PH 7285 – Social Determinants of Health
Douglas W. Roblin, PhD
Health Management and Policy
Course Basics
Fall Semester 2014
Class Day/Time:
Wednesday, 1 – 3:30 pm
Class Location:
Sparks Hall, Room 420 (lectures), 25 Park Place SPH Computer Lab
(denoted ** in the course schedule)
Prerequisite(s):
Faculty Accessibility
Required Course
Materials
1. PH7011 Epidemiology for Public Health or PH7017
Biostatistics for Public Health, 2. PH7140 Social and Behavioral
Dimensions of Public Health, and 3. PH 7160 Introduction to the
Healthcare System. Working knowledge of basic SAS DATA and
PROC procedures is preferred.
No specific textbook is required. Chapter readings are identified
for selected textbooks, which are available in the GSU library
reserve collection. Other required course materials are journal
articles which can be obtained through the GSU library website.
Instructor(s) of
Record:
Douglas W. Roblin, PhD
Office Location:
One Park Place, Room 662C
Phone
Number(s):
404-413-2339
Email:
DRoblin@GSU.Edu
Office Hours:
Office hours Monday, Tuesday, or Wednesday (10 am – 4 pm)
by appointment
I. Course Description:
This course introduces concepts and methods associated with social determinants of health
which is a domain of health research that describes and analyzes the social factors related
to etiology of health attitudes, behaviors, and outcomes in populations. Social epidemiology
is closely linked to other disciplines including the social and behavioral sciences. This course
will provide an overview of the social determinants of health, health disparities, social
epidemiology, social epidemiology research methods, and the linkages between social
epidemiology and health policy. This course takes a “life course” approach with a focus the
dynamic aspects of the relationship between social factors—health consequences (health
attitudes and behaviors, disease incidence and progression, and quality of life) by age,
period, and cohort. The course is comprised of primarily of lectures. There is some modest
SAS computer laboratory work, although a high level of competence is SAS is not required.
II. Course Objectives / Competency / Assessment of Student Learning:
This course is designed to support students in acquiring competence in the following four
areas, as indicated in the School of Public Health Graduate Student Handbook (see MPH
Core Competencies).

Use statistical software, perform appropriate statistical analyses based on the
research questions, research design, and appropriateness or tenability of statistical
assumptions. (MPH Core Competency #2)

Communicate epidemiologic concepts in both technical and lay language by
explaining trends and patterns of health-related events and the importance of
epidemiology in health policy, disease prevention, and health promotion. (MPH
Core Competency #6)

Apply evidence-based principles to critically evaluate current policies and practices in
healthcare delivery and in public health systems including present and future
healthcare reform proposals to address the quality, accessibility and cost of our
health systems. (MPH Core Competency #11)

Describe how social and behavioural risk factors contribute to individual and public
health outcomes. (MPH Core Competency #12)
Course Objectives
Demonstrate a basic understanding
of methods used for analysis and
reporting of findings in peerreviewed literature on social
determinants of health.
Develop the ability to write concise,
clear critiques of the strengths and
weaknesses of specific themes in the
literature on social determinants of
health with the potential to inform
design, implementation, and/or
evaluation of health interventions.
Critique peer-reviewed literature on
evidence describing the strengths of
weaknesses of a hypothesized
relationship between social
determinants of health and healthrelated attitudes and behaviors,
disease incidence, or quality of life
from early to mid-life.
Program Competency
Assessment Method(s)
MPH Core 2
SAS Lab (Methods) Oral
Presentation
MPH Core 6 and 12
Brief Paper #1-#4
MPH Core 6 and 12
Term paper #1
2
Critique peer-reviewed literature on
evidence describing the effectiveness
of an intervention to change how a
social determinants of health affects
health-related attitudes and
behaviors, disease incidence, or
quality of life.
MPH Core 6, 11, and 12 Term paper #2
IV. Course Assignments and Requirements
This course assumes substantial and informed student participation. General discussion of theory
and practice is encouraged and expected of all students. At a minimum, being informed requires
class attendance, completion of assigned readings and homework, and attention to health care news
and world events. Class attendance and thoughtful participation are important and will be reflected
in part in the final grade. Please notify the instructor of an absence before the class
Course requirements will contribute to grade as follows:
Term Paper #1
Term Paper #2
Brief Reports 1-4
SAS Lab Oral Presentation
TOTAL
30 points
40 points
24 points
6 points
100 points
Term Papers: Each student will individually submit a paper that is to be 6-10 pages in length
(excluding bibliography), double spaced, 12 point font with 1 inch margins left, right, top
and bottom. The paper should be supported by research published in 4-6 articles that are
considered to be strong evidence from peer-reviewed sources. Term paper topics must be
selected from the list presented by the instructor for this course (see below), unless an
alternative topic proposed by the student is approved by the instructor.
