GEOGRAPHY 280

The Geography of Health and Health Care

Winter, 2008

Monday, Wednesday, Friday 11:30-12:20 Smith 120

Quiz Sections: Thursdays at varying times

 

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

Email: jmayer@u.washington.edu

Tel: (206) 543-7110

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

F-259 (Department of Epidemiology)

Office Hours; Wednesday 1-2:30 (Smith 412-C) or by appointment

 

TAs:       Tim Stiles (tastiles@u.washington.edu)

                       Spencer Cohen (zhuge99@u.washington.edu)

                        Sarah Paige (spaige2@u.washington.edu)

                        Mike Babb (babbm@u.washington.edu)

 

Schedule: As noted in the on-line schedule, we will meet for lectures, films, and presentations on Monday, Wednesday, and Friday. You will meet in quiz sections on Thursdays. Attendance at quiz section is both important for your learning, and is 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 exams must be the work of each of you, individually.

 

THE COURSE:

 

In this course, we will examine, learn, and debate the concepts of health, global health care, disease, and illness from a geographical perspective. 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; our focus, like that of public health, will be on understanding health and disease from the perspective of populations.

 

The specific objectives of the course are to:

 

1)      Facilitate a critical understanding of health, disease, illness, and society;

2)   Introduce some of the major contemporary issues in global health;

2)      Promote an understanding of how geography as a discipline contributes to understanding health and health care;

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

4)      Understand global change in relation to health; and

5)        Within the context of the course content, improve writing, communications, critical thinking, and analytical skills.

 

THE REQUIREMENTS:

Specific requirements for the course are on the last page of this handout.

 

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/issue1/honesty.htm

 

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 presumption 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.

 

THE READING:

 

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

 

Abraham Verghese, My Own Country;

 

Anne Fadiman,  The Spirit Catches You and You Fall Down: A Hmong Child, Her Doctors, and the Collision of two Cultures.

 

Paul Farmer, Infections and Inequalities.

 

Tracy Kidder, Mountains Beyond Mountains: Healing the World: The Quest of Paul Farmer

 

Paul E. Terry, Breaking Stone Silence: Giving Voice to AIDS Prevention in Africa.

 

 

COURSE OUTLINE:

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

and course progress

 

Week of Mon. January 7: INTRODUCTION TO COURSE AND TO GEOGRAPHY OF HEALTH AND DISEASE

Reading: Verghese ch. 1-5, pp. 5-106.

 

WEEK OF January 14th

THE CHALLENGES OF GLOBAL HEALTH: examples  (will begin on Fri Jan 11)

Reading: Verghese ch. 6-16, pp. 107-274

 

Avian Flu: Is it a Threat?

 

Urban Slum Health

 

 Vaccines: Development, Distribution (logistics), and Ethical Dilemmas

 

  Global Burden of Disease; Measurement and Geographical Differences

 

 

WEEKS OF JANUARY 21 AND JAN 28 : NOTE: MONDAY JAN. 21st IS MARTIN LUTHER KING DAY—NO CLASS

 

THE GEOGRAPHY OF HIV/AIDS

 

Introduction to Disease Ecology;

 

Emerging Infectious Diseases;

 

Where did HIV/AIDS begin?

 

How has HIV/AIDS spread?

 

The Global Burden of HIV/AIDS;

 

HIV/AIDS in the United States;

 

HIV/AIDS in Africa;

 

HIV/AIDS in Asia;

 

HIV and Tuberculosis;

 

                       Reading:

                                                Rest of Verghese, week of Jan 21;

                                                Kidder, pp. 3-113, week of Jan. 21;

 

                                                Farmer, pp. xi-93, and 184-227 week of Jan. 26;.

                                                Terry xiii-45, week of Jan 26.

                                               

                                               

 

Week of February 29th: GEOGRAPHY OF “APPARENTLY” NON-INFECTIOUS DISEASES

 

                       Cancers

 

Cardiovascular Disease

 

Neurological Diseases

 

                       

                                                Reading: Rest of Kidder;

                                                                        Farmer, pp. 94-157

Terry, pp. 47-131.;

 

                                                                        Additional journal articles may be assigned

 

 

 

Week of February 4th

POVERTY AND HEALTH: THE SOCIAL DETERMINANTS OF HEALTH

 

Poverty and Health;

 

The Social Determinants of Health;

 

Income Inequality and Health;

                        Reading: Farmer, pp. 157-183; 228-282;

                                                   Terry, pp. 133-275.

                                               

Week of February 11th:

HEALTH EFFECTS OF DISASTERS: NATURAL AND HUMAN-MADE (“ANTHROPOGENIC”)

 

 

Week of February 18th

GEOGRAPHY AND HEALTH ERVICES:

Note: Monday February 18th is Presidents Day; no class

 

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

 

The Importance of Health Service Location;

 

Urban-Rural Differences in Health Care;

 

Reading: Fadiman, pp. vi-59 (incl “Do Doctors Eat Brains?)

 

Week of February 25th: Comparative Health Systems;

 

Why Do Different Systems Arise in Different Countries?

 

The British National Health System;

 

The Canadian Health Care System;

 

Reading: Fadiman, pp. 60-139.

 

Week of March 3rd: Comparative Health Care Systems (cont); Culture, Multiculturalism, and Health

 

                        The Hmong Experience: Epidemiology of Migration and War

 

Multiculturalism and Health;

 

Health and Cultural Conflict in the United States;

 

Incorporating a Diversity of Beliefs

 

Reading: Fadiman, pp. 140-288. 

 

 

Last day of class: Friday March 14th.

Grading

 

Grades will be based on the following:

 

1)        Participation in quiz section (based upon short, simple quizzes 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 on Thursday,

3)        30% for a take-home final exam to be distributed during the last week of class. This will be due on Monday of final exam week.