299-303.
Manton, K.G., Gu, X., Lamb, V.L. (2006). Change in chronic disability from 1982 to
2004-2005 as measured by long-term changes in function and health in the U.S. elderly population. PNAS 103(48):18374-9.
Freedman, V.A.,Martin, L.G., Schoeni, R.F., Cornman, J.C. (2008). Declines in late-life disability: the role of early- and mid-life factors. Social Science and Medicine
66:1588-1602.
Seeman, T.E., Merkin, S.S., Crimmins, E.M., Karlamangla, A.S. (2010). Disability trends among older Americans: National Health and Nutrition Examination Surveys, 1988 –
1994 and 1999 –2004. American Journal of Public Health 100:100-7.
Parker, M.G., Thorslund, M. (2007). Health trends in the elderly population: getting better and getting worse. The Gerontologist 47(2):150-8.
Westendorp, R.G.J. (2006). What is healthy aging in the 21 st century? American Journal of Clinical Nutrition 83(2):404S409S. (Just the section “Longer well or poorly longer?”) Available at: http://www.ajcn.org/cgi/content/full/83/2/404S
Additional readings and references
Verbrugge, L.M., Jette, A.M. (1994). The disablement process. Social Science &
Medicine 38:1-14.
Bryant,L.L.; Shetterly,S.M.; Hamman,R.F. (2002). Modifiable risks of incident functional dependence in Hispanic and non-Hispanic white elders: The San Luis Valley Health and Aging Study. The Gerontologist 42:690-7.
Next week:

Changing demographics activity: See “Course Requirements” and eCollege for details.
CBHS 6626 Syllabus (4/16/2020) page 9 of 22

Assignment due: Changing demographics activity
General topics

Why is aging an important issue for public health?

Population perspective

Variability, diversity, and disparities

Population-level effects of changing demographics
Lecture #1: Population health perspective
Discussion #1: Effects of changing demographics
Lecture #2: Variability and diversity
Discussion #2: Public health issues and the roles of public health related to aging and diversity
Lecture #3: Intro to time value of money (for budget assignment)
Readings
Required readings
Rose, G. (1985). Sick individuals and sick populations. International Journal of
Epidemiology 14(1):32-8.
Frieden, T.R. (2010). A framework for public health action: the health impact pyramid.
American Journal of Public Health 100:590-5.
Hartley, D. (2004). Rural health disparities, population health, and rural culture.
American Journal of Public Health 94:1675-8.
Discussion topic readings
Klinenberg, E. (2002). The city of extremes. In Heat wave: A social autopsy of disaster in
Chicago . Chicago: University of Chicago Press, Introduction, 14-36.
Additional readings
Rose, G. (1992). Prevention for individual s and the ‘high risk’ strategy. In The Strategy of Preventive Medicine . New York: Oxford University Press; Chapter 4, 29-52.
Rose, G. (1992). “The population strategy of prevention.” In The Strategy of Preventive
Medicine . New York: Oxford University Press; Chapter 7, 95-106.
Sarto, G.E. (2004). The gender gap: new challenges in women’s health. Sexuality,
Reproduction & Menopause 2(1), 9-14.
Kelley-Moore, J., Ferraro, K. (2004). The Black/White disability gap: Persistent Inequality in later life? Journal of Gerontology Social Sciences 59B, S34-43.
Next week:

Benefits and budget activities: See “Course Requirements” and eCollege for details.
Assignment due: Benefits and budget activities
General topics

Income, wealth, poverty, economic security

Social status

Work and retirement
Lecture #1: Socioeconomic status and social class
Discussion #1: Individual economics of aging (benefits and budgets)
CBHS 6626 Syllabus (4/16/2020) page 10 of 22

