University of Pennsylvania
Graduate Program in Public Health
MPH Degree Program
Course Syllabus – Spring 2011
Title: PUBH 516 – Public Health Genetics
Course Units: 1.0 c.u.
Course Description: This is a lecture course that will provide a topical overview of issues in
public health genetics. The purpose of this course is to introduce students to the complex issues
involved in applying and integrating genetic technology and information into public health.
Through a series of lectures and observational experiences, students will learn about the history
of public health genetics, the role that genetics play in public health, and issues involved in
applying genetic technology in clinical and research settings. Lectures will also address the
ethical, legal, and social implications of genetic testing in populations and research designed to
identify susceptibility genes in diverse ethnic and racial groups.
Placement / Room Assignment:
Monday, 4:30 – 7:30 PM
Anatomy-Chemistry, Room 149
Course Director:
Chanita Hughes Halbert, Ph.D.
chanita@mail.med.upenn.edu
3535 Market Street, Suite 4100
Philadelphia, PA 19104
Phone: 215-746-7144
Facsimile: 215-746-7140
Office Hours: Before class and by appointment
Pre-Requisites: Currently enrolled in a Master’s program and other students with the
permission of the instructor.
Course Overview: This course aims to provide the student with an overview of public health
genetics and issues involved in applying genetic information to disease prevention and health
behaviors.
Co-Requisites: None
Course Objectives:
At the completion of this course, the student will be able to:

Understand the implications of genetic factors for health promotion and disease
prevention.

Evaluate the accessibility, effectiveness, and quality of individual and population-based
genetic services.

Understand the complexity of communicating genetic risk information.

Identify the ethical, legal, and social issues in applying genetic information in clinical and
research settings.
Evaluation Methods:
20%
30%
25%
25%
Class participation
Discussion questions
Mid-term
Final paper
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
B
83-86
C
73-76
A- 90-92
B- 80-82
C- 70-72
F
Please note that an A+ carries the same weight (4.0) as an A.
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:
Content/Competency
What is public health
genetics
Date
January 24, 2011
Integrating genetics into
public health practice
January 31, 2011
Public knowledge and
attitudes about genetics
and genetic testing
Accessibility to genetic
services
February 7, 2011
Risk communication
February 21, 2011
Psychological, behavioral,
and familial implications
of genetic risk information
February 28, 2011
Spring Break
March 7, 2011
February 14, 2011
Topic
 Course introduction
 Public health impact of disease
 Overview of public health and public
health genetics
 What is genetic information
 Frameworks for integrating genetics into
public health practice
 Challenges for integrating genomics into
public health practice
 Genetic testing
 Knowledge and attitudes about genetic
and genetic testing among health care
providers and consumers
 Uptake of genetic testing
 Access to genetic testing in special
populations
 Minority recruitment in cancer genetics
research
 Conceptualizations of disease risk
 Strategies for communicating genetic
risk information
 Direct-to-consumer advertising
 Impact of genetic risk information on
psychological functioning
 Impact of genetic risk information on
familial functioning
 Impact of genetic risk information on
health behaviors
 NO CLASS





Applying genetic
information to disease
prevention and treatment
March 14, 2011
Genetics and racial
disparities
March 21, 2011
Community involvement
in public health genetics
March 28, 2011
Guest lecture
Ethical, legal, and social
issues involved in genetics
research
Class presentations
Class presentations
April 4, 2011
April 11, 2011
 Readings TBA
 Readings TBA
April 18, 2011
April 26, 2011
 Readings as assigned by presenters
 Readings as assigned by presenters
Cancer
Diabetes
Obesity
Cardiovascular disease
Identifying racial and ethnic differences
in genetic risk factors
 Using genetics to address health
disparities
 Ethical, legal, and social issues involved
in using genetics to address disparities
 Models for involving communities in
genetics research and policy
Reading Assignments:
What is Public Health Genetics?
 Khoury MJ, Burke W, Thomson EJ. Genetics and public health: a framework for integration
of human genetics into public health practice. In MJ Khoury, W Burke, and EJ Thomson,
eds. Genetics and Public Health in the 21st Century (pp 2-23). New York: Oxford University
Press, 2000.
 Burke W, Zimmerman RL. Ensuring the appropriate use of genetic tests. Nat Rev Genet.
2004;955-959.
 Leviton LC, Rhodes SD, Chang CS. Public health: policy, practice, and perceptions. In AR
Kovner, Knickman JR, eds. Health Care Delivery in the United States 9th Edition (pp 85124). New York: Springer, 2008.
Integrating Genetics into Public Health Practice
 Khoury MJ, Gwinn M, Burke W, Bowen S, Zimmerman R. Will genomics widen or help
heal the schism between medicine and public health? Am J Prev Med. 2007;33:310-317.
 Rogowski WH, Grosse SD, Khoury MJ. Challenges of translating genetic tests into clinical
and public health practice. Nat Rev Genet. 2009;10:489-495.
 Chen LS, Kwok OM, Goodson P. US health educators’ likelihood of adopting genomic
competencies into health promotion. Am J Public Health. 2008;98:1651-57.
 Hay JL, Meischke HW, Bowen DJ, Mayer J, Shoveller J, Press N, Asgari M, Berwick M,
Burke W. Anticipating dissemination of cancer genomics in public health: a theoretical
approach to psychosocial and behavioral challenges. Ann Behav Med. 2007;34:275-86.
Knowledge and Attitudes about Genetics and Genetic Testing




