EPID 826, Days: Tuesday and Thursday Time: 3:30-4:45 pm Location: 1304 McGavran-Greenberg Building Credit Hours: 3 Prerequisites: An introductory epidemiology course (e.g., EPID 600) Instructors: James Thomas, MPH, PhD Epidemiology 2104-B McGavran-Greenberg Email: jim.thomas@unc.edu Tel: 966-7434 (administrative assistant: 966-7405) Semra Aytur Epidemiology Email: aytur@email.unc.edu Tel: (919) 960-9893 Course Objectives: The course aims to: Provide an overview of the social determinants of health. Describe and evaluate measures used in social epidemiology studies. Introduce students to key theorists, schools of thought, and debates in social epidemiology. Examine the relationship between ethics and the social forces contributing to the distribution of diseases. Describe interventions targeting social forces affecting disease occurrence.
Required Readings: Oakes JM, Kaufman JS (Eds.) Methods in Social Epidemiology. San Francisco: John Wiley & Sons, Inc., 2006. Klinenberg B. Heat Wave: A Social Autopsy of Disaster in Chicago. Chicago: University of Chicago Press, 2003. Readings available through UNC Blackboard. Assignments: 1. Assigned readings are to be read prior to their respective session. The class discussions will refer to the assigned readings, thus the student s participation in discussions will depend on reading the material. 2. Three essays will be required during the course in which students apply the lecture content to the content of the Klinenberg book, Heat Wave. 3. A paper, no more than 12 pages double-spaced, is due on the last day of the course. In this paper you will discuss the concepts, theories, and epidemiologic measures needed to assess a health outcome of your choice within a social context. In addition, you will describe any interventions that have been implemented to address this issue and suggest possible next steps. If no intervention has been implemented, you will speculate on actions that could be taken. Evaluation: 1. Participation in class discussions (15%) 2. Three essays (15% each = 45% total) 3. Final paper (40%)
Jan 10: Course introduction (Thomas, Aytur) Oakes & Kaufman, Chapter 1 - Introduction: Advancing methods in social epidemiology. Oakes & Kaufman, Chapter 2 The history of methods of social epidemiology Jan 15: Debates over social epidemiology (Setel) Debate in Lancet, 1998 Rothman KJ, Adami HO, Trichopoulos D. Should the mission of epidemiology include the eradication of poverty? Lancet.1998;352:810-3. Loff B, Black J. Human rights and epidemiology. Lancet 1998;352:1153. McMichael AJ. The role of epidemiologists in eradicability of poverty. Lancet 1998;352:1627. Kaplan GA. The role of epidemiologists in eradicability of poverty. Lancet 1998;352:1627-8. Debate in International Journal of Epidemiology, 2001 Zielhuis G, Kiemeney L. Social epidemiology? No way. Int J Epidemiol 2001;30:43-4. Krieger N. Commentary: Society, biology and the logic of social epidemiology Int J Epidemiol 2001;30:44-6. Macdonald K. Commentary: Social epidemiology. A way? Int J Epidemiol 2001;30:46-7. McPherson K. Commentary: Epidemiology? Keep it broad and deep. Int J Epidemiol 2001;30:48. Kaufman JS. Commentary: Social epidemiology? Way! Int J Epidemiol 2001;30:48-9. Siegrist J. Commentary: Social epidemiology-- a promising field Int J Epidemiol 2001;30:50. Jan 17: Proximal and distal (Thomas) Diamond J. Guns, Germs, and Steel: The Fates of Human Societies. New York: W.W. Norton, 1997. Chapter 4, Farmer Power. Jan 22: Social ethics and social epidemiology (Thomas) Fabienne P, Evans T. Ethical dimensions of health equity. In: Evans T, Whitehead M, Diderichsen F, Bhuiya A, Wirth M. Challenging Inequities in Health: From Ethics to Action. New York: Oxford University Press, 2001. 1
Jan 24: Causality (Aytur) Oakes & Kaufman, Chapter 16 Using causal diagrams to understand common problems in social epidemiology Daniel M, Moore S, Kestens Y. Framing the biosocial pathways underlying associations between place and cardiometabolic disease. Health & Place 2008;14:117-32. Jan 29: Social policy (Aytur) Tauras JA, Chaloupka FJ, Farrelly MC, et al. State Tobacco Control Spending and Youth Smoking. Am J Public Health 2005;95:338-44. Aytur S, Rodriguez D, Evenson K, Catellier D, Rosamond W. The sociodemographics of land use planning: Relationships to physical activity, accessibility, and equity. Health & Place (in press) Kaufman, J. Making Causal Inferences about Macrosocial Factors as a Basis for Public Health Policies (Ch. 17). In: Glalea S., ed. Macrosocial Determinants of Population Health. Springer, NY 2007 (pp. 355-73) Jan 31: The built environment (Aytur) Sampson R, Raudenbush S. Seeing disorder: neighborhood stigma and the social construction of "broken windows". Social Psychology Quarterly 2004; 67(4): 319-42 Cohen D, Inagami S, Finch B. The built environment and collective efficacy. Health & Place 2008 (14): 198-208 Gordon-Larsen P, Nelson, M, Page P, Popkin B. Inequality in the built environment underlies key health disparities. Physical Activity and Obesity Pediatrics 2006 117: 417-24. Feb 5: Network analysis (Thomas) Oakes & Kaufman, Chapter 11 Network methods in social epidemiology Feb 7: Geographical analysis (Emch) Feb 12: Mapping (Emch) Readings to be determined by Dr. Emch. Feb 14: Place Method (Weir) Weir SS, Pailman C, Mahlalela X, et al. From people to places: Focusing AIDS prevention efforts where it matters most. AIDS 2003;17;895-903. 2
