Geography 280 The Geography of Health and Health Care




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GEOGRAPHY 280

The Geography of Health and Health Care

Winter, 2013

Tuesdays and Thursdays, 11:30-12:45, Smith 120

Note: The time schedule says 11:30-1:20 erroneously, because of room scheduling.

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@u.washington.edu

Tel: (206) 543-7110

Offices: 412-C Smith Hall (Department of Geography) and Health Sciences Building, F-161c (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) TAs:

Kristen Savage

Kristen.e.savage@gmail.com Eloho Tobrise etobris@uw.edu

Will McKeithen wmck@uw.edu

Yolanda Valencia valeny@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

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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, 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/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.
GRADES:

Grades will be based on the following:

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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 12. This will be due on Tuesday of final exam week (Tuesday, March 19). Your TA will give you further instructions for exam submission.

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.


Robert S. Desowitz, New Guinea Tapeworms and Jewish Grandmothers: Tales of

Parasites and Peoples. New York: W.W. Norton, 1987.


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%20mo untains&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


Julie Salamon, Hospital: Man, Woman, Birth, Death, Infinity Plus Red Tape, Bad

Behavior, Money, God, and Diversity on Steroids. New York: Penguin Group, 2008.


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:
4) Participation in quiz section (based upon short thought pieces on the reading)—

10%


5) 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,

6) 30% for a take-home final exam to be emailed to you on Tuesday, March 12. This will be due on Tuesday of final exam week (Tuesday, March 19). Your TA will give you further instructions for exam submission.

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Class papers (the “assignments”) will be due in TA mailboxes on Fridays. Paper #1 will be due by noon on Friday, 1/25 in your TA’s mailbox. Paper #2 will be due by noon on Friday, 2/8 in your TA’s mailbox. Paper #3 will be due by noon on Friday, 3/1 in your TA’s mailbox. The assignment and quiz section schedule is at the end of this document.



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 8: INTRODUCTION TO COURSE AND TO GEOGRAPHY OF HEALTH AND DISEASE

Disease ecology

Definitions

Measures of disease frequency and severity


Week of Tuesday, January 15;

THE CHALLENGES OF GLOBAL HEALTH: examples


Urban Slum Health

Global Environmental Change and Health

Global Burden of Disease; Measurement and Geographical Differences

Reading: Desowitz through p. 102 for Quiz Section


January 22, 29th, Feb 5

THE GEOGRAPHY OF HIV/AIDs, MALARIA, INFLUENZA, AND TUBERCULOSIS: THE GEOGRAPHIC IMPORTANCE OF MODES OF TRANSMISSION
Overview of Disease Ecology and the Political Ecology of Disease

Environment and Parasitic Diseases Emerging Infectious Diseases; Geographic Epidemiology of Influenza Global Patterns of HIV/AIDS;

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

HIV and Tuberculosis

Reading:

Finish Desowitz for quiz section, week of Mon. Jan. 21. Week of Mon. Jan 28: Kidder through p. 121

Week of Mon. Feb 4: Finish Kidder
*WE WILL NOT HAVE FORMAL QUIZ SECTIONS THE WEEK OF JANUARY 21ST DUE TO HOLIDAYS, BUT TAS WILL HOST EXTRA OFFICE HOURS TO COMPENSATE.
February 12, February 19: GEOGRAPHY OF “APPARENTLY” NON-INFECTIOUS DISEASES; ENVIRONMENTAL SOURCES OF DISEASE

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Cancers and Cancer Clusters Cardiovascular Disease Neurological Diseases

Reading:

Feb 12: Read Cohn through page 115.

February 19: continue reading Cohn and get ahead.
*WE WILL NOT HAVE FORMAL QUIZ SECTIONS THE WEEK OF FEBRUARY 18TH DUE TO HOLIDAYS, BUT TAS WILL HOST EXTRA OFFICE HOURS TO COMPENSATE.
February 26: GEOGRAPHY AND HEALTH SERVICES; GENERAL POLICY ISSUES IN HEALTH CARE

The Importance of Health Service Location; Accessibility

Components of Health Care

The Hospital and the Community

Regionalization and Health Care; Small Area Analysis and Evidence Based

Medicine;

Urban-Rural Differences in Health Care;

Reading: Feb 26: Finish reading Cohn; Read Salamon through page 73.


March 5, 12

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: Finish reading Salamon by the week of March 5.

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Some useful links for this course:
PubMED. The interface with the National Library of Medicine, which contains most of the relevant articles in medicine, public health, and medical geography. This includes everything from basic molecular pathophysiology to genetics, clinical trials and other areas of epidemiology, and geographic approaches to health and disease.
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

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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


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