University of Pennsylvania
Graduate Program in Public Health
MPH Degree Program
Course Syllabus – Spring 2011
Title: PUBH 517 (CPLN622) – Geography & Public Health
Course Units: 1.0 c.u.
Course Description: Geography and physical and social environments have profound effects on public health. Through this class, students will gain a conceptual understanding of: (1) how geography and health are related; (2) how the public health toolbox, including geographic information systems (GIS), can be used to study the places people live, work, and play and how these places either add to or detract from their health. This class will combine lectures and discussions of readings, presentations demonstrating how geographic methods can be used to address public health issues, and hands-on computer or small group activities. Students will learn based on a multidisciplinary framework that stresses the connections between various fields including public health, epidemiology, medicine, city planning, and the social sciences.
Placement / Room Assignment:
Tuesday, 6:00 – 9:00 PM
Arch Crest Room, 36th Street & Locust Walk
Course Directors: Douglas Wiebe, PhD
Lead Instructor dwiebe@exchange.upenn.edu
902 Blockley Hall
Phone: (215) 746-0149
Office hours: By Appointment
Pre-requisites: None.
Co-requisites: None.
Charles Branas, PhD cbranas@upenn.edu
936 Blockley Hall
Phone: (215) 573-5381
Office hours: By Appointment
Amy Hillier, PhD ahillier@design.upenn.edu
127 Meyerson Hall
Phone: (215) 746-2341
Office hours: By Appointment

Evaluation Methods: 15% Attendance and Participation
40% Homework Assignments – four assignments of 10% each
15% Mid-term Exam
30% Final Project and In-class Presentation
 FINAL PROJECT – Working in teams of two or three, (if possible, pairing public health and MUSA/CPLN students), conduct a GIS project linking health and the environment. Your project should include a clear research question, data collection, and data analysis. Each project must involve data collection and be focused on the implications of geography on health. Deliverables: teams will present their project
(background, methods, data analysis results, conclusions and implications) using
Powerpoint (and/or video) during an in-class presentation during the final two class sessions (10% of grade), and will submit a written summary (one per team; between 3-5 pages; 20% of grade). Teams and topics to be considered and decided upon over the first five class sessions.
ArcGIS SOFTWARE: Each student will be given a complimentary copy of ArcGIS software that can be installed on their personal computer (PC-compatible only, not Mac). The software license is valid for one year.
Academic Integrity:
Students are expected to adhere to the University’s Code of Academic
Integrity. Care should be taken to avoid academic integrity violations, including: plagiarism, fabrication of information, and multiple submissions. Students who engage in any of these actions will be referred to the Office of Academic Integrity, which investigates and decides on sanctions in cases of academic dishonesty.
See link for more information: http://www.upenn.edu/academicintegrity/index.html
MPH Academic Standing Policy/Academic Probation: According to University policy, a graduate student must maintain a ‘B’ average or better to be considered in good academic standing. A student who does not meet the University policy of a ‘B’ /3.0 average will be reviewed by the MPH Program Director, the Associate Director and the Academic Progressions
Committee.
A student may be put on academic probation for a period of 1 semester to improve his/her overall average may be put on academic probation for a period of 1 semester to improve his/her overall average.
Any course in which the student receives a grade below a B- will not be applied toward the Master of Public Health degree. The record of any student who receives an unsatisfactory grade (less than a ‘B-‘) in a course or who does not meet the University policy of a ‘B’ /3.0 average will be reviewed by the MPH Program Director, the Associate Director and the
Academic Progressions Committee.
A student may be put on academic probation for a period of
1 semester to improve his/her overall average
Students may continue to take other courses during the probation period and the student must make arrangements with the course director to remediate any grades lower than a B-. These arrangements must be approved by the MPH Program Director with input from the Academic
Progressions Committee as needed. Any student who is on academic probation for a period greater than 1 semester will be referred to the Academic Progressions Committee for review and

recommendation. This committee is authorized to dismiss the student or allow the student to remain in the program on a probationary basis. A return to good academic standing is contingent on receiving an acceptable grade (B or higher) in all remaining courses.
The MPH grading policy is at the discretion of the individual course instructors.
Please find below the generally used grading scale for the MPH Program.
A+ 97-100 B+ 87-89 C+ 77-79
A 93-96
A- 90-92
B 83-86
B- 80-82
C 73-76
C- 70-72
Please note that an A+ carries the same weight (4.0) as an A.
F 0-69
Incomplete Grade: It is expected that a matriculated Master of Public Health student shall complete the work of a course during the semester in which that course is taken. A student who fails to complete a course within the prescribed period shall receive at the instructor’s discretion either a grade of I (incomplete) or F (failure). If the incomplete is given, the instructor may permit an extension of time up to one year for the completion of the course. In such cases, any course which is still incomplete after one calendar year from its official ending must remain as incomplete on the student’s record and shall not be credited toward the MPH degree. Students who receive two or more incompletes within a semester may not register for the subsequent semester(s) without the permission of the Department.
For additional information on academic policies, please refer to the corresponding sections in the
Student Handbook.

