PUBHLTH 350 Global Public Health: Challenges and Transformations
Lectures: Monday and Wednesday: 10:00 am - 11:30 am
Location: SPH II, Rm 1020 (Main Auditorium)
Discussion sections: Thursday or Friday: 1 hour
Professor:
Matthew L. Boulton, MD, MPH
Senior Associate Dean for Global Public Health
Professor of Epidemiology
Professor of Preventive Medicine
Professor of Health Management & Policy
Editor-in-Chief, American Journal of Preventive Medicine
School of Public Health
and
Professor of Internal Medicine
Division of Infectious Disease
University Medical School
SPH II M5208
mboulton@umich.edu
Office hours: Wednesdays 12 – 3 pm (contact Shawna to confirm appointment)
Individual appointments will be held between 12-1:30 pm. Group appointments
will be held between 1:30-3:00 pm.
Administrative
Assistant:
Shawna Matzinger
SPH II M5224
(734) 615-7192
shawnlea@umich.edu
Graduate Student
Instructors:
Sonia Hegde, MPH
SPH II M5020
hegdes@umich.edu
Office hours: Tuesdays 1 pm – 3 pm
Abram Wagner, MPH
SPH II M5020
awag@umich.edu
Office hours: Wednesdays 2 pm – 4 pm
Section
Time
Thursday
Thursday
Thursday
Friday
Updated August 29, 2014
Room
10 am – 11 am
3 pm – 4 pm
4 pm – 5 pm
GSI
SPH II, Rm 4318
SPH II, Rm 1170
1
Course Description:
Public health has taken on increasing global dimensions. This course
examines the social, economic, and cultural factors impacting the health of
societies worldwide and identifies key global health conditions, including
obesity, vaccine-preventable diseases, cardiovascular diseases, cancer,
tobacco, mental health, HIV/AIDS, TG, and malaria.
Course Materials:
Jacobsen KH. Introduction to Global Health. 2nd ed. Burlington, MA: Jones &
Bartlett Learning; 2013. ISBN-10:1449688349
We recommend purchasing the second edition of this textbook. If students do
purchase the first edition, they are advised to be aware of differences
between the two editions
(http://samples.jbpub.com/9781449688349/TransitionGuide.docx). The first
three chapters of the textbook are available online
(http://www.jblearning.com/catalog/9781449688349/). Other readings will
be made available on CTools (http://ctools.umich.edu).
Prerequisites:
This course has no prerequisites. Other undergraduate public health courses
at the University of Michigan (http://www.sph.umich.edu/undergrad/) may
be taken before, after, or at the same time as the course.
Competencies:
By the end of this course, students should be able to:
• Describe key global health concepts: epidemiological transitions,
measures of health status, and the burden of disease
• Discuss the impact of social, economic, and cultural factors on societal
vulnerability to morbidity and mortality and approaches to prevention
and control
• Identify health conditions with a major impact on morbidity and
mortality and key biological concepts needed to understand their
public health importance
• Identify key organizations and institutions in terms of their roles in
global health and the manner in which they can collaborate to
address key global health issues
• Analyze the epidemiological features of a disease that provide
opportunities for successful interventions or present barriers to
successful intervention and control
• Analyze the socioeconomic features of a disease that provide
opportunities for successful interventions or present barriers to
successful intervention and control
• Synthesize the options for successful intervention with a given global
health problem and develop a viable strategy for implementation
Adapted from Association of American Colleges and Universities. Available at:
http://www.aacu.org/public_health/documents/Recommendations_for_Und
ergraduate_Public_Health_Education.pdf
Updated August 29, 2014
2
Course Requirements:
Discussion group participation
Weekly online responses
Assignment #1
Assignment #2
Assignment #3
Group presentation
Exam #1
Exam #2
Exam #3
100 points
100 points
75 points
75 points
75 points
75 points
150 points
150 points
200 points
1,000 points
Discussion sections
The purpose of the discussion sections is to review material from the lectures
and the readings. Structured activities will allow students to obtain more
applied exposure to the material and to fully explore current global public
health concepts. Attendance in the discussion sections is mandatory; for each
unexcused absence, 10 points from your grade will be deducted. Please e-mail
your GSI at least two days prior to your discussion section if you are unable to
attend; we will attempt to arrange for you to attend another section, if
appropriate. Use of laptops and other electronic devices is not permitted
during the discussion sections.
Weekly response
On most weeks, students will be required to complete a response on CTools:
either a quiz or an open response which will ask about lectures and readings
from the preceding week. These will be available on CTools from Wednesday
at 11:30am to Friday at 5pm in the weeks they are due. Students should
individually complete the response, but students may consult outside sources
(e.g., notes, the textbook). Instructions for each response will be provided
online.