Lecture #2: Work and retirement
Guest presenter: Ken Scott MPH
Activity #1: Brief intro to audit materials
Readings
Required readings
Wallace, S.P. (2011). Social determinants of health inequities and health care in old age.
In T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds). Public Health for an Aging
Society . Baltimore MD: Johns Hopkins University Press, Chapter 5.
Krieger,N.; Williams,D.R.; Moss,N.E. (1997). Measuring social class in US public health research: concepts, methodologies, and guidelines. Annual Review of Public Health
18:341-78.
The Elder Economic Security Initiative: The Elder Economic Security Standard Index for
Colorado . Available at: http://www.wowonline.org/documents/COElderIndex.pdf
Frank, J.C., Weiss, J. (2011). Public health workforce: preparing for an aging society. In
T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds). Public Health for an Aging
Society . Baltimore MD: Johns Hopkins University Press, Chapter 13.
Ilmarinen, J.E. (2001). Aging workers. Occupational and Environmental Medicine
58:546-52.
Silverstein M. (2008). Meeting the challenges of an aging workforce. American Journal of Industrial Medicine 51:269
–80.
National Institute for Occupational Safety and Health. (2009). The worklife initiative.
DHHS (NIOSH) Publication No. 2009-146
Flippen, C., Tienda, M. (2000). Pathways to retirement: Patterns of labor force participation and labor market exit among the pre-retirement population by race,
Hispanic origin, and sex. Journal of Gerontology 55B, S14-27.
Gallo, W., Bradley, E., Siegel, M., Stanislav, K. (2001). Health effects of involuntary job loss among older workers: Findings from the Health and Retirement Survey.
Journals of Gerontology:Social and Psychological Sciences 55B(3), S131-140.
Additional readings and references
Ekerdt, D.J. (2010). Frontiers of research on work and retirement. Journals of
Gerontology: Social Sciences 65B(1):69-80.
General topics

Cognition

Depression/emotional health

Social support and social isolation

Public health responses
Activity #1: CES-D
Activity #2: MMSE
Activity #3: Stroop
Lecture #1: The public health challenge of dementia
Guest presenter: Nancy West PhD
Lecture #2 and Discussion #1: Depression and social isolation
Discussion #2: Public health response: HAN Healthy Brain & depression/emotional health reviews & cognition/chronic condition review
Readings
CBHS 6626 Syllabus (4/16/2020) page 11 of 22

Required readings
Brayne, C. [yes, really] (2007). The elephant in the room – healthy brains in later life, epidemiology and public health. Nature Reviews 8, 233-9.
Chapman, D.P., Williams, S.M., Strine, T.W., Anda, R.F., Moore, M.J. (2006). Dementia and its implications for public health. Preventing Chronic Disease 3(2), 1-13.
Morrow-Howell, N., Gehlert, S. (2011). Social engagement and a healthy aging society.
In T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds). Public Health for an Aging
Society . Baltimore MD: Johns Hopkins University Press, Chapter 10.
Chapman, D.P., Perry, G.S. (2008). Depression as a major component of public health for older adults. Preventing Chronic Disease 2008 5(1). Available at. http://www.cdc.gov/pcd/issues/2008/jan/07_0150.htm
.
Steptoe, A., Marmot, M. (2003). Burden of psychosocial adversity and vulnerability in middle age: associations with biobehavioral risk factors and quality of life.
Psychosomatic Medicine 65:1029 –1037. Available at http://www.psychosomaticmedicine.org/cgi/reprint/65/6/1029 .
Klinenberg, E. (2002). Dying alone: the social production of isolation. In Heat wave: A social autopsy of disaster in Chicago . Chicago: University of Chicago Press,
Chapter 1, 37-78.
Additional readings and references
Steinman, L.E., Frederick, J.T., Prohaska, T., Satariano, W.A., Dornberg-Lee, S., Fisher,
R., et al. for the Late Life Depression Special Interest Project (SIP) Panelists (2007).
Recommendations for treating depression in community-based older adults.
American Journal of Preventive Medicine 33(3):175 –81.
Centers for Disease Control and Prevention (2011). The CDC Healthy Brain Initiative:
Progress 2006 ‒ 2011 . Atlanta GA: CDC. Accessible from this webpage: http://www.cdc.gov/aging//pdf/HBIBook_508.pdf
Schnittker, J. (2007). Look (closely) at all the lonely people: age and the social psychology of social support. Journal of Aging and Health 19(4), 659-82.
Skarupski, K., Mendez de Leon, C., Bienias, J., Barnes, L., Everson-Rose, S., Wilson,
R., Evans, D. (2005). Black-White differences in depressive symptoms among older adults over time. Journal of Gerontology Psychological Sciences , 60B(3), P136-42.
Next week:

Review walkability audit materials
Assignment: Review walkability audit materials posted on eCollege
General topics

Characteristics of the physical and built environment

Neighborhoods

Urban vs rural (non-metropolitan)