Brief Papers: Each student will individually submit a paper a 1-2 page critique that, in the
student’s own words, addresses the topic posed for the specific assignment (see below).
V. Grading Policy
Grading Scale:
94 – 100
90 – 93
87 – 89
83 – 86
80 – 82
77 – 79
73 – 76
70 – 72
A
AB+
B
BC+
C
C-
3
60 – 69
Below 60
D
F
Withdrawals: A student who withdrawals at any time up to the mid-point of the quarter
will be assigned a W or WF depending upon whether he/she is doing satisfactory work at
the time of withdrawal. An average grade of D or F at the time of withdrawal will be
assigned a grade of WF. After the mid-point of the quarter, the Registrar’s Office will assign
an automatic WF to any student who withdraws from the course without a hardship
withdrawal. If a student receives permission to withdraw under hardship, the Instructor will
assign a W or WF grade depending upon the student’s work up to the point of time that the
student withdrew.
The following is the formal policy at Georgia State University:
Effective Fall 2001, Instructors must on a date after the mid-point of the course to be set by
the Provost (or his designee),
1. give a WF to all those students who are on their rolls but no longer taking the class
and
2. report the last day the student attended or turned in an assignment.
Students who are withdrawn may petition the department chair for reinstatement into their
classes.
Incompletes: A student will be given the grade I only if nonacademic circumstances beyond
the student’s control prevent the student from completing a small segment of the course—
e.g., the final examination. For a student to receive the grade of I, he/she must be doing
satisfactory work (an average grade of C or better) up to the point that he/she could not
continue. Arrangements must be made with Instructor to remove the incomplete grade
within one quarter.
VI. Attendance Policy
Attendance is expected and will be reflected in part in the final grade.
VII. Late Assignments and Make-up Examination Policy
Make-up assignments are not provided, except in hardship cases that should be discussed in
advance with the Instructor. Any assignment turned in late may have points deducted up to
one letter grade for each day the assignment is late or fraction thereof. There is no
scheduled make-up time for exams or paper presentations. If a student cannot take an
exam or present at the scheduled time, they must consult with the Instructor on scheduling
the make-up.
VIII. Syllabus Deviation Policy
The course syllabus provides a general plan for the course; deviations may be necessary.
IX. Student Code of Conduct and Policy on Academic Honesty
4
All students at this University are expected to engage in academic pursuits on their own
with complete honesty and integrity. Any student found guilty of dishonesty in any phase of
academic work will be subject to disciplinary action. The complete Academic Honesty policy
is located in the GSU Graduate Catalog, Section 1350: http://enrollment.gsu.edu/catalogs/.
Students and faculty are expected to review and conform to the university’s policy on
academic honesty. Information on the Student Code of Conduct and related policies and
procedures are available at: http://codeofconduct.gsu.edu/
Special attention should be paid to the sections on plagiarism and multiple submissions:
Plagiarism. Plagiarism is defined as, “appropriating and putting forth as one’s own the ideas,
language, or designs of another” (The Living Webster, 1975) – and it is strictly forbidden.
Written and oral presentations must be a student’s own work. Students plagiarizing or
cheating in any form will face disciplinary action which could result in an “F” in this course
and suspension or expulsion from the University. Copying from written materials,
presentations, websites, etc. without source acknowledgement and referencing is
plagiarism. Read it, appreciate it, learn from it, and make sure you source it – and then
reflect it with your own thoughts and words! If you are uncertain about what constitutes
plagiarism, please contact the instructor.
Multiple Submissions. It is a violation of academic honesty to submit substantial portions of
the same work for credit more than once without the explicit consent of the faculty
member(s) to whom the material is submitted for additional credit. In cases in which there
is a natural development of research or knowledge in a sequence of courses, use of prior
work may be desirable, even required; however, the student is responsible for indicating in
writing, as a part of such use, that the current work submitted for credit is cumulative in
nature.