Assignments
Assignments are to be submitted via CTools in the "Assignments" tab by 5pm
on the day indicated in this syllabus; late assignments will be accepted up to a
week after the due date with a 50% penalty. Assignments are to be
individually completed without consulting other students. Please submit your
document as a .doc or .docx format with the following naming convention:
"assignment#_uniqname.doc" (for example: "assignment1_mboulton.docx").
More detailed instructions will be given for each assignment as due dates
approach.
Updated August 29, 2014
3
Assignment 1
The goal of this assignment is to apply epidemiological concepts covered in
class to a specific disease. Students describe the epidemiology of a disease
(including its morbidity and mortality, its geographic spread and its risk
factors), which organizations are working on controlling the disease, and how
this disease has changed as the world becomes more globalized.
(4 pages not including references, double spaced, 12-point font)
Assignment 2
Students will focus on analyzing the socioeconomic features of a disease in a
particular region of the world. Students will describe the distribution of the
disease by racial, ethnic, educational, economic, and cultural characteristics.
Students should also consider how aspects of the built environment affect the
spread of that disease. A short commentary on the difficulty of measuring a
specific socioeconomic characteristic should also be included.
(4 pages not including references, double spaced, 12-point font)
Assignment 3
In this assignment, students will participate in the larger (online) discussion of
health. Students will respond to a news or blog post in a short, thoughtful
commentary. In the report submitted for this class, students will summarize
the article, discuss how the writer approached the topic, and explain why the
students responded the way they did.
(2 pages not including references or appendix, double spaced, 12-point font)
Presentation
Students will be assigned to a group of 3 to 5 students. The group will prepare
a 20 minute discussion (15 minute presentation + 5 minute in-class
discussion) exploring a global health problem and discussing options and
strategies for a successful intervention. Students will be graded on quality of
the presentation slides, quality of the presentation, and response to class
questions. Students will also be required to be active participants in the
discussion during others' presentations, and they will complete a peer
evaluation form at the end of the project.
Exams
Exams are not cumulative, but they will require a general understanding of
material from previous exams. Material from the previous class will be
included on the exams. Exams will be approximately half multiple choice / fill
in the blank and half short answer response.
The final exam will be given on the last day of class. Students do not need to
attend class on December 15 at 4 pm (the scheduled final exam time).
Updated August 29, 2014
4
Academic Integrity:
The faculty and staff of the School of Public Health believe that the conduct of
a student registered or taking courses in the School should be consistent with
that of a professional person. Courtesy, honesty, and respect should be
shown by students toward faculty members, guest lecturers, administrative
support staff, community partners, and fellow students. Similarly, students
should expect faculty to treat them fairly, showing respect for their ideas and
opinions and striving to help them achieve maximum benefits from their
experience in the School.
Student academic misconduct refers to behavior that may include plagiarism,
cheating, fabrication, falsification of records or official documents, intentional
misuse of equipment or materials (including library materials), and aiding and
abetting the perpetration of such acts. Please visit
http://www.sph.umich.edu/academics/policies/conduct.html for the full SPH
Code of Academic Integrity and further definition of these terms.
Student Well-being:
SPH faculty and staff believe it is important to support the physical and
emotional well-being of our students. If you have a physical or mental health
issue that is affecting your performance or participation in any course, and/or
if you need help connecting with University services, please contact the
instructor or the Office of Academic Affairs.
Please visit http://www.sph.umich.edu/students/current/#wellness for more
information.
Student
Accommodations:
Students should speak with their instructors before or during the first week of
classes regarding any special needs. Students can also visit the Office of
Academic Affairs for assistance in coordinating communications around
accommodations.
Students seeking academic accommodations should register with Services for
Students with Disabilities (SSD). SSD arranges reasonable and appropriate
academic accommodations for students with disabilities. Please visit
http://ssd.umich.edu/accommodations for more information on student
accommodations.
Students who expect to miss classes, examinations, or other assignments as a
consequence of their religious observance shall be provided with a reasonable
alternative opportunity to complete such academic responsibilities. It is the
obligation of students to provide faculty with reasonable notice of the dates
of religious holidays on which they will be absent. Please visit
http://www.provost.umich.edu/calendar/religious_holidays.html#conflicts
for the complete University policy.
Updated August 29, 2014
5
Course Topics/Reading List:
Readings should be completed before the classes indicated below. Any changes to the reading schedule
will be reflected in CTools.
Date
Wed 9/3
Topics and Tasks
Introduction to the class
What is global public health?
Jacobsen sections 1.1, 1.2, and 1.3. Global health. (Available at
http://samples.jbpub.com/9781449688349/Chapter1.pdf)
Koplan JP, Bond TC, Merson MH, et al. Towards a common
definition of global health. Lancet. 2009;373:1993-1995.