Wayfinding

Preparation for walkability audit
Lecture #1: Older adults and the physical/built environment
Activity #1: Preparation for environmental audit
CBHS 6626 Syllabus (4/16/2020) page 12 of 22

Readings
Required readings
HAN walkability audit tool
Satariano, W.A., Ory, M.G., Lee, C. (2011). Planned and built environments in public health. In T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds). Public Health for an
Aging Society . Baltimore MD: Johns Hopkins University Press, Chapter 15.
Macintyre, S., Ellaway, A. (2003). Neighborhoods and health: An overview. In
Neighborhoods and health , Kawachi, I., Berkman, L.F., eds. New York: Oxford
University Press, Chapter 2, 20-42.
Klinenberg, E. (2002). Race, place, and vulnerability: urban neighborhoods and the ecology of support. In Heat wave: A social autopsy of disaster in Chicago . Chicago:
University of Chicago Press, Chapter 2, 79-128.
King, D. (2008). Neighborhood and individual factors in activity in older adults: Results from the Neighborhood and Senior Health Study. Journal of Aging and Physical
Activity 16:144-70.
Additional readings and references
Sallis, J.F., Cervero, R.B., Ascher, W., Henderson, K.A., Kraft, M.K., Kerr, J. (2006). An ecological approach to creating active living communities. Annual Review of Public
Health 27:297-322.
Wood, L., Shannon, T., Bulsara, M., Pikora, T., McCormack, G., Giles-Corti, B. (2008).
The anatomy of the safe and social suburb: An exploratory study of the built environment, social capital and residents’ perceptions of safety.
Health & Place
14:15 –31.
Geller, A.M., Zenick, H. (2005). Aging and the environment: a research framework.
Environmental Health Perspectives 113(9), 1257-62.
Hartley, D. (2004). Rural health disparities, population health, and rural culture.
American Journal of Public Health 94:1675-8.
Sharkey, J.R. (2009). Measuring potential access to food stores and food-service places in rural areas in the U.S. American Journal of Preventive Medicine 36(4S):S151-5.
Health, United States, 2001, with urban and rural chartbook . Washington DC: National
Center for Health Statistics. Available at: http://www.cdc.gov/nchs/data/hus/hus01.pdf
Health, United States, 2010 (without the urban and rural chartbook) is available at http://www.cdc.gov/nchs/data/hus/hus10.pdf
Materials to prepare for environmental walkability audit
Audit tool
Map example
Next week:
 Your older adult’s caregiving needs
Overview : In the third section of the course, we will explore the aging services network, the public health network, and health care systems that may respond to the challenges to healthy aging that we have identified. We will examine their structures and roles and policies related to them as they deal with an aging population. We then will discuss some ethical issues.
General topics

Structure of aging services network
CBHS 6626 Syllabus (4/16/2020) page 13 of 22


Collaboration with public health

Caregiving
Lecture #1: Aging services network and interactions with public health
Lecture #2: Formal and informal caregiving
Discussion #1: What caregiving needs and responsibilities might your older adults have?Time to work on project and presentations
Readings
Required readings
Administration on Aging. Summary of the Affordable Care Act and Opportunities for the
Aging Network . Available at: http://www.aoa.gov/AoARoot/Aging_Statistics/docs/AoA_Affordable_Care.pdf
Gitlin, L.N., Schulz, R. (2011). Family caregiving of older adults. In T.R. Prohaska, L.A.
Anderson, R.H. Binstock (eds). Public Health for an Aging Society . Baltimore MD:
Johns Hopkins University Press, Chapter 9.
Discussion topic readings
Pinquart, M., Sorensen, S. (2003). Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: a meta-analysis. Journal of
Gerontology: Psychological Sciences 58B(2), P112 –28.
Pinquart, M., Sorensen, S. (2005). Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: A meta-analysis. The Gerontologist
45(1), 90-106.
Feinberg, L.F., Newman, S.L. (2004). A study of 10 states since passage of the National
Family Caregiver Support Program: policies, perceptions, and program development.
The Gerontologist 44(6), 760-9.
National Caregiver Support Program. Available at: www.agingcarefl.org/caregiver/NationalSupport
Additional readings and references
Administration on Aging. About AoA. Available at: http://www.aoa.gov/about/about.asp
Administration on Aging. Historical evolution of programs for older Americans. Available at: http://www.aoa.gov/AoA_programs/OAA/resources/History.aspx
General topics