XI. Disability Accommodations Policy
Students who wish to request accommodation for a disability may do so by registering with
the GSU Office of Disability Services. Students may only be accommodated upon issuance by
the Office of Disability Services of a signed Accommodation Plan and are responsible for
providing a copy of that plan to instructors of all classes in which an accommodation is
sought. The Office of Disability Services is located in the GSU Student Center, Suite 230.
XIII. Career Services
The School of Public Health provides career services & student leadership opportunities
(student clubs & organizations) to all current SPH students and alumni. SPH Career Services
can help students with resume writing, interviewing, job searching, internship development,
and professional networking. Students are invited to attend our career events and
workshops, and individualized career counseling appointments can be arranged. To see
what career panels, career fairs, and events are available this semester, please visit:
http://publichealth.gsu.edu/students/career-resources/. The SPH Career Services office is
co-located with the Office of Academic Assistance in room 640 at One Park Place.
5
XIV. Course Evaluations Statement
Your constructive assessment of this course plays an indispensable role in shaping education
at Georgia State. Upon completing this course, please take time to fill out the online course
evaluation
XV. Additional Policies and Statements
Communication
Students should check Desire2Learn at least every other day especially before driving or
riding to GSU for this class. The syllabus, any changes to the syllabus, lecture slides and
homework will be posted to Desire2Learn. Should you have any questions about the course
or its requirements, please ask your question during class or contact the Instructor via
Desire2Learn. Students also may make an appointment to meet with the Instructor on class
concerns. Should you wish to contact the Instructor about your grades, please address them
in writing or in person to the Instructor. Please do not use e-mail to communicate about
grade concerns.
Copyright Policy
“For the purpose of copyright, students must adhere to the following rules:
1) Materials in the course reserves may only be accessed by a passcode or password by
students enrolled in that course, and only for the semester of course enrollment
2) Students may not distribute copies of course reserves materials to other students
Grade Point Average Requirements
An overall grade point average (GPA) of 3.0 or better must be earned to receive the MPH
degree. All core courses must be completed with a grade of B or better, and no more than
six semester hours of grades less than B will be accepted for the degree. No grade below a C
will be accepted toward the degree. Please refer to the Institute’s academic standing policy
on Academic Warning and Suspension described in the Institute of Public Health section of
the Graduate Catalog:
http://www2.gsu.edu/~catalogs/2012-2013/graduate/
Course schedule, topics and readings:
The table provides a general plan for the course; deviations may be necessary.
Class
Date
Aug. 27
Class Topic
Class Readings
Course
Overview
Krieger N. 2001. A Glossary for social epidemiology. Journal of
Epidemiology and Community Health, 55, 693-700.
6
Sept. 3
Biological vs.
Social
Determinants of
Disease and
Health
Marmot, M. 2006. Health in an unequal world. The Lancet, 368,
2081-2094.
Inequality in
Disease and
Health in the US
and Globally
Videoclip: Meet The Experts: www.youtube.com “Trailer UNNATURAL CAUSES: Is Inequality Making Us Sick?”
Social Models of
Disease and
Health 1
Allostasis Model: McEwen, B.S. 1998. Stress, adaptation, and
disease. Allostasis and allostatic load. Annals of the New York
Academy of Sciences, 840, 33-44.
Navarro, V. 2009. What we mean by social determinants of
health. Global Health Promotion, 16, 5-16.
Health Belief Model: Rosenstock, I.M, et al. 1988. Social learning
theory and the health belief model. Health Education &
Behavior, 15,175-183.
Self-Regulatory Model: Leventhal, H. et al. 2003. The Commonsense model of self-regulation of health and illness. In L. D.
Cameron & H. Leventhal (Eds.), The self-regulation of health and
illness behavior, Pp. 42-65.
Sociocultural Model: Phelan, J., et al. 2014. Stigma, status, and
population health. Social Science and Medicine, 103, 15-23.
Sept.
10
Social Models of
Disease and
Health 2
Social Conditions Model: Link, B.G., & Phelan, J. 1995. Social
conditions as fundamental causes of disease. Journal of Health
and Social Behavior, Suppl., 80-94.
Chronic Care Model: Wagner, E.H. et al. 1996. Organizing care
for patients with chronic illness. Milbank Quarterly, 74, 511-544.