Course Outline / Assignments:
Class Date Class Topics
1 1/19 Introduction to
Geography and Public
Health
Topics: logistics, schedule, assignments, grading guidelines, introduction lecture
Activity: Watch
“Unnatural Causes: Is
Inequality Making Us
Sick? Part 5: Place
Matters” (30 min)
2 1/26 Diffusion and Clustering
(Branas)
Topics: measures of diffusion, networks and barriers, population potential, cluster detection
Activity: Suspected
Legionnaires’ Disease in
Bogalusa
3 2/2 Health & the Built
Environment (Hillier)
Topics: W.E.B. Du Bois and The Philadelphia
Negro ; history of public health and planning collaborations; sprawl; measures of the built environment
Activity: Measuring walkability
Readings
 Witold Rybczynski, “The Green Case for
Cities,”
The Atlantic Online , October 2009.
 Malcolm Gladwell, “Mosquito Killer,”
The
New Yorker , July 2, 2001.
 Melinda Meade and Robert Earickson. Disease
Diffusion in Space. Chapter 8 in Medical
Geography , 2nd ed., 2000 Guilford Press, pp.
262-305.
 Michael Thun and Thomas Sinks.
Understanding cancer clusters. CA Cancer J

Clin 2004; 54: 273-280.
Ian R.H. Rockett. Population and Health: An
Introduction to Epidemiology. 2 nd
ed.
Population Bulletin 1999; 54(4): 3-40.



David Sloane (2006), “From Congestion to
Sprawl: Planning and Health in Historical
Context,”
Journal of the American Planning
Association , Vol. 72(1): 10-18.
Howard Franklin (2007), “Sprawl and Urban
Health,” Article 7 in H. Patricia Hynes and
Russ Lopez, eds., Urban Health: Readings in the Social, Built, and Physical Environments of
U.S. Cities , pp. 141-168.
J. F. Sallis and K. Glanz (2006). The role of built environments in physical activity, eating, and obesity in childhood. The Future of
Children 16 (1): 89-108.
Optional Readings:
 W.E.B. Du Bois, The Philadelphia Negr o
(1899), “Chapter 1, The Scope of this Study,” pp. 1-4, “Chapter 2, The Problem,” pp. 5-9,
“Chapter 15, “The Environment of the Negro,”

4
5
2/9 Health & the Social
Environment (Wiebe)
Topics: Measuring social exposures, defining neighborhood, social distance
Activity: Google Earth,
Six degrees of separation
2/16 Measuring the
Environment with Field
Data (Hillier)
Topics: Reliability and validity of field measures
(ecometrics); measuring the food environment; measuring physical activity
Activity: Developing a new field measure

 pp. 287-321.
Ross C. Brownson, Christine M. Hoehner,
Kristen Day, Ann Forsyth, James F. Sallis
(2009). Measuring the Built Environment for
Physical Activity: State of the Science
American Journal of Preventive Medicine
36(4S):S99–S123.
Robert Sampson (2003), “Neighborhood-level
Context and Health: Lessons from Sociology,”
Chapter 6 in Kawachi & Berkman, eds.
Neighborhoods and Health , pp. 132-146.
 Stephen Raudenbush (2003), “The Quantitative
Assessment of Neighborhood Social
Environments,” Chapter 5 in Kawachi &
Berkman, eds. Neighborhoods and Health , pp.


112-131.
Karen Glanz et al (2007), Nutrition
Environment Measure Survey in Stores
(NEMS-S) American Journal of Preventive
Medicine 32(4): 282-289.
T. L. McKenzie, D. A. Cohen, A. Sehgal, S.
Williamson, and D. Golinelli (2006). System for Observing Play and Recreation in
Communities (SOPARC): Reliability and feasibility measures. Journal of Physical
Activity and Health 3 (Suppl. 1): S208-22.
HOMEWORK 1: Field Data (due Tuesday 2/23)
Create and test your own field data collection instrument for measuring the built or social environment as it relates to public health. Be sure to conduct a literature review of existing measures before you begin. You may either adapt an existing measure or develop your own from scratch. Your final assignment should include: (1) a brief review of existing measures and explanation of how yours is different; (2) the instrument; (3) a protocol for using the instrument (detailed instructions); and
(4) a summary of your results from piloting the instrument. Your instrument should adhere to the