Medicare/Medicaid

Social Security
Lecture #1: Future of entitlement programs
Guest Lecturer: Adam Atherly PhD
Readings
Required readings
Buchner, D.M. (2011). Public health policy successes. In T.R. Prohaska, L.A. Anderson,
R.H. Binstock (eds). Public Health for an Aging Society . Baltimore MD: Johns
Hopkins University Press, Chapter 11.
Stone, R.I., Benson, W.F. (2011). Financing and organizing health and long-term care services for older populations. In T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds).
Public Health for an Aging Society . Baltimore MD: Johns Hopkins University Press,
Chapter 3.
CBHS 6626 Syllabus (4/16/2020) page 14 of 22

Binstock, R.H. (2011). Resource allocation in an aging U.S. society. In T.R. Prohaska,
L.A. Anderson, R.H. Binstock (eds). Public Health for an Aging Society . Baltimore
MD: Johns Hopkins University Press, Chapter 18.
Feldstein, P.J. (2006). Medicare. In P.J. Feldstein. The Politics of Health Legislation: An
Economic Perspective [3 rd edition]. Chicago: Health Administration Press, Chapter
9, 269-92.
Centers for Medicare and Medicaid Services. Medicare program – general information: overview. Available at: http://www.cms.hhs.gov/MedicareGenInfo/
Centers for Medicare and Medicaid Services. History: overview. Available at: http://www.cms.hhs.gov/History/
Centers for Medicare and Medicaid Services. Medicaid program – general information: overview. Available at: http://www.cms.hhs.gov/MedicaidGenInfo/
Next week preparation:

Elder abuse: prevalence, reporting, preventing
General topics

Public health network

Falls prevention

Elder abuse
Lecture #1: Public health network
Lecture #2: Falls prevention
Guest Lecturer: Carolyn DiGuiseppi MD MPH PhD
Discussion #1: Elder abuse and what to do about it
Readings
Required readings
Fried, L.P. (2010). What are the roles of public health in an aging society? In T.R.
Prohaska, L.A. Anderson, R.H. Binstock (eds). Public Health for an Aging Society .
Baltimore MD: Johns Hopkins University Press, Chapter 2.
National Association of Chronic Disease Directors (2009). Meeting the Challenges of an
Aging Society: The Experience of State Health Departments . Available at: http://www.chronicdisease.org/nacdd-initiatives/healthy-aging/relatedresources/Aging_Society_SHD.pdf
Kaiser Family Foundation (2011). Medicare policy fact sheet: Medicare spending and financing. Available at: http://www.kff.org/medicare/upload/7305-06.pdf
Discussion readings (elder abuse)
Abbey, L. (2009). Elder abuse and neglect: when home is not safe. Clin Geriatr Med 25,
47 –60.
Cooper, C., Selwood, A., Livingston, G. (2008). The prevalence of elder abuse and neglect: a systematic review. Age and Ageing 37, 151 –160.
Krienert, J.L., Walsh, J. A., Turner, M. (2009). Elderly in America: a descriptive study of elder abuse examining National Incident-Based Reporting System (NIBRS) data,
2000-2005. Journal of Elder Abuse & Neglect 21,4, 325-345.
Donohue, W.A., Dibble, J.L., Schiamberg, L.B. (2008). A social capital approach to the prevention of elder mistreatment. Journal of Elder Abuse & Neglect , 20, 1, 1-23.
Ploeg, J., Fear, J., Hutchison, B., MacMillan, H., Bolan, G. (2009). A systematic review of interventions for elder abuse. Journal of Elder Abuse & Neglect , 21, 3, 187- 210.
Additional readings and resources
CBHS 6626 Syllabus (4/16/2020) page 15 of 22

Colorado Department of Human Services. Protective Programs Descriptions . Available at http://www.colorado.gov/cs/Satellite/CDHS-SelfSuff/CBON/1251582068463
Centers for Disease Control and Prevention. Elder Maltreatment . Available at http://www.cdc.gov/ViolencePrevention/eldermaltreatment/index.html
General topics

Geriatric medicine (and long-term care)

