Hserv 534 Global Population Health and Development

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Hserv 534Global Population Health and
Development

• Stephen Bezruchka
• TA Ira Stollak
• 3 credits

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Course ObjectivesStudents will

• describe the basic assumptions and approach
  towards studying the determinants of health of
  populations
• discuss how different populations have achieved
  different levels of health
• carry out various exercises that have an activist
  element to them

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Agenda today

• Enrolment limited to 24 (room size),
• can take as independent study (see instructor)
• Sign-up sheet
• Sign up for facilitating discussion of papers
• Review syllabus
• Entry Survey
• Producing health

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How?

• Reading before lecture 1/2-1 hour
• READING PACKET TO BE PURCHASED
• Rams Copy Center 4144 Univ Way NE
• DVD's CD's on reserve at the Health Sciences
  Library, T 344
• Lectures (slides from last year are on web may be
  updated after lectures)
• http//courses.washington.edu/hserv534/
• DISCUSSION
• Class begins with 20 minutes of time for
  discussion of assigned reading, with student
  facilitator

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Textbooks

• Wilkinson, R. G. (2005). The Impact of
  Inequality how to make sick societies healthier.
  New York, New Press.
• Wilkinson RG. Unhealthy Societies The
  Afflictions of Inequality. London Routledge,
  1996.
• SOUTH CAMPUS BOOKSTORE look also at Hserv 482
  there

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Other Important Books, Readings Web Sites

• See web-syllabus there is much expanded from the
  handout and has many sources

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Whether you?

• Student facilitator (15)
• Commentary on Great Leveller (10)
• Class participation (10) Initial attendance
  sheet
• Student awareness vital signs monitor (10)
• DISSEMINATION EXERCISE (30)
• Essay (25) on constrained topic (see syllabus)

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Student Facilitator Reading Discussion

• Sign-up sheet for students
• EVERYONE reads the articles, book chapters
  assigned for discussion at the beginning of each
  session, based on material from the previous one
• FACILITATOR organizes the class discussion
  around that point for beginning 20 minutes
• two students will sign up for some days and
  balance participation with more than one paper.
• Facilitator guidelines in course reading packet

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READINGS

• Consider reading them before the class for which
  they are related to, and reviewing them just
  before the next class when they will be discussed

Session 4 (Apr 4) Happiness Readings
discussed before pertain to History prehistory
Session 5 (Apr 6) Childhood Readings
discussion before lecture pertain to Happiness
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Facilitator Sign-Up Sheet

• -email Ira with 1st, 2nd, and 3rd choice of days
  by 8 pm Wednesday (March 29, TOMORROW)
• (Readings for Session to be done at the
  beginning of the following class) e.g.
• 1ST CHOICE () to facilitate Tues April 11
• 2nd Choice () to facilitate Thur May 19
• 3rd choice () to facilitate _______
• Ira will build a schedule from that

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Facilitator Evaluation

• Content and Planning
• -Formulated engaging questions for discussion
• -Goals of discussion outlined
• - Reflects understanding of readings
• - Keeps discussion focused on readings previous
  lecture
• - Focused on a few main issues
• Facilitation Skills
• -Guides discussion (doesnt lead)
• - Encourages a safe environment
• - Manages participation (engages quieter members,
  ensures ability for all to participate, limits
  monopolizing of discussion by students)
• (- Effectively coordinates with other
  facilitator)
• - Manages time effectively

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DISSEMINATION EXERCISE
30
Debriefings June 1
Outline April 27
CHOOSE ONE OF

• Pre-nuptial agreement
• Primary school curriculum
• Draft
• union pamphlet/flyer
• Legislation
• Produce one of
• PSA (for teenagers)
• Website
• Graphic (art communic.)
• Adbusters' counter ad
• Poster for Ave homeless
• Patient fact sheet
• Do Survey

• Develop use talking points script with
  shopkeepers (7-11, or Nordstroms)
• Give a lecture to group near UW (church,
  homeless, rounds, )
• Play Money Game
• Give lecture
• Work with community Group
• Take lead for HS Open House table for PHF April
  28, 29
• Meeting today 4 pm H 670

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CRITICAL ESSAY (25)
June 2
OR
AGAINST IDEAS
FURTHER ANALYSIS

• 24 topics in syllabus

• Why ideas not in other courses
• Gov't sponsored research as foil
• How to redistribute?
• Compare US and 2 other country's health outcomes
• 2 countries in World Health Chart
• Population-health related articles in major media

SEE ME OR TA IF WANT TO WRITE ON SOMETHING ELSE
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JOIN Population Health Forum LISTpart of class
participation