Fried LP, Bentley ME, Buekens P, et al. Global health is public
health. Lancet. 2010;375:535-537.
Discussion 1
Measures of health: RR, OR, YLL, DALYs, QALYs
Jacobsen section 1.5 Risk factors; and section 1.6. Prevention
(Available at
http://samples.jbpub.com/9781449688349/Chapter1.pdf);
and chapter 2. Measuring the Global Burden of Disease
(Available at
http://samples.jbpub.com/9781449688349/Chapter2.pdf).
Fri 9/5
COMPLETE ONLINE RESPONSE #1 BY 5PM
Mon 9/8
Constructing goals in global public health: the MDGs
Jacobsen chapter 15. Global health progress and priorities.
Waage J, Banerji R, Campbell O, et al. The Millenium Development
Goals. Lancet. 2010; DOI:10.1016/S0140-6736(10)61196-8.
Dr. Boulton
Wed 9/10
History of public health and medicine
Readings TBD
Dr. Howard
Markel
Discussion 2
Study designs and sampling frames
Jacobsen chapter 3. Research and Global Health (Available at
http://samples.jbpub.com/9781449688349/Chapter3.pdf).
Mon 9/15
Epidemiological transitions: the past
Jacobsen section 1.4. Health transitions in the 20th century.
Omran AR. The epidemiologic transition: A theory of the
epidemiology of population change. Milbank Q. 1971: 49, 509538.
Dr. Boulton
Wed 9/17
Epidemiological transitions: the future
Barrett. Emerging and re-emerging infectious diseases. Annu Rev
Anthropol. 1998;27:247-271.
Harper K, Armelagos G. The changing disease-scape in the third
Dr. Boulton
Updated August 29, 2014
Lecturer
Dr. Boulton
6
epidemiological transition. Int J Environ Res Public Health.
2010;7:675-697.
Discussion 3
Finding and reading public health articles
Fri 9/19
COMPLETE ONLINE RESPONSE #2 BY 5PM
Mon 9/22
Socioeconomic status and health disparities
Jacobsen chapter 4. Socioeconomic determinants of health.
Frieden TR. A framework for public health action: the health
impact pyramid. AJPH. 2010;100(4):590-595.
Sonia Hegde
Wed 9/24
Migration
Gong. Urbanization and health in China. Lancet. 2012; 379: 843–
52.
Nakanishi. A comparison between Japanese-Americans living in
Hawaii and Los Angeles and native Japanese: the impact of
lifestyle westernization on diabetes mellitus. Biomedicine &
Pharmacotherapy. 2004;58:571–7 (only read sections 1, 2, and
5).
Abram Wagner
Discussion 4
Cross-national comparisons
Fri 9/26
ASSIGNMENT #1 DUE AT 5PM
Mon 9/29
Obesity, diabetes, and exercise
Popkin BM. Does global obesity represent a global public health
challenge? Am J Clin Nutr. 2011;93:232-233.
Subramanian SV, Perkins JM, Ozaltin E, et al. Weight of nations: a
socioeconomic analysis of women in low- to middle-income
countries. Am J Clin Nutr. 2011;93:413-421.
Dr. Boulton
Wed 10/1
Agriculture and food security
Jacobsen chapter 11. Global nutrition.
Other readings TBD.
Dr. Andrew
Jones
Discussion 5
Population pyramids
Fri 10/3
COMPLETE ONLINE RESPONSE #3 BY 5PM
Mon 10/6
EXAM #1
Wed 10/8
Globalization and the spread of disease
Jacobsen chapters 9. Control of infectious diseases; and 13.
Globalization and health.
Updated August 29, 2014
Dr. Boulton
7
Discussion 6
Writing workshop
Fri 10/10
COMPLETE ONLINE RESPONSE #4 BY 5PM
Mon 10/13
Fall break – No class
Wed 10/15
The environment and climate change
Jacobsen chapter 8. The environmental context of health.
Kjellstrom T, Butler AJ, Lucas RM, et al. Public health impact of
global heating due to climate change. Int J Public Health.
2010;55:97-103
Discussion 7
Strategies for rational discussion of scientific topics
Fri 10/17
COMPLETE ONLINE RESPONSE #5 BY 5PM
Mon 10/20
Maternal health
USAID. Levels and trends in the use of maternal health services in
developing countries. 2011 (only need to read discussion on
pp. 73-77).
Firoz. Measuring maternal health: focus on maternal morbidity.
Bull World Health Organ. 2013;91:794-796.
Dr. Boulton
Wed 10/22
Mental health, stress, and discrimination
Miranda JJ, Patel V. Achieving the Millennium Development Goals:
does mental health play a role. PLoS Med. 2005;2(10):e291.
