HBHE 815/16 MODULE #3 Social Determinants of Health: Theoretical and Conceptual Foundations Shelley Golden,

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1 HBHE 815/16 MODULE #3 Social Determinants of Health: Theoretical and Conceptual Foundations Shelley Golden, Office hours by appointment in 364 Rosenau This module is designed to facilitate student understanding of the ways in which social structures might impact opportunities, lived experiences and choices related to health. Course readings and discussions will cover: 1) mechanisms of social stratification; 2) influence of stratification on distribution of resources, exposure to stressors, and expectations for beliefs and behavior; and 3) aspects of the social environment currently under exploration in public health and health behavior research and practice, including physical and social spaces, socioeconomic distributions, and experiences of discrimination. Participation and Preparation (35% of module grade) The primary function of class time is to discuss the readings, and their application to the HBHE field, in depth. In advance of class, the instructor will provide a set of comprehension and discussion questions related to the readings that students can use as guides during the preparation for discussion, but students should take an active role in the classroom discussion. Participation grades will be based on three criteria: 1) preparation, 2) quality of comments, and 3) respectful and productive engagement with other students. Discussion Leading (15% of module grade) Although the instructor will provide a brief introduction to the material at the start of the class, provide clarifications about course material, and ensure that key points are covered in the discussion, the primary discussion will be facilitated by students. Each week 2-3 students will create a class plan that guides discussion and interpretation of the readings. Each class should include a variety of discussion techniques (e.g. large group discussion, small group discussion, application activity, individual reflection). Students should plan a timetable for discussion that incorporates 5-10 minutes for instructor introduction of the material, a 15 minute break toward the middle of class time and 10 minutes for instructor wrap-up. Social Determinants Paper Introduction (35% of module grade for paper, 15% for peer feedback) One of the most difficult challenges in public health writing is to comprehensively, yet concisely, summarize previous literature in order to motivate a research question. Public health journals often dedicate only 2-5 paragraphs for introduction and background, in which an author makes a case for the relevance of his or her research. For this assignment, you will develop such an introduction for a social determinant research question of your choice. You are limited to 1,000 words (about 2-3 double spaced pages), not counting references. While structure for this sort of writing varies, I suggest the following: 1. Brief description of the health topic and behavior you are targeting (1-2 paragraphs) 2. Description of the key social determinant(w) you propose to research, including review of relevant, previous literature, and the theoretical underpinning of the relationships among variables (2-4 paragraphs) 3. Explanation of research question and why it is important to investigate. (1 paragraph) Two recent examples of papers with similarly styled introductions include: Cunningham SA & Zavodny M. (2011). Does the sale of sweetened beverages at school affect children s weight? Social Science & Medicine. 73(9): Shelton RC et al. (2011). The association between social factors and physical activity among lowincome adults living in public housing. American Journal of Public Health. 101(11):

2 In addition, because peer feedback (giving and receiving) is a necessary and useful skill in academia, you will exchange your paper with 1-2 other students for feedback. For each paper you receive, you should draft a one paragraph response with constructive criticism. During the final class, we will dedicate ~30 minutes for groups to meet and share feedback. Papers will be assessed based on 1) appropriate inclusion of key points; 2) quality of argument in support of the research question; and 3) writing clarity and style. Peer feedback will be assessed based on the quality and clarity of the constructive comments. Due dates: the research question you will be motivating to me by Wednesday, January 30. the completed paper to me and the members of your peer feedback group before 11:59 p.m. on Sunday, February 10. Bring 2 copies of each peer review paragraph with you to class on Wednesday, February 13, one for me and one for the author. Be sure to indicate both your name and the original author s name on each paragraph. January 9, 2012: Introduction to the Social Determinants of Health Objectives for the class: 1) Define social determinants of health; 2) Explore processes that result in social stratification and inequalities; 3) Consider general social consequences of inequality Braveman P, Egerter S & Williams DR. (2011). The social determinants of health: Coming of age. Annual Review of Public Health. 32: Link BG & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health and Social Behavior; Extra Issue: (Note, if you are interested in this article you might consider their follow-up article in 2010 in the same journal). Minkler M. (1999). Personal responsibility for health? A review of the arguments and evidence at century s end. Health Education & Behavior. 26(1): Frohlich KL, Corin E & Potvin L. (2001). A theoretical proposal for the relationship between context and disease. Sociology of Health and Illness. 23(6): Galea S, Tracy M, Hoggatt KJ, Dimaggio C & Karpati A. (2011). Estimated deaths attributed to social factors in the United States. American Journal of Public Health. 101(8): Commission on the Social Determinants of Health. (2008). Chapters 1-3. In Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization. Weber L. (2006). Reconstructing the landscape of health disparities research: Promoting dialogue and collaboration between feminist intersectional and biomedical paradigms. In Schulz AJ & Mullings L. Gender, Race, Class and Health: Intersectional Approaches. San Francisco: Jossey-Bass. Pp