• MISSION an organization of health activists
  originally launched at the University of
  Washington, raises awareness of, promotes
  dialogue about, and explores how political,
  economic and social inequalities interact to
  reduce the overall health status of our society.
  We host forums, sponsor discussions, develop
  curriculum, teach courses, sponsor workshops,
  and provide speakers to promote knowledge and to
  advocate for action in service of a healthier
  society.
• Monthly or more frequent meetings
• SUBSCRIBE email to
• pophealth-join_at_mailman.u.washington.edu
• PHF website http//depts.washington.edu/eqhlth/
• GET ON LIST AND MAKE ONE POSTING IN THE FIRST TWO
  WEEKS OF THE COURSE, AND ONE BEFORE LAST CLASS
• FIRST MEETING THIS QUARTER AT 4 PM TODAY IN H 670

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What is health?
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What would you do to produce a healthy individual?

• What do you do yourself to be healthy?
• If you have children, what do you do for them to
  be healthy?

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What would you do to produce a healthy individual?

• What do you do yourself to be healthy?
• If you have children, what do you do for them to
  be healthy?
• HOW WOULD YOU KNOW IF YOU ARE SUCCESSFUL?

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What would you do to produce a healthy family?

• Next generation of families in the USA to be
  healthy?

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What would you do to produce a healthy family?

• Next generation of families in the USA to be
  healthy?
• HOW WOULD YOU KNOW IF YOU ARE SUCCESSFUL?

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What would you do to produce a healthy USA??

• HOW WOULD YOU KNOW IF YOU ARE SUCCESSFUL?

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How healthy is the US (2003) ?Health
Olympics(ranking of countries by Life Expectancy)

• Number one Gold
• 1-5 _______
• 6-10 _______
• 11-15 _______

• 16-20 _______
• 21-25 _______
• 26-30 _______
• 31 _______

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How healthy was the US 50 years ago?Health
Olympics

• 1-5 _______
• 6-10 _______
• 11-15 _______

• 16-20 _______
• 21-25 _______
• 26-30 _______
• 31 _______

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HEALTH OLYMPICS 2003 UN Human Development Report
2005
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EPISTEMOLOGY Three types of Questions

• questions of fact
• questions of interpretation
• What do people say about the facts
• questions or presuppositions
• What is unexpressed?
• What is the framework of discussion or
  assumptions?
• what are the premises that bound the thinking
  that you are supposed to not reflect upon or not
  be subject to discussion?
• what are the set of questions you are allowed to
  ask and the ways you are allowed to look at them?

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EPISTEMOLOGY Scientific Revolutions
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EPISTEMOLOGY Scientific Revolutions

• Ptolemaic universe to Copernicus
• Aristotelian dynamics to Newtonian mechanics to
  Special and General Relativity
• Greek atoms to Bohr model
• Hans Bethe and energy source of stars
• Creationism to evolution
• Human body, genetics, biomedical revolution?

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Scientific Revolution

• Popular beliefs do not explain the facts about
  health
• Normal science often suppresses ideas that could
  undermine its foundations and "research" tries to
  force nature into normal science boxes (of past)
  and have adherents invested in this
• Kuhn shift with professional commitments has not
  yet occurred with health of populations (Sci Rev)
  because need to revaluate the prior "facts"
• "Pre-paradigmatic pop-health schools" (Europe,
  UK, Canada, Australia, US (Harvard, Michigan,
  Seattle)

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COURSE Non-disciplinary synthesis

• Key idea quality of social relations and
  overall health is better in more equal societies
• -psychological literature concentrates on
  individual, ignoring susceptibility to powerful
  sociological processes
• -sociological literature addressing social class
  stratification ignores interaction with
  individual psychology
• -global biology provides mechanisms through which
  caring and sharing acts to produce health in
  populations
• to produce health, we have to change the
  structure of society that determines who gets
  what
• -these ideas take considerable time to mature

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Expectations of students from this course

• produce a shift in thinking from traditional
  public health interventions towards producing
  health at the population level (become a global
  surgeon)
• develop an ability to think critically about the
  material presented
• plant the glimmers of thinking that student can
  use to work on "health" issues broadly construed
• serious consideration of epistemology, ie
  critical of how we come to think things are true
• getting items in one's political toolbox

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BEFORE NEXT SESSION

• Purchase course packet at Ram's Copy Center 4144
  Univ Way NE
• Read
• Concepts, measures (health, economic, income
  distr) In SYLLABUS
• Blaxter paper in course packet
• Book Reading
• Impact of Inequality Chapter 1
• Unhealthy Societies Chapters 1, 2
• Complete VITAL SIGNS MONITOR (if not already
  done)
• EMAIL IRA with facilitation choices by 8 pm
  tomorrow