GEOGRAPHY 280

The Geography of Health and Health Care

Winter, 2012

Tuesdays and Thursdays, 11:30-12:45, Bagley 131

 

Note: The time schedule says 11:30-1:20 erroneously, only because of room scheduling. The class is approved for only 150 minutes/week of lecture. Thus, we will not go that late.

Quiz Sections: Mondays and Wednesdays at varying times

 

Dr. Jonathan D. Mayer, Professor, Departments of Epidemiology, Geography, Global Health, Internal Medicine (Infectious Diseases), Family Medicine, and Health Services

Email: jmayer@uw.edu

Tel: (206) 543-7110

Offices: 412-C Smith Hall (Department of Geography) and Health Sciences Building,

F-259 (Department of Epidemiology)

Office Hours: By appointment. For an appointment, please submit an email to:

 Mayer.appts@yahoo.com. Please do not send these requests to my personal email since I receive up to 150 emails per day, and your request might “get lost” in all of those messages.

 

Note: This is a “W” course (writing credit). Everybody who completes the requirements for the course will receive a W.

 

TAs:   

Katherine Cofell (kcofell@uw.edu)

Smith 430

Office hours by appointment. Regular office hours to be announced during week 2 of the quarter.

 

Jason Young youngjc2@u.washington.edu

 

Natalie White natalie.jayne.w@gmail.com

 

Dena Aufseeser denaa@uw.edu

 

Schedule: As noted in the on-line schedule, we will meet for lectures, films, guest lectures, and presentations on Tuesdays and Thursdays. You will meet in quiz sections on Mondays or Wednesdays. Attendance at quiz section is both important for your learning, and mandatory.

 

Quiz sections are more “discussion sections.”  They will consist of some review and discussion of topics introduced in the lecture sessions, but will also introduce some new material, and will cover the readings more specifically. This is also the venue for introducing and grading the assignments, discussed on the last page of this document.

There will be a take-home, open book final examination.


 

THE COURSE:

 

In this course, we will examine, learn, and debate the concepts of health, global health care, disease, and illness from the perspective of how environment, biology, and society—include politics and power-- interact to produce states of health and disease. The focus of this course will be on geographical patterns of health and disease, from the viewpoint of populations rather than individuals. The focus of medicine is on the treatment of individuals. The focus of the course, like that of public health generally, is on populations.

By the end of the course, you should be able to:

 

1) Understand how health, disease, illness, environment, biology, and society contribute to disease. You should be able to understand in-depth articles on this topic in publications such as The Economist, Wall Street Journal, Guardian, and  The New York Times.  you should be able to write an editorial in any newspaper; and you should be able to describe these relationships to one of your friends in other classes, or to somebody like a lawyer, physician, or other professional who is sitting next to you on an airplane;

 

2) Understand, describe, and critique some of the major contemporary issues in global health;

 

3) Understand how geography as a discipline contributes to understanding health and health care;

 

4) Understand the role of health and disease as fundamental issues in society

 

5) Understand global change in relation to health; and

 

6) Within the context of the course content, improve your writing, communication, open minded thinking, and analytical skills.

 

THE REQUIREMENTS:

 

A word on academic honesty and integrity is in order. This is extremely important, so please read this carefully. If you continue past the first day in class, this means that you agree to abide by the rules spelled out in URL below. We will adhere strictly to the rules of the University of Washington and the academic community in prohibiting plagiarism, cheating, and academic honesty. These provisions are spelled out in detail at the following website, with which all students are expected to be familiar. Each year in this class, several cases of cheating and plagiarism, unfortunately, are discovered. To prevent this, you must read the contents of the following website:

 

            http://depts.washington.edu/grading/pdf/AcademicResponsibility.pdf

 

We assume that each and every student is familiar with the contents of this web page. No excuses will be accepted for academic dishonesty. Whenever any written work is submitted, it will be graded with the assumption that the student has read and understood this website, and has agreed to abide by the standards dictated by UW’s standards for academic honesty. There will be no acceptable exceptions or excuses for violation of these policies.

 

THE READING:

 

The following books are required for the course. These may be acquired from the University Bookstore, other local bookstores, or a web-based book company.

 

Abraham Verghese, My Own Country. New York: Vintage Books, 1995. E-book available for purchase at:

http://www.amazon.com/My-Own-Country-Doctors-Story/dp/0679752927/ref=sr_1_1?ie=UTF8&qid=1325270522&sr=8-1

as well as other vendors (Note: you will need to download the free Kindle application available at that URL. Also:

http://tinyurl.com/7m2v6um

 

Tracy Kidder, Mountains Beyond Mountains: Healing the World: The Quest of Paul Farmer. New York: Random House, 2003. E-book available for $11.99 at:

http://books.google.com/ebooks?id=nEjXAmEBAi8C&dq=mountains%20beyond%20mountains&as_brr=5&source=webstore_bookcard, as well as other online vendors.

Also: http://tinyurl.com/7vvylp4

 

Jonathan Cohn, Sick: The Untold Story of America’s Health Care Crisis—and the People Who Pay the Price. New York: HarperCollins, 2007. E-book available for $10.99 at http://books.google.com/ebooks?id=z4wlKEZ3TssC&dq=Jonathan%20Cohn&as_brr=5&source=webstore_bookcard, as well as other online vendors.

Also: http://tinyurl.com/85m6m9g

 

Anne Fadiman, The Sprit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Electronic version available for $9.99 at: http://books.google.com/ebooks?as_brr=5&q=anne+fadiman&as_sub=&oq=Fadiman

http://tinyurl.com/7amze2f

Electronic reserve: Occasional readings, particularly of the most current research, much of which will be published during the quarter.