Chen LS, Goodson P. Public health genomics knowledge and attitudes: a survey of public
health educators in the United States. Genet Med. 2007;9:496-503.
Lanie AD, Jayaratne TE, Sheldon JP, Kardia S, Anderson ES, Feldbaum M, Petty EM,
Exploring the public understanding of basic genetic concepts. J Genet Couns. 2004;13:305320.
Sabatino SA, McCarthy EP, Phillips RS, Burns RB. Breast cancer risk assessment and
management in primary care: provider attitudes, practices, and barriers. Cancer Detect Prev.
2007;31:375-83.
Barlow-Stewart K, Taylor SD, Treloar SA, Stranger M, Otlowski M. Verification of
consumers’ experiences and perceptions of genetic discrimination and its impact on
utilization of genetic testing. Genet Med. 2009;11:193-201.
Accessibility to genetic services
 Lin-Fu JS, Lloyd-Puryear M. Access to genetic services in the United States: a challenge to
genetics in public health. In Khoury MJ, Burke W, and Thomson EJ, eds. Genetics and
Public Health in the 21st Century (pp 273-289). New York: Oxford University Press, 2000.
 Halbert CH, Kessler L, Stopfer JE, Domchek S, Wileyto EP. Low rates of acceptance of
BRCA1 and BRCA2 test results among African American women at increased risk for
hereditary breast-ovarian cancer. Genet Med. 2006;8:576-582.
 Ricker C, Lagos V, Feldman N, Hiyma S, Fuentes S, Kumar V, Gonzalez K, Palomares M,
Blazer K, Lowstuter K, MacDonald D, Weitzel J. If we build it…will they come?
Establishing a cancer genetics services clinic for an underserved predominately Latina
cohort. J Genet Couns. 2006;15:505-14.
Risk Communication
 Condit CM, Parrot RL, O’Grady B. Principles and practices of communication processes for
genetics and public health. In Khoury MJ, Burke W, Thomson EJ, eds. Genetics and Public
Health in the 21st Century (pp 549-567). New York: Oxford University Press, 2000.
 Browner CH, Preloran HM, Casado MC, Bass HN, Walker AP. Genetic counseling gone
awry: miscommunication between prenatal genetic service providers and Mexican-origin
clients. Soc Sci Med. 2003;56:1933-1946.
 Green MJ, Peterson SK, Baker MW, Harper GR, Friedman LC, Rubinstein WS, Mauger DT.
Effect of a computer-based decision aid on knowledge, perceptions, and intentions about
genetic testing for breast cancer susceptibility: a randomized controlled trial. JAMA.
2004;292:469-498.
 Geransar R, Einsiedel E. Evaluating online direct-to-consumer marketing of genetic tests:
informed choices or buyers beware? Genet Test. 2008;12:13-23.
Psychological, Behavioral, and Familial Implications of Genetic Risk Information
 Halbert CH, Lynch H, Lynch J, Main D, Kucharski S, Rustgi AK, Lerman C. Colon cancer
screening practices following genetic testing for hereditary nonpolyposis colon cancer
(HNPCC) mutations. Arch Intern Med. 2004;164:1881-1887.
 Tercyak KP, Johnson SB, Roberts SF, Cruz AC. Psychological responses to prenatal genetic
counseling and amniocentesis. Patient Educ Couns. 2001;43:73-84.

Harvey-Berino J, Gold EC, West DS, Shuldiner AR, Walston J, Starling RD, Nolan A, Silver
K, Poehlman ET. Does genetic testing for obesity influence confidence in the ability to lose
weight? J Am Diet Assoc. 2001;101:1351-1353.
Application of Genetic Information to Disease Prevention and Treatment
 Readings to be assigned
Genetics and Health Disparities
 Braun L. Race, ethnicity and health. Can genetics explain disparities. Perspect Biol Med.
2002;45:159-174.
 Tate SK, Goldstein DB. Will tomorrow’s medicines work for everyone. Nat Genet.
2004;36:S34-S42.
 Burchard EG, Ziv E, Coyle N, Gomez SL, Tang H, Karter AJ, Mountain JL, Perez-Stable EJ,
Sheppard D, Risch N. The importance of race and ethnic background in biomedical research
and clinical practice. N Engl J Med. 2003;348:1170-5.
Community Involvement in Public Health Genetics
 Gollust SE, Apse K, Fuller BP, Miller PS, Biesecker BB. Community involvement in
developing policies for genetic testing: assessing the interests and experiences of individuals
affected by genetic conditions. Am J Public Health. 2005;95:35-41.
 Sharp RR. Community involvement in the ethical review of genetic research: lessons from
the American Indian and Alaska Native Populations. Environ Health Perspect.
2002;110:145-145.
 Bonham VL, Citrin T, Modell SM, Franklin TH, Bleicher WE, Fleck LM. Communitybased dialogue: engaging communities of color in the United States’ genetic policy
conversation. J Health Polit Policy Law. 2009;34:325-59.