6
7
2/23 Measuring the
Environment with
Administrative Data
(Branas)
Topics: Data dimensions, types of data, data linkage, problems with spatial data
Activity: Internet demonstration of geographic health data available online
3/2 Modeling Movement
Through Space (Wiebe)
Topics: Migration; indirect exposure modeling; spacetime activity patterns
GIS Applications: STARS project
Activity: Interactive demonstration of GPS activity pattern data principles of good field measures presented in class.
 Lance A. Waller and Carol A. Gotway. Spatial
Data. Chapter 3 In: Applied Spatial Statistics for Public Health Data . 2004 John Wiley &
Sons.
 Charles Branas, Therese Richmond, Dennis
Culhane, Douglas Wiebe. Novel linkage of individual and geographic data to study firearm violence. Homicide Studies 2008; 12(3): 298-
320.
 Arline T Geronimus. Invited commentary: using area-based socioeconomic measures – think conceptually, act cautiously. American
Journal of Epidemiology 2006; 164(9): 835-
840.
HOMEWORK 2: Administrative Data (due
Tuesday 3/2)
Select a publicly available online dataset that has geographic identifiers linked to health information.
Download these data, read them into a spreadsheet, database, or statistical software package. Perform basic operations with these data demonstrating at least one example of a prevalence calculation for the geographic region or subregion(s) for which you have data. Finally, create at least one map of the information contained within the dataset you downloaded – this can be any type of map(s) you choose.
 Niel E. Klepeis et al. The National Human
Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants. J Expo Anal Environ Epidemiol
2001;11(3):231-52.
 Wiebe DJ, Branas CC. Daily activities and violence in community landscapes. In
(Wachter S, ed.) How place matters.
University of Pennsylvania Press (in press).
MIDTERM EXAM: One hour, in class, closed book to test understanding of class content to date.
HOMEWORK 3: Movement Through Space
(due Tuesday 3/16)
Keep a diary of 3-7 consecutive days of your

8
9 activities. Analyze your data, and submit a summary (3 pages maximum) of your activities and an assessment of the health implications of your activities over the course of your diary days.
3/16
SPRING BREAK (3/9): No class
Network and Discrete  Mark S. Daskin. Introduction to location
Location (Branas)
Topics: Facility siting, theory and models. Chapter 1 In:
Applications
Network and
Discrete Location. Models, Algorithms, and
. 1995 Wiley & Sons, NY, pp. 1-
3/23 location science models, access to healthcare, decision support
Activity: Using Excel
Solver to optimally locate ambulances
Community
Participatory Methods
(Hillier)
Activity: Guest speaker
Nicole Thomas,
Philadelphia Area
Research Community
Coalition (PARCC)

18.
Charles ReVelle. Siting ambulances and fire companies. New tools for planners. American
Planning Association Journal 1991; 57(4):
471-484.
 Charles Branas, Charles ReVelle. TRAMAH to the Rescue. Operations Research /
Management Science Today 1999; 26(3):38-
40.

Carolyn C. Cannuscio, Eve E. Weiss, Hannah
Fruchtman, Jeannette Schroeder, Janet Weiner, and David A. Asch (2009), “Visual epidemiology: Photographs as tools for probing street-level etiologies,” Social Science
& Medicine 69: 553-564.

Barbara Israel et al (2005), Community-Based
Participatory Research: Lessons Learned from the Centers for Children’s Environmental
Health and Disease Prevention Research,
Environmental Health Perspectives 113(10):
1463-1471.

Suzanne B. Cashman et al (2008). “The Power and the Promise: Working with Communities to Analyze Data, Interpret Findings, and Get to
Outcomes.”
American Journal of Public
Healt h 98(8): 1407-1417.
Optional Reading:

Witnesses to Hunger website www.witnessestohunger.org
HOMEWORK 4: Photo-Voice and CBPR (due
Tuesday 3/30)
Take photographs highlighting elements of the built and social environment from one block in your neighborhood or another neighborhood of interest that you believe impact health. Create a

10 3/30 Modeling the
Environment with GIS
(Hillier)
Topics: Network analysis, measuring distances
11 between points, inverse distance weighting (IDW), kernel densities, “hot spot”/point pattern analysis
4/6 Modeling the
Environment with GIS
(Hillier)
Topics: Map algebra
(raster GIS), cartograms, animation
12 4/13 Modeling the
Environment with
Spatial Statistics (Wiebe)
Topics: spatial autocorrelation, spatial weights matrix, spatial regression
Activity: Spatial regression with GeoDa.
13 4/22 Final Project
Presentations
14 4/27 Final Project
Presentations presentation that incorporates no more than 10 photos and your voice describing your different perspectives.
 Hillier, Amy, Cole, Brian, Smith, Tony E.,
Yancey, Antronette, Williams, Jerome, Grier,
Sonya and McCarthy, William (2009),
Clustering of Unhealthy Outdoor
Advertisements Around Child-serving
Institutions: A Comparison of Three Cities.
Health & Place 15: 935-945.
 C. Dana Tomlin (2009), “Using Map Algebra to Model Urban Heat,” in Tomlin and Culhane, eds., Philly.Dot.Map: The Shapes of

Philadelphia .
Cartograms http://hetv.org/resources/cartograms.htm
Selected exercises from:
 Luc Anselin (2005), Exploring Spatial Data with GeoDa: A Workbook (revised). Center for Spatially Integrated Social Statistics;
University of Illinois – Urbana-Champaign