Feb 19: Income and SES (Rose) Oakes & Kaufman, Chapter 3 Indicators of socioeconomic position Oakes & Kaufman, Chapter 5 Measuring poverty Social Epidemiology: Concepts and Measures Feb 21: Income inequality (Nielson) Readings to be determined by Dr. Nielson. Feb 26: Neighborhood effects: theory (Aytur) Macintyre S. Deprivation amplification revisited; or, is it always true that poorer places have poorer access to resources for healthy diets and physical activity? International Journal of Behavioral Nutrition and Physical Activity 2007; 4:32. Diez Roux A. Investigating Neighborhood and Area Effects on Health. Am J Public Health 2001; 91:1783 1789. Recommended: Oakes M. The (mis)estimation of neighborhood effects: causal inference for a practicable social epidemiology. Social Science & Medicine 2004;58:1929 52. Feb 28: Neighborhood effects: measurement (Aytur) Oakes & Kaufman, Chapter 8 Measures of residential community contexts Messer L. Invited Commentary: Beyond the metrics for measuring neighborhood effects. Am J Epidemiol 2007:165:868-71. Mujahid M, Diez Roux A, Morenoff JD et al. Assessing the measurement properties of neighborhood scales: from psychometrics to ecometrics. Am J Epidemiol 2007:165:858-67. Mar 4: Disparities research (Thomas) Oakes & Kaufman, Chapter 6 Measuring health inequalities Mar 6: Health care access (Ricketts) Readings to be determined by Dr. Ricketts. Mar 11/13 Spring break 3
Mar 18: Cross-national comparative research (Siddiqi) Siddiqi A, Hertzman C. Towards an epidemiologic understanding of the effects of long-term institutional changes on population health: A case study of Canada versus the USA. Soc Sci Med 2007;64:589-603. Siddiqi A, Subramanian SV, Berkman L, et al. The welfare state as a context for children s development: a study of the effects of unemployment and unemployment protection on reading literacy scores. Int J Soc Welfare 2007;16:314-25. Mar 20: Interventions (Thomas) Rose G. Sick individuals and sick populations. PAHO Epidemiological Bulletin 1985;6:1-8. (Originally published in Int J Epidemiol 1985;14:32-8.) O Dwyer LA, Baum F, Kavanagh A, MacDougall C. Do area-based interventions to reduce health inequalities work? A systematic review of evidence. Critical Public Health 2007;17:317-35. Mar 25: Race and racism (Jones?) Oakes & Kaufman, Chapter 4 Measuring and analyzing race, racism, and racial discrimination. Mar 27: Sex and gender (Pettifor) Ann Blanc. The Effect of power in sexual relationships on sexual and reproductive health: an examination of the evidence. Studies in Family Planning. 2001, 32(3): 189-213 Harvey M, Bird S. What makes women feel powerful? An exploratory study of relationship power and sexual decision-making with African American at risk for HIV/STDs. Women & Health. 2004;39:189-213. Apr 1: Introduction to modeling (Messer) Oakes & Kaufman, Chapter 13 Multilevel studies. Apr 3: Qualitative methods (Setel) Denzin NK, Lincoln YS. Introduction: Entering the Field of Qualitative Research. In: Denzin NK, Lincoln YS (Eds.), The Landscape of Qualitative Research: Theories and Issues. Thousand Oaks, California: Sage Publications, 1998. 4
Apr 8: Mixed methods (Setel) Tashakkori A, Teddlie C. Mixed Methodology: Combining Qualitative and Quantitative Approaches. Thousand Oaks, California: Sage Publications, 1998. Chapter 1: Introduction to mixed method and mixed model studies in the social and behavioral sciences. Tashakkori A, Teddlie C. Mixed Methodology: Combining Qualitative and Quantitative Approaches. Thousand Oaks, California: Sage Publications, 1998. Chapter 7. Examples of mixed model designs. Apr 10: Migration and incarceration (Thomas) Kark SL. The Social pathology of syphilis in Africans. South African Medical Journal 1949;23:77-84. Thomas JC, Torrone E. Incarceration as forced migration: Selected community health effects. Am J Public Health 2006;96:1762-5 Apr 15: Data sources (Thomas) Oakes & Kaufman, Chapter 9 Using census data to approximate neighborhood effects. Apr 17: Verbal autopsy (Setel) Setel PW, Macfarlane SB, Szreter S, et al. A scandal of invisibility: Making everyone count by counting everyone. Lancet 2007;370:1569-77. Apr 22: Life course studies (Rose) Ben-Shlomo Y, Kuh D. A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol. 2002;31:285-93. Pollitt RA, Rose KM, Kaufman JS. Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes: a systematic review. BMC Public Health. 20050;5:7. Apr 24: Open lecture (topic to be requested by the students) 5