GEOGRAPHY 280

The Geography of Health and Health Care

Winter, 2009

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 afternoons by appointment only—no drop ins.

 

TAs:          Tish Lopez (maoquai@u.washington.edu)

                        Maureen Hickey Putnam (mhhp@u.washington.edu)

                        Kathryn Gillespie (katieag@u.washington.edu)

                        Andrew Childs (agc4@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. New York: Vintage Books, 1995.

 

Jonny Steinberg, Sizwe’s Test: A Young Man’s Journey Through Africa’s AIDS Epidemic. New York: Simon and Schuster, 2008.

 

Jonathan Harr, A Civil Action. New York: Vintage Books, 1995.

 

Anne Fadiman, The Spirit Catches You and You Fall Down: A Hmong Child, Her Doctors, and the Collision of two Cultures. New York: Farrar, Strauss, and Giroux, 1997.

 

Tracy Kidder, Mountains Beyond Mountains: Healing the World: The Quest of Paul Farmer. New York: Random House, 2003.

 

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.”

 


 

COURSE OUTLINE:

 

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

and course progress. Events such as the evolving epidemic of avian influenza, and cholera in Zimbabwe will be integrated into the course.

 

Week of Mon. January 5: INTRODUCTION TO COURSE AND TO GEOGRAPHY OF HEALTH AND DISEASE

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

 

Week of  January 12th

THE CHALLENGES OF GLOBAL HEALTH: examples  (will begin on Fri Jan 9th)

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

                        Steinberg, preface and Part One (pp. 1-75).

 

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 19th AND January 26th : NOTE: MONDAY January 19th 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?

                       Global Patterns 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 26th);

                                                Kidder, pp. 3-113, (week of Jan. 19th)

Steinberg, part two, pp. 79-232 (week of Jan 19th);

                                               

 

Week of February 2nd and 9th: GEOGRAPHY OF “APPARENTLY” NON-INFECTIOUS DISEASES; ENVIRONMENTAL SOURCES OF DISEASE

 

                       Cancers and Cancer Clusters

Cardiovascular Disease

Neurological Diseases

                                                Reading: Rest of Kidder(week of Feb. 2nd);

                                                                        Rest of Steinberg (week of Feb 2nd)

                                                                        All of Harr (week of Feb 9th).

 

Week of February 16th

POVERTY AND HEALTH: THE SOCIAL DETERMINANTS OF HEALTH\

Note: Monday February 16th is Presidents Day. No class.

 

Poverty and Health;

The Social Determinants of Health;

Income Inequality and Health;

                       

Week of February 23rd

GEOGRAPHY AND HEALTH SERVICES; POLICY ISSUES IN HEALTH CARE

 

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 March 2nd: 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 9th: 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. 

 

 

 

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.