Palliative and end-of-life care
Lecture #1 and Discussion #1: Geriatric medicine and end-of-life care – public health perspectives
Guest lecturer: Cari Levy MD, Division of Health Care Policy and Research, University of Colorado Denver
Readings
Required readings
National Quality Forum (2011). Multiple Chronic Conditions Measurement Framework
[draft report for commenting]. Available at: http://www.qualityforum.org/Projects/Multiple_Chronic_Conditions_Measurement_Fr amework.aspx?section=PublicandMemberComment2011-12-142012-01-
13#t=2&s=&p [link at bottom of webpage]
Boyd, C.M., Darer, J., Boult, C., Fried, L.P., Boult, L., Wu, A.W. (2005). Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases:
Implications for pay for performance. JAMA 294, 716-24.
Besdine, R. (2005). Caring for older Americans: the future of geriatric medicine. Journal of the American Geriatrics Society 53(6 suppl), S245-56.
Higginson, I.J., Koffman, J. (2005). Public health and palliative care. Clinics in Geriatric
Medicine 21, 45-55.
Rao, J.K., Alongi, J., Anderson, L.A., Jenkins, L., Stokes, G-A., Kane, M. (2005).
Development of public health priorities for end-of-life initiatives. American Journal of
Preventive Medicine 29(5), 453-60.
Stjernsward, J., Foley, K.M., Ferris, F.D. (2007). The public health strategy for palliative care. Journal of Pain and Symptom Management 33, 486-93.
Additional readings and resources
General topics

Public health and the aging population

Community-based practice: interventions
Lecture #1: Designing community-based interventions in older populations: The process of translation and dissemination
Guest Lecturer via videotape: Thomas Prohaska PhD, George Mason University
(previously University of Illinois Chicago)
Readings
Required readings
CBHS 6626 Syllabus (4/16/2020) page 16 of 22

Klinenberg, E. (2002). Emerging dangers in the urban environment. In Heat wave: A social autopsy of disaster in Chicago . Chicago: University of Chicago Press,
Conclusion, 225-235.
Prohaska, T.R., Smith-Ray, R., Glasgow, R.E. (2011). Translation, dissemination and implementation issues. In T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds). Public
Health for an Aging Society . Baltimore MD: Johns Hopkins University Press, Chapter
8.
Navarro, A.M., Voetsch, K.P., Liburd, L.C., Giles, H.W., Collins, J.L. (2007). Charting the future of community health promotion: recommendations from the National Expert
Panel on Community Health Promotion. Preventing Chronic Disease [serial online]
2007 Jul [ viewed 1/10/12 ]. Available from: http://www.cdc.gov/pcd/issues/2007/ jul/07_0013.htm
Additional readings and references
National Council on Aging. Center for Healthy Aging. Community Programs . Available from: http://healthyagingprograms.org/content.asp?sectionid=8
National Association of Chronic Disease Directors. Healthy Aging Council. Available at: http://www.chronicdisease.org/nacdd-initiatives/healthy-aging/healthy-aging-council
Mangin, D., Sweeney, K., Health, I. (2007). Preventive health care in elderly people needs rethinking. BMJ 335:285-7.
Preparation for next week:

Obesity prevention intervention
General topics

Community-based research
Lecture #1: Conducting community-based translation and dissemination research
Discussion topic #1: Obesity prevention intervention
Time to work on project and presentations
Readings
Required readings
Furner, S.E., Anderson, L.A. (2011). Assessing the health and quality of life of older populations: concepts, resources, and systems. In T.R. Prohaska, L.A. Anderson,
R.H. Binstock (eds). Public Health for an Aging Society . Baltimore MD: Johns
Hopkins University Press, Chapter 3.
Minkler, M., Blackwell, A.G., Thompson, M., Tamir, H. (2003). Community-based participatory research: implications for public health funding. American Journal of
Public Health 93, 1210-3.
Discussion topic readings
Additional readings and resources
Prohaska, T., Belansky, E., Belza, B., Buchner, D., Marshall, V., McTigue, K., Satariano,
W., Wilcox, S. (2006). Physical activity, public health, and aging: critical issues and research priorities. Journal of Gerontology: Social Sciences 61B(5), S267-73.
Preparation for next week:

Audit report
Assignment due: Walkability audit report
CBHS 6626 Syllabus (4/16/2020) page 17 of 22

Discussion #1: Walkability audit experiences, results, and policy recommendations
General topics

Ethical decision-making

Research with older adults (COMIRB)

Final reflections on Heat Wave
Lecture #1: Ethical decision-making, ethical research
Guest Lecturer: Casey Frank JD
Discussion #1: Klinenberg & Heat Wave
Review and exam preparation
Readings
Required readings
Ethical decision-making guidelines
Discussion topic readings
Klinenberg, E. (2002). Governing by public relations. In Heat wave: A social autopsy of disaster in Chicago . Chicago: University of Chicago Press, Chapter 4, 165-84.
Assignment due: Take-home final due by noon on May 17 (eCollege dropbox)
CBHS 6626 Syllabus (4/16/2020) page 18 of 22


Activity/Discussion #1: Think of people you think are aging/did age well or poorly. What characteristics of those people contribute to your perceptions?