Access to Care Model: Aday, L.A. & Andersen, R.M. 1981. Equity
of access to medical care: a conceptual and empirical overview.
Medical Care, 19, 4-27.
Sept.
17
Methods 1:
Review of
Experimental
and QuasiExperimental
Designs,
Mediators and
Moderators**
Mohr LB. Impact Analysis for Program Evaluation. Thousand
Oaks, CA: Sage Publications, 1988.
Baron, R.M., & Kenny, D.A. 1986. The moderator-mediator
variable distinction in social psychological research: Conceptual,
strategic, and statistical considerations. Journal of Personality and
Social Psychology, 51, 1173-1182.
7
Preacher, K.J., & Hayes, A.F. 2004. SPSS and SAS procedures for
estimating indirect effects in simple mediation models. Behavior
Research Methods, Instruments, & Computers, 36, 717-731.
Brief Paper #1 due.
Sept.
24
Methods 2:
Hierarchical
Models,
Interrupted
Time Series
Models **
Singer, J.D. 1998. Using SAS PROC MIXED to fit multilevel models,
hierarchical models, and individual growth models. Journal of
Educational and Behavioral Statistics, 24, 323-355.
Wagner, A.K., et al. 2002. Segmented regression analysis of
interrupted time series studies in medication use research.
Journal of Clinical Pharmacy and Therapeutics, 27, 299-309.
SAS Lab (Methods) Presentation.
Oct. 1
Early Life
Avison, W.R. 2010. Incorporating children’s lives into a life course
perspective on stress and mental health. Journal of Health and
Social Behavior, 51, 361-365.
Poulton, R. 2002. Association between children’s experience of
socioeconomic disadvantage and adult health: a life-course
study. The Lancet, 360, 1640-1645.
Ch. 3, Marmot & Wilkinson, “Early Life”
Oct. 8
Education and
Literacy
Ross, C.E., & Wu, C-L. 1995. The Links between education and
health. American Sociological Review, 60, 719-745.
Berkman, N.D., et al. 2011. Low health literacy and health
outcomes. Annals of Internal Medicine, 155, 97-107.
Paasche-Orlow, M.K., et al. 2005. The Prevalence of limited health
literacy. Journal of General Internal Medicine, 20, 175-184.
St. Leger, L. 2001. Schools, health literacy and public health:
possibilities and challenges. Health Promotion International, 16,
197-205.
Oct. 15
Worklife:
Occupation and
Worksite
Sparks, K., et al. 2001. Well-being and occupational health in the
21st century workplace. Journal of Occupational and
Organizational Psychology, 74, 489-509.
Ch. 6, Marmot & Wilkinson, “Health and the Psychosocial
Environment at Work”
Brief Paper #2 due.
8
Oct. 22
Aging and the
Elderly
Diez Roux, A.V., et al. 2002. Socioeconomic disadvantage and
change in blood pressure associated with aging. Circulation, 206,
703-710.
Graham, J.E., et al. 2006. Stress, age, and immune function:
Toward a lifespan approach. Journal of Behavioral Medicine, 29,
389-400.
Karlamangla, A.S., et al. 2002. Allostatic load as a predictor of
functional decline. MacArthur studies of successful aging. Journal
of Clinical Epidemiology, 55, 696-710.
Kim, E.S., Hawes, A.M., & Smith, J. 2014. Perceived neighborhood
cohesion and myocardial infarction. Journal of Epidemiology and
Community Health, ePub First Online (as of 8/20/2014).
Pollitt, R.A., et al. 2005. Evaluating the evidence for models of
life course socioeconomic factors and cardiovascular outcomes.
BMC Public Health, 5, 7.
Rosenberg, D.E., et al. 2013. Outdoor built environment barriers
and facilitators to activity among midlife and older adults with
mobility disabilities. Gerontologist, 53, 268-279.
Seeman, T.A. et al. 2010. Socioeconomic differentials in
peripheral biology: cumulative allostatic load. Annals of the
New York Academy of Science, 1186, 223-239.
Shoou-Yi, D.L., et al. 2006. Health literacy and social support
among elderly Medicare enrollees in a managed care plan.
Journal of Applied Gerontology, 25, 324-337.
Oct. 29
Neighborhood
(“Built
Environment”)
Borell, L. et al. 2004. Neighborhood characteristics and mortality
in the Atherosclerosis Risk in Communities Study. International
Journal of Epidemiology, 33, 398-407.
