SEMESTER AT SEA COURSE SYLLABUS Voyage: Summer 2013 Discipline: Public Health Course Title: SEMS 2500 101: Introduction to Global Public Health Proposed as: Lower Division Faculty Name: Paige P. Hornsby, Ph.D. Pre-requisites: None COURSE DESCRIPTION Public health is multidisciplinary, universally relevant, and constantly evolving. This survey course reviews the core disciplines that comprise public health: epidemiology, social & behavioral sciences, health policy & management, environmental health science, and biostatistics. Students will explore the links between health and development, culture, the environment, poverty, education, and demographic characteristics. Students will learn about current global health challenges, especially those faced by the countries visited on the voyage, through a combination of lectures, small group activities, case studies, and journal article discussions. COURSE OBJECTIVES 1. Define and understand the differences between health, public health and global health; 2. Describe how the methods of epidemiology are used to conduct research and safeguard the population s health; 3. Describe risk factors and modes of transmission for infectious and chronic diseases and their role in personal and population health; 4. List the leading causes of morbidity and mortality of populations in the different countries visited on the voyage; 5. Discuss the roles of development, culture, the environment, poverty, education, gender, race, ethnicity and other demographics in affecting population health and appreciate the multiple determinants of health; 6. Appreciate the importance of respectful community engagement in promoting population health; and 7. Recognize the impact of public health policies and legislation on both individuals and populations. REQUIRED TEXTBOOKS AUTHOR: Skolnik, Richard TITLE: Global Health 101 PUBLISHER: Jones & Bartlett Learning ISBN #: 978-0-7637-9751-5 DATE/EDITION: 2 nd edition, 2012 AUTHOR: Levine, Ruth TITLE: Cases Studies in Global Health Cases #8 and #10 ONLY PUBLISHER: Jones & Bartlett Learning ISBN #: TBD Information forthcoming from Jones & Bartlett DATE/EDITION: 2007 1
TOPICAL OUTLINE OF COURSE C1 - June 19 Topic: Principles & Goals of Public Health (lecture & discussion) Define the terms health, public health, and global health Discuss examples of public health efforts Discuss examples of global health activities Describe some of the guiding principles of public health work Describe the Millennium Development Goals and their relation to global health Discuss the global effort to eradicate smallpox Reading: Skolnik, ch. 1 C2 - June 20 Topic: Health Determinants, Measurement & Trends (lecture & discussion) Describe the determinants of health Define the most important health indicators Discuss the differences between various public health measures and terms Describe the leading causes of death in low-, middle-, and high-income countries Describe the demographic and epidemiologic transitions Reading: Skolnik, ch. 2 C3 - June 21 Topic: History of Public Health: John Snow & Cholera (film & small group case study) Describe the origins of public health and public health research Discuss the development of public health research methodology Describe the process of disease outbreak investigation Describe the chain of infection for cholera Reading: John Snow case study Assignments due: 1-2 page description/justification of public health topic for photo-journal C4 - June 22 Topic: Health, Education, Poverty & the Economy (lecture & discussion) Describe the links between health and education Discuss the connections among health, productivity, and earnings Describe key relationships among health, the costs of illness, and the impact of health expenditure on poverty Discuss critical connections between health and equity Discuss the two-way relationship between health and development Reading: Skolnik, ch. 3 Assignments due: Reading quiz 2
June 23 - June 26: Casablanca June 26 Field Lab The Roles of Governmental and Non-Governmental Organizations in Global Health The National Institute of Hygiene and UNICEF Rabat, Morocco C5 - June 27 Topic: Trachoma in Morocco (small group case study) Reading: Trachoma in Morocco case study C6 - June 28 Topic: Ethical & Human Rights Concerns in Global Health (lecture & discussion) Review key ethical and human rights concerns as they relate to global health Discuss some of the central treaties and conventions related to human rights Understand the most important ethical guidelines for research with human subjects Discuss some historically significant cases in human rights research Identify key ethical principles for making decisions about allocating resources for health Reading: Skolnik, ch. 4 Assignments due: Photo-journal installment C7 - June 29: Topic: Culture & Health (lecture & discussion) Define culture Describe the most important relationships between culture and health Outline some of the theories of how behavior change occurs in health Describe some key measures to promote behavior change for better health Discuss the importance of social assessments Reading: Skolnik, ch. 6 Assignments due: Field Lab paper June 30: No class C8 - July 1 Topic: Culture & Health, cont d (small group article discussion) Reading: 1. Mokhtar et al. Diet, culture and obesity in Northern Africa. J of Nutr 2001. 2. Fakhfakh et al. Tobacco use in Tunisia: behavior and awareness. Bulletin of the WHO 2002. 3. Maziak et al. Tobacco smoking using a waterpipe: a reemerging strain in a global epidemic. Tobacco Control 2004. 3