Lecture #1: Introduction to the course

Lecture #2: Brief history of gerontology, aging theories

Activity #2: Intro to environmental audit
General topics
 What do we mean by “aging” and by “being old”?

Demographics of aging in the United States

How do we talk about aging?

Discussion #1: What do we mean by aging, by being old? How do you know that someone is old? What characteristics make you think so? Why?

Lecture #1: The demography and biology of aging: Who is aging and how?

Lecture #2: How do we talk about aging?

Discussion #2: First impressions of Heat Wave
General topics

Social-ecological framework

Epidemiology of aging

Chronic diseases and conditions

Function and disability

Lecture #1: What factors affect aging? A social-ecological framework
(basis also for subsequent activities): create and write a short paper about a fictitious older person. See
“Course Requirements” and eCollege for details.
CBHS 6626 Syllabus (4/16/2020) page 19 of 22


Lecture #2: Chronic disease, disability and modifiable risk

Discussion #1: Compression of morbidity/ mortality/disability
General topics

Why is aging an important issue for public health?

Population-level effects of changing demographics

Lecture #1: Population health perspective

Discussion #1: Effects of changing demographics

Lecture #2: Variability and diversity

Discussion #2: Public health issues and the roles of public health related to aging and diversity

Lecture #3: Intro to time value of money (for budget assignment)
General topics

Income, wealth, poverty, economic security

Social status

Work and retirement

Lecture #1: Socioeconomic status and social class

Discussion #1: Individual economics of aging (benefits and budgets)

Lecture #2: Work and retirement (Ken Scott MPH)

Activity #1: Brief intro to audit materials
General topics

Cognition

Depression/emotional health

Social support and social isolation

Screening activities

Lecture #1: The public health challenge of dementia (Nancy
West PhD)

Lecture #2 and Discussion #1: Depression and social isolation

Discussion #2: Public health response
CBHS 6626 Syllabus (4/16/2020) page 20 of 22

General topics

Characteristics of the physical and built environment

Neighborhoods

Urban vs rural (non-metropolitan)

Wayfinding

Preparation for walkability audit

Lecture #1: Older adults and the physical/built environment

Activity #1: Preparation for environmental audit
General topics

Structure of aging services network

Collaboration with public health

Caregiving

Lecture #1: Aging services network and interactions with public health

Lecture #2: Formal and informal caregiving

Discussion #1: What caregiving needs and responsibilities might your older adults have?
General topics

Medicare/Medicaid

Social Security
Lecture #1: Future of entitlement programs (Adam Atherly PhD)
General topics

Public health network

Falls prevention

Elder abuse

Lecture #1: Public health network

Lecture #2: Falls prevention (Carolyn DiGuiseppi MD MPH PhD)

Discussion #1: Elder abuse and what to do about it
General topics
CBHS 6626 Syllabus (4/16/2020) page 21 of 22


Geriatric medicine (and long-term care)

Palliative and end-of-life care

Lecture #1 and Discussion #1: Geriatric medicine and end-oflife care – public health perspectives (Cary Levy MD)
General topics

Public health and the aging population

Community-based practice: interventions

Lecture #1: Designing community-based interventions in older populations: (Thomas Prohaska PhD)
General topics

Community-based research

Lecture #1: Conducting community-based translation and dissemination research

Discussion topic #1: Obesity prevention intervention

Time to work on project and presentations

Discussion #1: Walkability audit experiences, results, and policy recommendations
General topics

Ethical decision-making

Research with older adults

Final reflections on Heat Wave

Lecture #1: Ethical decision-making, ethical research (tentative
Casey Frank JD)

Discussion #1: Klinenberg & Heat Wave

Review and exam preparation
CBHS 6626 Syllabus (4/16/2020) page 22 of 22