Finch BK, Hummer RA, Kol B, et al. The role of discrimination and
acculturative stress in the physical health of Mexican-origin
adults. Hispanic Journal of Behavioral Sciences. 2001;23:399429.
Dr. Boulton
Discussion 8
Presentation assignments
Fri 10/24
COMPLETE ONLINE RESPONSE #6 BY 5PM
Mon 10/27
Culture and attitudes towards health care
Pelto PJ, Pelto GH. Studying knowledge, culture, and behavior in
applied medical anthropology. Medical Anthropology
Quarterly. 1997;11(2):147-163.
Jegede AS. What led to the Nigerian boycott of the polio
vaccination campaign. PLoS Medicine.2007;4(3):e73.
Sonia Hegde
Wed 10/29
Vaccines
Jacobsen chapter 5. Child health.
Greenwood B, Salisbury D, Hill AVS. Vaccines and global health.
Phil Trans R Soc B. 2011;366: DOI 10.1098/rstb.2011.0076.
Dr. Boulton
Updated August 29, 2014
Dr. Boulton
8
Discussion 9
Models
Fri 10/31
ASSIGNMENT #2 DUE AT 5PM
Mon 11/3
Cardiovascular disease
Jacobsen chapter 7. Noncommunicable diseases and aging.
Anand SS, Yusuf S. Stemming the global tsunami of cardiovascular
disease. Lancet. 2011;377:529-532.
Dr. Boulton
Wed 11/5
Cancer
Coughlin SS, Ekweume DU. Breast cancer is a global health
concern. Cancer Epidemiology. 2009;33:315-318.
Jemal A, Bray F, Center MM. Global cancer statistics. Ca Cancer J
Clin. 2011;61:69-90.
Dr. Boulton
Discussion 10
Recap
Fri 11/7
COMPLETE ONLINE RESPONSE #7 BY 5PM
Mon 11/10
EXAM #2
Wed 11/12
Public health research and ethics in developing countries
Jacobsen chapter 14. Health, human rights, and humanitarian aid.
Discussion 11
PRESENTATIONS
Fri 11/14
COMPLETE ONLINE RESPONSE #8 BY 5PM
Mon 11/17
Malaria and Tuberculosis
Jacobsen sections 10.3. TB; and 10.4. Malaria.
McNeil DG. "Eradicate Malaria? Doubters Fuel Debate." New York
Times. 2008, March 4.
WHO. Global tuberculosis report 2012: Execute Summary. 2012.
Dr. Boulton
Wed 11/19
Tobacco, alcohol, and other drugs
Warren CW, Lea V, Lee J, et al. Findings from the Global Youth
Tobacco Survey. Global Health Promotion. 2009;16:38.
Rehm J, Mathers C, Popova S. Global burden of disease and injury
and economic cost attributable to alcohol use and alcohol-use
disorders. Lancet. 2009;373:2223-2233.
Dr. Boulton
Discussion 12
PRESENTATIONS
Fri 11/21
COMPLETE ONLINE RESPONSE #9 BY 5PM
ASSIGNMENT #3 DUE AT 5PM
Mon 11/24
HIV/AIDS
Updated August 29, 2014
Sonia Hegde +
Abram Wagner
Dr. Gary Harper
9
Jacobsen section 10.2. HIV/AIDS.
Other readings TBD
Wed 11/26
Global health organizations and movements
Jacobsen chapter 12. Global health payers and players.
Garrett L. The challenge of global health. Foreign Affairs.
2007;86(1);14-38.
Farmer P. From "marvelous momentum" to health care for all.
Foreign Affairs. 2007;86(2):155-161.
Discussion
Thanksgiving break – no class
Mon 12/1
Evidence-based public health policy
Yamey and Feachem. Evidence-based policymaking in global
health - the payoffs and pitfalls. Evidence-Based Medicine.
2011. doi:10.1136/ebm.2011.100060.
Birbeck et al. Global health: the importance of evidence-based
medicine. BMC Medicine 2013;11:223.
Dr. Boulton
Wed 12/3
Science and technology
Juma C, Yee-Cheong L. Reinventing global health: the role of
science, technology, and innovation. Lancet.
2005;365(9464):1105-1107.
Cortese DA. A vision of individualized medicine in the context of
global health. Clinical Pharmacology & Therapeutics.
2007;82:491-493
Abram Wagner
Discussion 13
Review for final
Fri 12/5
COMPLETE ONLINE RESPONSE #10 BY 5PM
Mon 12/8
Global primary health care
Frenk. The global health system: strengthening national health
systems as the next step for global progress. PLoS Med.
2010;7(1): e1000089.
Balarajan Y, Selvaraj S, Subramanian SV. Health care and equity in
India. Lancet. 2011;377(9764):505-515.
Wed 12/10
EXAM #3
Updated August 29, 2014
Dr. Boulton
Dr. Boulton
10