3 January 16, 2012: Stratification and its Tools Objectives for the class: 1) Describe processes of social categorization; 2) Understand current trends in stratification; 3) Explore key terms: capital and power Massey DS. (2007). How stratification works (Chapter 1). In Categorically Unequal: The American Stratification System. New York: Russell Sage Foundation. Pp (Chapter 2 is also included this is optional). Neckerman KM & Torche F. (2007). Inequality: Causes and consequences. Annual Review of Sociology. 33: Overbeck J. (2010). Concepts and historical perspectives on power. In Guinote A & Vescio TK. (Eds.) The Social Psychology of Power. New York: The Guilford Press. Pp Bourdieu P. (1986). The forms of capital. In Biggart NW. (Ed.) (2002). Readings in Economic Sociology. Malden, MA: Blackwell Publishers Inc. Pp Sweet E. (2011). Symbolic capital, consumption and health inequality. American Journal of Public Health. 101(2): Massey DS. (2007). The Rise and Fall of Egalitarian Capitalism. (Chapter 2). In Categorically Unequal: The American Stratification System. New York: Russell Sage Foundation. Pp January 23, 2012: Socioeconomic status Objectives for the class: 1) Identify multiple dimensions of socioeconomic status; 2) Identify potential causal pathways explaining correlations between socioeconomic status and health Kreiger N, Williams DR & Moss NE. (1997). Measuring social class in US public health research: Concepts, methodologies, and guidelines. Annual Reviews of Public Health. 18: Pampel, FC Krueger, PM, Denney, JT Socioeconomic Disparities in Health Behaviors. Annual Review of Sociology, 36: Eibner C & Evans W. (2005). Relative deprivation, poor health habits and mortality. The Journal of Human Resources. 40(3): Cutler DM & Lleras-Muney A. (2010). Understanding differences in health behaviors by education. Journal of Health Economics. 29:1-28. Haas SA, Glymour MM & Berkman LF. (2011). Childhood health and labor market inequality over the life course. Journal of Health & Social Behavior. 52(3): Catalano R, Goldman-Mellor S, Saxton K, et al. (2011). The health effects of economic decline. Annual Review of Public Health, 32, Wilkinson RG & Pickett K (2007). The problems of relative deprivation: Why some societies do better than others. Social Science & Medicine. 65(9): Clougherty JE, Souza K & Cullen MR. (2010). Work and its role in shaping the social gradient in health. Annals of the New York Academy of Sciences, 1186:

4 January 30, 2012: Social constructions of identity Objectives for the class: 1) Identify health disparities based on race, gender, other aspects of identity and their intersections; 2) Explore processes of resource distribution, stigmatization and role assumption that may result in identity-based disparities in health and behavior. Link BG & Phelan JC. (2001). Conceptualizing stigma. Annual Review of Sociology. 27: Williams DR. (2012). Miles to go before we sleep: Racial inequalities in health. Journal of Health & Social Behavior. 53(3): Factor R, Kawachi I & Williams DR. (2011). Understanding high risk behavior among nondominant minorities: A social resistance framework. Social Science & Medicine. 73(9): Rieker PP, Bird CE & Lang ME. (2010). Understanding gender and health: Old patterns, new trends, and future directions. In: Chloe E. Bird, Peter Conrad, Allen M. Fremont, and Stefan Timmermans (eds). Handbook of Medical Sociology, 6th ed., pp Nashville: Vanderbilt University Press. Courtenay WH. (2000). Constructions of masculinity and their influence on men's well-being: a theory of gender and health. Social Science & Medicine. 50: Krieger N. (2012). Methods for the scientific study of discrimination and health: An ecosocial approach. American Journal of Public Health. 102(5): Parker R & Aggleton E. (2003). HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Social Science & Medicine. 57: Stuber J, Galea S & Link BG. (2008). Smoking and the emergence of a stigmatized status. Social Science & Medicine. 67: Kawachi I, Daniels N & Robinson DE. (2005). Health disparities by race and class: why both matter. Health Affairs. 24(2): Pascoe EA & Richman LS. (2009). Perceived discrimination and health: A meta-analytic review. Psychological Bulletin. 135(4): February 6, 2012: Place and social space Objectives for the class: 1) Identify key physical and social components of place with importance for health and health behavior; 2) Consider appropriate aggregation of space as meaningful place. Diez Roux A & Mair C. (2010). Neighborhoods and health. Annals of the New York Academy of Sciences, 1186: Bernard P. et al. (2007). Health inequalities and place: a theoretical conceptualization of neighborhood. Social Science & Medicine. 65: Kramer MR & Hogue CR. (2009). Is segregation bad for your health? Epidemiologic Reviews 31: Gordon-Larsen P, Nelson MC, Page P & Popkin BM. (2006). Inequality in the built environment underlies key disparities in physical activity and obesity. Pediatrics. 117(2): Yamanis TJ et al. (2010). Social venues that protect against and promote HIV risk for young men in Dar es Salaam, Tanzania. Social Science & Medicine. 71:

