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GHS 201B
This course explores the interconnection between the cultural, social and
economic determinants of health in societies both in high-income countries
(immigrant and cross-cultural health) and in low- and middle-income countries.
It reviews the history of health systems development (organization, financing)
and maps out a broad set of questions about the achievements and failures
of health development efforts in relation to social and economic factors.
A focus will be on measurement of disease burden, the impact of globalization
on public health, the translation of qualitative research to policy,
and the uses of cost-effectiveness analysis and other economic methods.
The course will emphasize the social determinants of health and the themes
of disease prevention and treatment throughout.
Teaching format: Lectures, seminars, independent study, assigned papers
3 Units Credit over one quarter
- 1.5 hours of lecture per week
- 1.5 hours of seminar plus three hours of independent study per week
At the end of the course students will be able to:
- Describe how culture and health intersect, citing examples of both positive and negative interactions
- Describe the concept of health systems and give examples of variants in different regions of the globe
- Debate the impact of societal and economic status on health, and of health on economic status
- Demonstrate a basic understanding of how to use qualitative and economic research methods for analysis and evaluation of public health programs
- Recognize macro level institutional and structural factors that impact health and health care implementation in relation to local cultural and regional contexts
- Describe how qualitative research becomes translated into policy and cite examples of success and failure
- Contrast examples of different cultural influences on health-seeking behavior giving specific examples
- Describe the social and cultural determinants of health from an anthropological perspective, including ethnic identity, family and kinship, gender, religion and belief systems, and shamanism/traditional healers
- Explain how cultural and social determinants are both obstacles and resources for health development, citing examples
- Learn the metrics used by economists to assess the burden of disease, and measurement of cost effectiveness, and cost benefit of health interventions
- Describe the economic and historical determinants that influence variations in global health by contrasting two geographic regions
- Describe Health Diplomacy: political tool to stabilize conflict and pursue equity
- Recognize stigmatization, politicization of health, and the resentment of foreign aid work, research versus intervention versus policy making
- Introduction to course materials, expectations, methodological techniques to be introduced, requirements, etc. What do we mean by “culture” and how has it been seen/used in International Public Health historically and today? When do language, history, politics, economics, social structure, beliefs, religion, and identity become determinants of health? When are “cultural factors” an obstacle to health? When are they resources? Why is cultural history important? (Dr. Burke)
- Economic determinants of health. Definition and measurement of health status, geographic and temporal patterns in longevity, health, and disease. Definition and measurement of national and family income, spending on health care, association of income / health spending and health, impact of changes in income on health (Dr. Kahn)
- The changing political and ethical concepts of global
public health—what is entailed, who are the new players, what considerations are there? Exploring the larger socio-economic and political context of globalization and global health. Rise and proliferation of NGOs. Role of Pharmaceutical industries in global health. The rise of bio-security as a model for health intervention. The role of Faith-Based aid in global health. An introduction to Global Health Diplomacy and Ethics. An exploration of the differences between humanitarian aid, health aid, health research, and global public health. Where and how do “ethics” become involved? From clinical trials to human rights agendas in international health. What are the contours of “the ethical” in global biosciences and how do these impact public health efforts? Where do ethical concerns impinge on epidemic control, on adherence regimes, on access to pharmaceuticals? (Dr. Adams)
- From ethnography to policy. An exploration of the translational challenges and strategies involved in moving from qualitative research methods to policy-making. (Dr. Justice)
- Guest Lecture. Socio-cultural determinants of health. (TBA)
- Economic effects of health and health care. Definition and measurement of health care utilization and expenditures, and economic productivity. Review of studies on effects of health and health care on economic productivity, income, and wealth. (Dr. Kahn)
- Overview of economic methods. Summary and examples of key health economic fields of inquiry: costing, econometrics, QALYs and utility assessment, DALYs and disability assessment, cost-effectiveness analysis, cost-benefit analysis. (Dr. Kahn)
- Health care delivery systems. Definition of systems to organize and finance health care: categories of health care financing (government payer, insurers, out-of-pocket); service structure and expenditure, by type of care (outpatient, inpatient, medications), system (traditional, modern), payer (e.g., government, individual), facility, ownership (public vs. private), sources of funds. Contribution of new multi-national efforts e.g. Global Fund. (Dr. Kahn)
- Economic determinants of health in Costa Rica (Dr. Will Dow)
- Final student presentations
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