Browning, C.R., et al. 2002. Neighborhood structural
disadvantage, collective efficacy, and self-rated health in an
urban setting. Journal of Health and Social Behavior, 43, 383399.
Chaskin, R.J. 1997. Perspectives on neighborhood and
community: a review of the literature. Social Service Review,
71(4), 521-547.
9
Cummins, S., et al. 2007. Understanding and representing ‘place’
in health research: a relational approach. Social Science &
Medicine, 65, 1825-1838.
Diez Roux, A.V. 2010. Neighborhoods and health. Annals of the
New York Academy of Sciences, 1186, 125-145.
Ding, D., & Gebel, K. 2012. Built environment, physical activity,
and obesity: What have we learned from the literature? Health
& Place, 18, 100-105.
McCormack, G.R., & Shiell, A. 2011. In search of causality: a
systematic review of the relationship between the built
environment and physical activity among adults. Journal of
Behavioral Nutrition and Physical Activity, 8:125.
Mujahid, S., et al. 2011. Neighborhood stressors and race/ethnic
differences in hypertension prevalence (The Multi-ethnic Study of
Atherosclerosis). American Journal of Hypertension, 24, 187-193.
Papas, M.A., et al. 2007. The Built environment and obesity.
Epidemiologic Review, 29, 129-143.
Pickett, K.E., & Pearl, M. 2001. Multilevel analyses of
neighborhood socioeconomic context and health outcomes: a
critical review. Journal of Epidemiology and Community Health,
55, 111-122.
Ch. 7 Cockerham, “Living Conditions and Neighborhood
Disadvantage”
Ch. 14 Marmot & Wilkerson, “Neighborhoods, Housing, and
Health”
Harvard Geocoding Project.
http://www.hsph.harvard.edu/thegeocodingproject/
Ch. 8 and Ch. 9, Oakes & Kaufman, “Measures of Residential
Community Contexts” and “Using Census Data to Approximate
Neighborhood Effects”.
Term Paper #1 due.
Nov. 5
Social Networks
and Social
Capital
Brownell, K.D., et al. 2010. Personal responsibility and obesity:
a constructive approach. Health Affairs, 29, 379-387.
10
Christakis, A., and Fowler, J.H. 2008. The collective dynamics of
smoking in a large social network. New England Journal of
Medicine, 358, 2249-2258.
Christakis, A., and Fowler, J.H. 2007. The spread of obesity in a
large social network over 32 years. New England Journal of
Medicine, 357, 370-379.
Shim, J. 2010. Cultural health capital: a theoretical approach to
understanding health care interactions. Journal of Health and
Social Behavior, 51, 1-15.
Uchino, B. 2006. Social support and health: a review of
physiological processes potentially underlying links to disease
outcomes. Journal of Behavioral Medicine, 29, 377-387.
Ch. 1, Christakis & Fowler, “In the Thick of It”.
Ch. 8, Kawachi & Berkman, “Social Cohesion, Social Capital, and
Health”
Ch. 8, Marmot & Wilkerson, “Social Support and Social
Cohesion”
Ch. 10, Kawachi, Subramanian & Kim, “Social Capital and Health
Related Behaviors”.
Nov. 12
Socioeconomic
Status,
Macroeconomic
Cycles
Adler, N., & Stewart J. 2010. Health disparities across the
lifespan: meaning, methods, and mechanisms. Annals of the New
York Academy of Sciences, 1186, 5-23.
LaVeist, T.A. 2000. On the study of race, racism, and health: a
shift from description to explanation. International Journal of
Health Services Research, 30, 217-219.
Phelan, J.C., Link B.G., & Tehranifar, P. 2010. Social conditions
as fundamental causes of health inequalities: theory, evidence,
and policy implications. Journal of Health and Social Behavior,
51, S28-S40.
Subramanian, S.V., et al. 2002. The Macroeconomic
determinants of health. Annual Review of Public Health, 23,
287-302.
Tapia Granados, J.A., et al. 2014. Individual joblessness,
contextual unemployment and mortality risk. American Journal
of Epidemiology, 180, 280-287.
11
Wilkinson, R.G. & Pickett, K. 2006. Income inequality and
population health: a review and explanation of the evidence.
Social Science and Medicine, 62, 1768-1784.