5 Hanibuchi T et al. (2012). Place-specific constructs of social capital and their possible associations to health: A Japanese case study. Social Science & Medicine. 75: Campbell T & Campbell A. (2007). Emerging disease burdens and the poor in cities of the developing world. Journal of Urban Health. 84(1): i54-i64. Browning CR. (2002). The span of collective efficacy: Extending social disorganization theory to partner violence. Journal of Marriage and Family. 64: Szreter S & Woolcock M. (2004). Health by association? Social capital, social theory and the political economy of public health. International Journal of Epidemiology. 33: Morland K, Wing S, Diez Roux A & Poole C. (2002). Neighborhood characteristics associated with the location of food stores and food service places. American Journal of Preventive Medicine. 22(1): February 13, 2012: Modifications to Social Structures to Enhance Health Objectives for the class: 1) Identify strategies for addressing social determinants of health; 2) Consider practical strength and limitations of such strategies; 3) Explore two case examples of structural interventions to address health. Wallerstein NB, Yen IH & Syme SL. (2011). Integration of Social Epidemiology and Community- Engaged Interventions to Improve Health Equity. American Journal of Public Health. 101(5): Koh H., et al. (2010). Translating research evidence into practice to reduce health disparities: A social determinants approach. American Journal of Public Health. 100(S1): S72-S80. Smith KE & Katikireddi SV (2012). A glossary of theories for understanding policymaking. Journal of Epidemiology and Community Health. Published online Oct. 25: pp Robert SA & Booske BC. (2011). US opinions on health determinants and social policy as health policy. American Journal of Public Health. 101(9): (summarized in Williams article) Choose one of: o Ludwig J et al. (2011). Neighborhoods, obesity, and diabetes A randomized social experiment. New England Journal of Medicine. 365: o Krishnan S et al. (2008). Poverty, Gender Inequities, and Women s Risk of Human Immunodeficiency Virus/AIDS. Annals of the New York Academic of Sciences. 1136: Blank RM. (2003). Selecting among anti-poverty policies: Can an economist be both critical and caring? Review of Social Economy. 59(4): Woolf SH. (2009). Social policy as health policy. JAMA. 301(11): Williams DR, Costa MV, Odunlami AO & Mohammed SA. (2008). Moving upstream: How interventions that address the social determinants of health can improve health and reduce disparities. Journal of Public Health Management and Practice. 14(Suppl): S8 17. Friel S & Marmot MG. (2011). Action on the social determinants of health and health inequities goes global. Annual Review of Public Health. 32:

6 Robert Wood Johnson Foundation. A new way to talk about the social determinants of health. Available at:

Course syllabus. SOC 4384 SOCIAL EPIDEMIOLOGY Fall 2013 Monday & Wednesday: 10:00am-11:15am ECSS 2.203

Course syllabus. SOC 4384 SOCIAL EPIDEMIOLOGY Fall 2013 Monday & Wednesday: 10:00am-11:15am ECSS 2.203 Course syllabus SOC 4384 SOCIAL EPIDEMIOLOGY Fall 2013 Monday & Wednesday: 10:00am-11:15am ECSS 2.203 Instructor: Katerina Anestaki Office hours: ONLY by appointment E-mail: axa122430@utdallas.edu Course