C9 - July 2 Topic: Child Health (lecture & discussion) Understand the most important causes of child illness and death around the world Discuss the importance of neonatal death in overall child deaths Understand why some children survive and others die Describe the most cost-effective child health interventions Describe some examples of successful child health initiatives Discuss some of the challenges of further enhancing the health of children Reading: Skolnik, ch. 10 July 3-5: Antalya C10 - July 6 Topic: Diarrhea in Egypt (small group case study) Reading: Diarrhea in Egypt case study Assignments due: Reading quiz C11 - July 7 Topic: The Environment & Health (lecture & discussion) Discuss the most important environmental threats to health Review the burden of disease from pollution and poor sanitation Examine the contribution of personal hygiene to reducing the burden of environmentally related health problems Describe some of the most cost-effective ways of reducing the global burden of environmental health problems Reading: Skolnik, ch. 7 Assignments due: Photo-journal installment July 8-11: Istanbul C12 - July 12 Topic: Health Issues among University Students in Turkey (small group article discussion) Reading: 1. Oksuz et al. Socioeconomic factors and health risk behaviors among university students in Turkey: Questionnaire study. Croat Med J 2005. 2. Ozcebe et al. Risky behaviors of university students: a cross-sectional study. Turkish J PH 2012. C13 - July 13 Topic: Midterm Exam Assignments due: Photo-journal installment 4
July 14-17: Piraeus C14 - July 18 Topic: Nutrition & Global Health (lecture & discussion) Define key terms related to nutrition Describe the determinants of nutritional status Discuss nutrition needs at different stages of the life cycle Discuss the burden of under-nutrition problems globally Review the costs and consequences of the burden of under-nutrition problems Discuss measures that can be taken and important successes in addressing under-nutrition Reading: Skolnik, ch. 8 C15 - July 19 Topic: Women s Health (lecture & discussion) Describe the importance of women s health to individuals, families, and communities Describe the determinants of women s health and how they vary in different settings Discuss the burden of disease for women worldwide Describe critical challenges and success stories in improving women s health Reading: Skolnik, ch. 9 Assignments due: Photo-journal installment C16 - July 20 Topic: Non-communicable Diseases (lecture & discussion) Describe the most important non-communicable diseases Discuss the importance of these diseases to global health Discuss the burden of non-communicable diseases worldwide Outline the costs and consequences of non-communicable disease, tobacco use, and excessive alcohol consumption Review measures that can be taken to address the burden of non-communicable disease in cost-effective ways Reading: Skolnik, ch. 12 Assignments due: Reading quiz July 21-26: Livorno - Civitavecchia C17 - July 27 Topic: Diet and Chronic Disease (small group article discussion) Reading: 1. Knoops et al. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women. JAMA 2004. 2. Belahsen et al. Population health and Mediterranean diet in southern Mediterranean countries. PH Nutr 2006. 5
3. Trichopoulou et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ 2005. C18 - July 28 Topic: Communicable Diseases (lecture & discussion) Discuss the determinants of selected communicable diseases, including emerging and reemerging infectious diseases and antimicrobial resistance Understand the key concepts concerning the prevention and transmission of those diseases Review the costs and consequences of communicable diseases of importance Outline some of the most important examples of successful interventions against communicable diseases Understand the key challenges to the future prevention and control of these diseases Reading: Skolnik, ch. 11 Assignments due: Photo-journal installment July 29 31: Malta C19 - August 1 Topic: Epidemics Old & New: The Black Plague & HIV/AIDS (film & small group case study) Reading: Black Plague case study C20 - August 2 Topic: Unintentional Injuries (lecture & discussion) Define the most important types of unintentional injuries Describe the burden of disease related to those injuries Discuss how that burden varies by age, sex, region, and type of injury Outline the costs and consequences of those injuries Review measures that can be taken to address key injury issues in cost-effective ways Describe some successful cases of preventing unintentional injuries Reading: Skolnik, ch. 13 Assignments due: Reading quiz; Photo-journal installment August 3-8: Marseilles - Barcelona C21 - August 9 Topic: Poster Workshop Session Reading: None Assignments due: Draft photo-journal posters C22 - August 10 Topic: Natural Disasters & Humanitarian Emergencies (lecture & discussion) 6