Williams, D.R., et al. 2003. Racial/ethnic discrimination and
health: Findings from community studies. American Journal of
Public Health, 93, 200-208.
Ch. 1, Marmot, “Some Are More Equal Than Others”
Ch. 3, Oakes & Kaufman, “Indicators of Socioeconomic Position”.
Ch. 2 and Ch. 4, Berkman & Kawachi, “Socioeconomic Position”
and “Income Inequality and Health”
Ch. 4 and Ch. 5, Cockerham, “The Power of Class” and “Class and
Health”
Brief Paper #3 due.
Nov. 19
Coverage and
Access
Andersen, R.M., et al. 1983. Exploring dimensions of access to
medical care. Health Services Research, 18, 49-74.
Andersen, R.M. 1995. Revisiting the behavioral model and
access to medical care: does it matter. Journal of Health and
Social Behavior, 36, 1-10.
Rowe, J.W., et al. 2008. The effect of consumer-directed health
plans on the use of preventive and chronic illness services. Health
Affairs, 27(1), 113-20.
Bloche, M.G. 2007. Consumer-directed health care and the
disadvantaged. Health Affairs, 26, 1315-1327.
IOM. 2002. Health Insurance is a Family Matter.
IOM. 2003. Uninsured in America.
Frontline “Sick Around America”. Videoclip.
http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/vi
ew/
Nov. 26
Dec. 3
NO CLASS
Health Policy for
Addressing
Social
CDC. Healthy People 2020. Social Determinants of Health.
http://www.healthypeople.gov/2020/topicsobjectives2020/overvi
ew.aspx?topicid=39
12
Determinants of
Health
IOM. 2012. How Far Have We Come in Reducing Health
Disparities? Progress Since 2000. Workshop Summary.
IOM. 2013. Health Literacy: Improving Health, Health Systems,
and Health Policy Around the World. Workshop Summary.
Kleinman, A. 2010. Four social theories for global health. The
Lancet, 375, 1518-1519.
Nutbeam, D. 2000. Health literacy as a public health goal: a
challenge for contemporary health education and communication
strategies into the 21st century. Health Promotion International,
15, 259-268.
Ross, C.L., et al. 2012. Health impact assessment of the Atlanta
BeltLine. American Journal of Preventive Medicine, 42, 203-213.
Schroeder, S.A. 2007. We can do better – Improving the health
of the American people. New England Journal of Medicine,
1221-1228.
WHO. Commission on Social Determinants of Health. 2008.
Closing the gap in a generation: Health equity through action on
the social determinants of health.
Brief Paper # 4 due.
Dec. 10
Term Paper #2 due.
Notes:
1. Required readings for productive class discussion are identified in bold font.
2. Classes marked with the double asterisk (**) will be computer laboratory based classes. The class
will consist of approximately 1 hour of instruction followed by 1.5 hours of practical experience in the
computer laboratory using SAS code and a dataset provided by the instructor for analysis,
interpretation, and discussion of output.
Recommended Textbooks:
Berkman, L.F., & Kawachi, I., Editors. (2000). Social Epidemiology. Oxford: Oxford University Press.
Christakis, N.A. & Fowler, J.H. (2009). Connected: How Your Friends’ Friends’ Friends Affect
Everything You Feel, Think, and Do. New York: Little, Brown and Company.
Cockerham, W.C. (2013). Social Causes of Health and Disease. 2nd Ed. Malden, MA: Polity Press.
Kawachi, I., Subramanian, S.V., and Kim, D., Editors. (2010). Social Capital and Health. New York:
Springer Science.
13
Marmot, M., & Wilkinson, R.G., Editors. (2006). Social Determinants of Health. 2nd Ed. Oxford:
Oxford University Press.
Oakes, J.M., & Kaufman, J.S., Editors. (2006). Methods in Social Epidemiology. San Francisco: JosseyBass.
Note: All books have been placed on reserve at the GSU library. While there is no “required”
textbook for this course, the Marmot and Wilkinson, eds. (2006) is highly recommended as it provides
an excellent overview of social determinants of health. This book is available in paperback from
Amazon.com
Assignment Descriptions
Assignment
SAS Lab Oral
Presentation
Topic
Lab based: Estimate 1 model using
mediator/moderator and 1 model
using hierarchical models with
instructor provided dataset. Return
SAS output with summary of
interpretation.