 

Finally, subscribe to the online service ProMED, which is the “Program for Monitoring Emerging Diseases.” Go to www.promedmail.org. You will be redirected, and in the upper left, there will be a link to “subscribe/unsubscribe.”


 

 

Grades will be based on the following:

 

1)    Participation in quiz section (based upon short thought pieces on the reading)—10%

2)    60% for 3 short papers of equal weight in quiz section (20% each). Each paper should be about 3 pp. This will be explained further in quiz section next week.

3)    30% for a take-home final exam to be emailed to you on Tuesday, March 6. This will be due on Tuesday of final exam week (Tuesday, March 13). Your TA will give you further instructions for exam submission.

 

Class papers will be due on Mondays or Wednesdays, depending on when your section meets. You will learn more about due dates and assignments later in the week.

 

COURSE OUTLINE:

 

Note: Dates are only approximate and will vary depending upon “breaking news”

and course progress. Events such as the evolving epidemic cholera in Haiti, the rapid spread of the emerging virus NDM-1 that is resistant to virtually all antimicrobials, and what I predict to be a significant influenza season will be integrated into the course.

 

Week of Tuesday, January 3: INTRODUCTION TO COURSE AND TO GEOGRAPHY OF HEALTH AND DISEASE

            Disease ecology

            Definitions

            Measures of disease frequency and severity

 

Reading: Begin reading Kidder

 

Week of Tuesday, January 10; January 12th

THE CHALLENGES OF GLOBAL HEALTH: examples 

 

Urban Slum Health

Global Environmental Change and Health

            Global Burden of Disease; Measurement and Geographical Differences

            Reading: Continue reading Kidder

 

                       

January 17th, 19th, 24th, 26th

THE GEOGRAPHY OF HIV/AIDs, MALARIA, INFLUENZA, AND TUBERCULOSIS: THE GEOGRAPHIC IMPORTANCE OF MODES OF TRANSMISSION

 

Assignment 1: Due in section during the week of Monday, Jan. 23.

 

Overview of Disease Ecology and the Political Ecology of Disease

Emerging Infectious Diseases;

Geographic Epidemiology of Influenza

            Global Patterns of HIV/AIDS;

Where did HIV/AIDS begin? Molecular Epidemiology and Social Patterns

HIV/AIDS in the United States;;

HIV and Tuberculosis

Global Environment and Malaria;

            Reading:

Finish Kidder for quiz section on either Jan. 23 (Mon) or Jan 25 (Wed); Note: No quiz sections on Monday January 16th—MLK Day (University holiday) or Wed. January 18th. TAs will be available during the week.

Finish Verghese by Jan. 30 or Feb. 1.

                       

January 31st, February 2, 7: GEOGRAPHY OF “APPARENTLY” NON-INFECTIOUS DISEASES; ENVIRONMENTAL SOURCES OF DISEASE

 

Assignment 2: Due in section during the week of Monday, Feb. 6.

 

            Cancers and Cancer Clusters

Cardiovascular Disease

Neurological Diseases

Reading: Begin reading Fadiman

 

February 9, 14, 16:

BRINGING CULTURE INTO HEALTH CARE

            Interpretation of Signs and Symptoms

            Multiple Understandings of Health and Disease

            Hmong Culture and Encounters with US Health Care

Reading: Finish Fadiman by Feb. 13th (for quiz section) or Feb. 15th

 

February 21, 23, 28

GEOGRAPHY AND HEALTH SERVICES; GENERAL POLICY ISSUES IN HEALTH CARE

 

Assignment 3: Due in section during the week of Monday, Feb. 27. The Importance of Health Service Location; Accessibility

 

Regionalization and Health Care; Small Area Analysis and Evidence Based Medicine;

Urban-Rural Differences in Health Care;

            Reading: Begin reading Cohn

 

March 1, 6, 8

COMPARATIVE HEALTH SYSTEMS AND HEALTH CARE REFORM IN THE USA.

 

Why Do Different Systems Arise in Different Countries?

The US Health Care “System”

The British National Health System;

The Canadian Health Care System

US Health Care Policy

Reading: Complete Cohn for section on either Feb. 27 or March 1

e-reserve

           

Some useful links for this course:

 

Centers for Disease Control and Prevention (CDC)

 

Morbidity and Mortality Weekly Report (MMWR). An essential short digest of vital health information and outbreak investigations in the US.

 

Emerging Infectious Diseases. A top-notch publication by CDC. You may subscribe to either the online or hard copy editions for free.

 

World Health Organization

 

Intergovernmental Panel on Climate Change

*IPCC 4th Assessment--Impacts Chapter 8 is the health section

 

National Institutes of Health (NIH)

 

National Center for Health Statistics

ProMED

 

UNAIDS (UN Program on AIDS)

 

Stop TB Partnership

 

Global Fund to Stop AIDS, Tuberculosis, and Malaria

 

UW electronic journal collection

 

PubMED. (Interface with National Library of Medicine—all major public health, medical, and relevant geography articles are included here) Make sure that you sign in on the top right if you will need links to the actual articles in e-journals.

 

Google Flu Trends

 

Health and Medical Geography Specialty Group

 

Toxic Release Inventory Program—geographically referenced dataset of toxic releases in the US

 

National Cancer Institute cancer clusters homepage

 

CDC cancer clusters

 

CDC National Environmental Health Tracking Program

 

 

American Cancer Society

            ACS Data and Statistics

 

National Cancer Institute Maps and Graphs

 

Environmental Health Perspectives—foremost journal in environmental health