Describe several types of disasters that impact human health Discuss the health effects of natural disasters and complex humanitarian emergencies Review how those health impacts vary by age, sex, location and type of disaster Describe key measures that can be taken to mitigate the health impacts of natural disasters and complex humanitarian emergencies Reading: Skolnik, ch. 14 August 11 16: Cadiz - Lisbon C23 - August 17 Topic: Poster presentations Reading: None Assignments due: Final photo-journal posters August 18: Study Day C24 - August 19: Final Exam August 20: Reflection and Reentry August 21: Convocation and Packing August 22: Southampton FIELD WORK FIELD LAB (At least 20 percent of the contact hours for each course, to be led by the instructor.) Title: The Role of Governmental and Non-Governmental Organizations in Global Health in Morocco: The Moroccan National Institute of Hygiene and UNICEF Port: Casablanca (Note: field lab location is Rabat) Date: Wednesday, June 26, 2013 FIELD ASSIGNMENTS 1. Brief paper (3 pages) comparing governmental and non-governmental organizations role in addressing global health challenges. This will be due 3 days after we depart Casablanca. In this paper, students should answer the following questions: What are the most important global health issues faced by the country visited? What are the respective roles of governmental and non-governmental organizations in addressing these issues? What is each organization doing to combat these issues? How effective are the programs they are implementing? How could their work be improved? 2. Photo-journal installments and final poster. Students will each choose a health topic of interest and document their observations on that topic in each port through photojournalism. The required 7
components of the project are as follows: 3 5 photos per port that capture relevant images for the chosen topic a caption for each photo that describes how the photo is relevant to the topic a paragraph for each country providing background information on the importance of the topic for that country, the prevalence or other relevant descriptive statistical information, whether there are particular subgroups within the population that are at increased risk, and programs or policies in place to address the issue. One installment is due the second day after each port visit A final poster utilizing information from 3 5 of the ports is due at the end of the course. OTHER ASSIGNMENTS Students will be divided in to small groups of 4 6 to discuss case studies and journal articles in class on the dates noted. There will be 4 quizzes, a midterm, and a final exam. METHODS OF EVALUATION / GRADING RUBRIC Class attendance, small group participation, and quizzes: 20% Photo-journal installments and poster: 20% Field lab participation and paper: 20% Midterm exam: 20% Final exam: 20% Grading Scale: A+ 97-100 B+ 87-89 C+ 77-79 D 60-69 A 93-96 B 83-86 C 73-76 F < 60 A- 90-92 B- 80-82 C- 70-72 RESERVE LIBRARY LIST AUTHOR: Markle WH et al. TITLE: Understanding Global Health PUBLISHER: McGraw Hill ISBN #: 13:978-0-07-14878-9 DATE/EDITION: 2007 AUTHOR: Lindstrand A et al. TITLE: Global Health, an Introductory Textbook PUBLISHER: Studentlitteratur (Denmark) ISBN #: 978-91-44-02198-0 DATE/EDITION: 2006 AUTHOR: Jacobsen KH TITLE: Introduction to Global Health PUBLISHER: Jones & Bartlett ISBN #: 13:978-0-7637-5159-3 DATE/EDITION: 2008 AUTHOR: Riegelman R 8
TITLE: Public Health 101 PUBLISHER: Jones & Bartlett Learning ISBN #: 13:978-0-7637-6044-1 DATE/EDITION: 2010 ELECTRONIC COURSE MATERIALS AUTHOR: Mokhtar N et al. ARTICLE/CHAPTER TITLE: Diet, culture and obesity in Northern Africa JOURNAL/BOOK TITLE: The Journal of Nutrition VOLUME: 131(3) DATE: March 1, 2001 PAGES: 8875-8925 AUTHOR: Fakhfakh R et al. ARTICLE/CHAPTER TITLE: Tobacco use in Tunisia: behavior and awareness JOURNAL/BOOK TITLE: Bulletin of the World Health Organization VOLUME: 80(5) DATE: 2002 PAGES: 350-356 AUTHOR: Maziak W et al. ARTICLE/CHAPTER TITLE: Tobacco smoking using a waterpipe: a reemerging strain in a global epidemic JOURNAL/BOOK TITLE: Tobacco Control VOLUME: 13 DATE: 2004 PAGES: 327-333 AUTHOR: Oksuz E et al. ARTICLE/CHAPTER TITLE: Socioeconomic factors and health risk behaviors among university students in Turkey: questionnaire study JOURNAL/BOOK TITLE: Croatian Medical Journal VOLUME: 46(1) DATE: 2005 PAGES: 66-73 AUTHOR: Ozcebe H et al. ARTICLE/CHAPTER TITLE: Risky behaviors of university students: a cross-sectional study JOURNAL/BOOK TITLE: Turkish Journal of Public Health VOLUME: 10(1) DATE: 2012 PAGES: 1-12 AUTHOR: Knoops KTB et al. ARTICLE/CHAPTER TITLE: Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women JOURNAL/BOOK TITLE: Journal of the American Medical Association 9
VOLUME: 292(12) DATE: Sept 2004 PAGES: 1433-1439 AUTHOR: Belahsen R et al. ARTICLE/CHAPTER TITLE: Population health and Mediterranean diet in southern Mediterranean countries JOURNAL/BOOK TITLE: Public Health Nutrition VOLUME: 9(8A) DATE: 2006 PAGES: 1130-1135 AUTHOR: Trichopoulou A et al. ARTICLE/CHAPTER TITLE: Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study JOURNAL/BOOK TITLE: British Medical Journal VOLUME: 330(7498) DATE: 2005 PAGES: 991 -? ADDITIONAL RESOURCES 1. Students will need access to the following website: World Health Organization country data for the countries on the voyage, available at: http://www.who.int/countries/en/ 2. Students will each need a poster board for the end-of-voyage poster presentations. HONOR CODE Semester at Sea students enroll in an academic program administered by the University of Virginia, and thus bind themselves to the University s honor code. The code prohibits all acts of lying, cheating, and stealing. Please consult the Voyager s Handbook for further explanation of what constitutes an honor offense. Each written assignment for this course must be pledged by the student as follows: On my honor as a student, I pledge that I have neither given nor received aid on this assignment. The pledge must be signed, or, in the case of an electronic file, signed [signed]. 10