Due Date
Sept. 17
Points
6
The class will be split into 3-4 groups of equal size and balanced on levels of self-reported SAS skills
to give a balanced mix of basic to advanced skills within and across groups. Each SAS lab class will
consist of 1-1.5 hours of instruction in the method(s), dataset, and SAS program(s). Each group will
then apply the instruction and SAS program to the dataset(s) to generate output for summary of
results in several “Powerpoint slides”. At the conclusion of the second class, each group will present
to the class its summary of the output and conclusions of the associations of social determinants of
health with health outcomes.
Assignment
Brief Paper 1
Brief Paper 2
Brief Paper 3
Topic
Summarize the relative strengths or
weaknesses of evolutionary, social,
and behavioral theories in
accounting for exposure to social
determinants and health outcomes
over a person’s life course.
Use one or more of the conceptual
described in Classes 2 and 3 to
outline how health and health
related attitudes and behaviors
develop in childhood and
adolescence.
Describe how the physical (built
environment) and social (social
cohesion) characteristics of a
person’s residential or work (if
employed) circumstances might
moderate one another in influencing
Due Date
Sept. 17
Points
6
Oct. 15
6
Nov. 12
6
14
Brief Paper 4
health and health related attitudes
and behaviors.
Describe the changing roles of
financial and social capital in
affecting health attitudes, behaviors
and outcomes across the life course,
including across generations. Are
these factors independent or
interdependent?
Dec. 3
6
Brief papers should be 1-3 pages, double-spaced, 1” margins, Times New Roman font. The purpose
of these papers is to permit each student to summarize a synthesis of course materials and readings,
as well as related materials, which address the paper topic. References are encouraged, but are not
required (and if included will not count in the page count).
Each brief paper is due by 1 pm on the assigned date. The paper must be uploaded to the
designated dropbox on D2L.
Term Paper #1
Critique of Existing Literature on the Association of a Social Determinant on Health on Health
Attitudes and Behaviors, Disease Incidence, or Health Outcomes.
Each student will individually submit a paper that is to be 6-10 pages in length (excluding
bibliography), double-spaced, in 12 point Times New Roman font, with 1” margins (left, right, top
and bottom). The suggested word count is 2000-3000 words. The header should contain the
student’s name and the page number. APA Citation style should be used. Papers used or being used
in another class are NOT acceptable without prior review and permission by the instructor.
Regardless of the topic, your paper should include the following sections labeled with headings
specifically listed below (please note that page recommendations are guidelines that reflect the
approximate proportions of each section of the paper. The word count of 2000-3000 specifies the
length):
1. Introduction (1-2 pages)
a. Succinctly and clearly state the topic you are going to address.
b. Why it is important?
2. Literature Review (3-5 pages)
a. Discuss 4-6 primary original research articles from peer-reviewed literature that
evaluate the empirical association of the relationship between the social
determinant of health and: health attitudes and behaviors, disease incidence,
and/or health outcome(s).
b. Synthesize the literature in your own words. Do not merely summarize each article.
Attempt to find several themes within the articles that indicate the possible causal
pathways by which the social determinant influences the endpoints.
3. Strengths and Limitations of the Literature (1-2 pages)
a. Please describe the strengths and limitations of the primary articles cited
paraphrased in your own words. Do not just paraphrase the strengths and
limitations stated in each paper.
b. What is it we do not yet know or understand about the topic you have chosen?
c. What additional research is needed to more completely answer questions related to
your topic?
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4. Conclusions (1-2 page)
a. Briefly summarize your paper.
b. State overarching conclusion.
5. References
Term paper 1 is due by 1 pm on the assigned date. The paper must be uploaded to the designated
dropbox on D2L.
Term Paper #2: Evidence of the Effectiveness of an Intervention to Modify the Association of a
Social Determinant on Health on Health Attitudes and Behaviors, Disease Incidence, or Health
Outcomes.
This paper should be an evidenced based analysis of an intervention, not simply a description of the
public health or health care problem. Preferably, the intervention to be evaluated and described
will address the general topic proposed in Term Paper 1. If so, the Introduction to Term Paper 2
becomes a synthesis of Term Paper 1. Students should apply critical thinking based on strong
evidence from the literature, making sure to cite publications that support or contradict the
implementation of the intervention on a larger scale or in other settings that might:
1) buffer the adverse effects of a social determinant of health on: health attitudes and
behaviors, disease incidence, and/or health outcome(s)
2) enhance the beneficial effects of a social determinant of health on: health attitudes and
behaviors, disease incidence, and/or health outcome(s)
Each student will individually submit a paper that is to be 6-10 pages in length (excluding
bibliography), double-spaced, in 12 point Times New Roman font, with 1” margins (left, right, top
and bottom). The suggested word count is 2000-3000 words. The header should contain the
student’s name and the page number. APA Citation style should be used. Papers used or being used
in another class are NOT acceptable without prior review and permission by the instructor.
Regardless of the topic, your paper should include the following sections labeled with headings
specifically listed below (please note that page recommendations are guidelines that reflect the
approximate proportions of each section of the paper. The word count of 2000-3000 specifies the
length):
1. Introduction (1-2 pages)
a. Succinctly and clearly state the topic you are going to address.
b. Why it is important?
2. Literature Review (3-5 pages)
a. Discuss 4-6 primary original research articles from peer-reviewed literature that
evaluate the potential for the intervention to modify the relationship between the
social determinant(s) and: health attitudes and behaviors, disease incidence, and/or
health outcome(s).
b. Synthesize the literature in your own words. Do not merely summarize each article.
Attempt to find several themes within the articles that indicate the possible causal
pathways by which the social determinant influences the endpoints.
3. Strengths and Limitations of the Literature (1-2 pages)
a. Please describe the strengths and limitations of the primary articles cited
paraphrased in your own words. Do not just paraphrase the strengths and
limitations stated in each paper.
b. What is it we do not yet know or understand about the topic you have chosen?
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c. What additional research is needed to more completely answer questions related to
your topic?
4. Conclusions (1-2 page)
a. Briefly summarize your paper.
b. State overarching conclusion.
5. References
Term paper2 is due by 1 pm on the assigned date. The paper must be uploaded to the designated
dropbox on D2L.
Potential Topics to Support Development of Term Papers 1 and 2
These are ideas based on my own research or discussion points raised in other literature on
the social determinants of health.
How do you explain the fact that a large number of heart attacks occur at early ages in
people with cholesterol levels below the median level for the United States? That heart
attacks seldom occur at these ages in Japan? What is the implication for primary prevention
of heart disease in the United States?
Choose a population that interests you. Using one or more conceptual models of social
determinants of health, suggest ways for developing a conceptual framework, collecting
empirical data, and applying it to design, implementation, and evaluation of an intervention
to 1) improve the beneficial effects of the social determinant(s) or 2) mitigate the adverse
effects of the social determinant(s).
Identify a vulnerable population, and describe whey this population is vulnerable – paying
particular attention to social determinants of adverse health outcomes. What guidelines
can you offer for methods to improve the efficacy of a program to address the adverse
effects in this vulnerable or hard-to-reach population.
Find out the morbidity rates for coronary heart disease in a geographic area. Are there
significant differences between demographic or socioeconomic groups within this area
and/or compared with other areas? Suggest explanations for these differences. NOTE: CAN
APPLY TO CANCER, DIABETES, NEONATAL OUTCOMES.
Why is it hard for adults [children] to make lifestyle change. Collect 3-4 peer reviewed
research articles on interventions that have successfully changed lifestyle and improved a
specific health outcome. How did the intervention modify a particular causal pathway in the
SDH—Outcome relationship? Was the program or intervention more or less effective in
specific subgroups? Why? Why not?
Aside from cancer clusters, other aspects of disease incidence or morbidity/mortality tend
to cluster (e.g. obesity, suicide). What are some social determinants that contribute to
clustering? Does clustering differ by demographic or socioeconomic subgroups? Why?
What interventions or programs might be effective in mitigating social factors contributing
to clustering?
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There is conflicting evidence on whether economic downturns (such as the recent “Great
Recession”) degrade or improve population health attitudes and behaviors and perhaps
even short-term health outcomes. What is the evidence? Can public health interventions
be designed to buffer the potential adverse effects or enhance the potential beneficial
effects?
The effect of psychosocial stress on physiologic health and disease incidence may be
mediated by the effects of psychosocial stress on health behaviors (e.g. diet, exercise) which
are also known to affect physiologic health and disease incidence. What is the evidence as
to the strength of a direct or mediated association? What are the implications for the
efficacy of interventions to improve health behaviors?
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