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Syllabi: HISTORICAL AND SOCIOLOGICAL PERSPECTIVES IN PUBLIC HEALTH 2001

INSTITUTION: University Of Pittsburgh

FACULTY: Jonathon Erlen, Ph.D. (Phone: 6488927); erlen@pitt.edu; Elizabeth Kelly Scanlon, MPH, MSPL escanlon@concentric.net

ENROLLMENT: Mandatory for all Doctor of Public Health Students in the Health Services Administration program in the Graduate School of Public Health (GSPH)

TIME: Tuesday, 1:00 p.m. to 3:30 p.m.

LOCATION: 200 Scaife Hall, History of Medicine Room

COURSE REQUIREMENTS:

This doctoral level course is primarily a reading/discussion seminar; therefore, class discussion is the major grading factor in this course. All students are required to attend and actively participate in all class sessions. One grade will be subtracted from a student's course grade for each absence after two absences. All students are required to submit three questions based on the reading assignments for the weekly class the day prior to class via email to Dr. Erlen at erlen@pitt.edu. Some of these questions will be used during the class as part of the course agenda. Also all students will submit at the start of each class session a half page essay on one or more of the major themes presented in that week's reading assignment. All class assignments must be typed. On March 28 each student will turn in what they think should be five goals for public health for the 2000-2010 period. On April 4 all student will turn in their course research paper-see instructions on the following page. All assignments must be typed! The course grade will be determined as follows: 75% for class participation, 20% for the course research paper, and 5% for paper presentation in class. Students with disabilities who require special testing accommodations or other classroom modifications should notify the instructor and the Office of Disability Resources and Services (DRS) no later than the 4th week of the term. Students may be asked to provide documentation of their disability to determine the appropriateness of the request. DRS is located in 216 William Pitt Union and can be contacted at 648-7890.

REQUIREMENTS FOR FINAL PAPER AND PRESENTATIONS:

  1. Make an appointment to meet with Dr. Erlen to discuss potential paper topics and get approval by the end of the first month of class.

  2. Contact Elizabeth Kelly Scanlon by email at escanlon@concentric.net to discuss potential questions to be discussed related to cultural and/or sociological issues related to the topic to be discussed.

  3. The final paper must be 10-15 pages in length and explore in detail both the historical and sociological aspects of the topic. It must be typed and double-spaced. It must include footnotes and a bibliography.

  4. The paper will be due on 4/4/00. Two copies of the paper must be turned in.

  5. Each student will have an opportunity to select which day they prefer to present their paper on a first come/first selected basis. The dates for presentations are 4/11/00, 4/18/00, or 4/25/00. Please discuss the presentations dates with Ms. Scanlon as soon as you have made your decision.

  6. Presentations may include the use of audiovisuals as appropriate. We will arrange to have an overhead and a flip chart available for each presenter. Additional AV needs will be handled on a case by case basis. Allow time for questions at the end of each presentation.

COURSE SCHEDULE

JANUARY 16

B.I. Changing Definitions of and Views about the Concepts of Disease, the "Sick Role," Health Care and Health Care Providers.

  1. Examine the historical changes in how society defined/defines the concept of disease/illness.

  2. Define and discuss the evolution of the "sick role," both as accepted by the public and by public health.

  3. Discuss the evolution of the concept of both health and the health care provider.

  4. Discuss the impact of cultural diversity on public health practices.

Reading Assignment

  • Rosenberg, Charles E. "Disease and social order in America: Perceptions and expectations." In AIDS: The Burden of History. pp. 12-32.

  • Cassell, Eric J. "Ideas in conflict: The rise and fall (and rise and fall) of new views of disease." In Daedalus, vol. 115, no. 2, (Spring) 1986: 19-41.

  • Tesh, Sylvia N. Hidden Arguments. Chapters 1-2, 7.

  • Rosenberg, Charles E. "Disease in history: Frames and framers." The Milbank Quarterly, 1989, 67 (Supplement 1):1-15.

  • Warren, B. S. "The relation of wages to the public health." Printed first in American Journal of Public Health, 1918(8): 883-887. American Journal of Public Health, 1999(89): 1641-1644.

  • Barsky, Arthur J. "The paradox of health." New England Journal of Medicine, February 18, 1988, 38(7): 414-418.

  • Burnham, John C. "American medicine's golden age: What happened to it?" In Sickness and Health in America, 1985, pp. 248-258.

  • Link, Bruce G.; and Phelan, Jo C. "Editorial: Understanding sociodemographic differences in health-The role of fundamental social causes." American Journal of Public Health, 1996, 86 (4): 471-473.

  • Guralnick, Jack, M., et. al. "Annotation: Race, ethnicity, and health outcomes- unraveling the mediating role of socioeconomic status." American Journal of Public Health, 1997, 87(5): 728-729.

  • Levy, Barry S. "Creating the future of public health: Values, vision, and leadership." American Journal of Public Health, 1998, 88 (2): 188-192.

  • "Use of race and ethnicity in public health surveillance: Summary of the CDC/ATSDR workshop." MMWR, 1993, 42(RR-10): 1-17.

  • "Martinez, Rose M.; and Lillie-Blanton, Marsha. "Why race and gender remain important in health service research." American Journal of Preventive Medicine, 1996, 12(5): 316-318.

JANUARY 23-30

B.II-III Professionalization and Socialization of Public Health, Public Health Workers, and Health Policy Making.

  1. Examine the historical basis of the professional sovereignty of American medicine and the consequences for the development of public health in America.

  2. Describe the emergence of selective, high quality professional education for both medicine and public health.

  3. Discuss the relationship of professional education/ socialization and professional ideologies to the evolution of public health, preventive medicine and health policy making in America.

Reading Assignment

    B.II.

  • Duffy, John. The Sanitarians, pp. 1-204.

  • Winslow. Charles E. A. "Public health at the crossroads." First printed in American Journal of Public Health, 1926(16): 1975-1085. American Journal of Public Health, 1999(89): 1645-1648.

  • Rosenkrantz, Barbara G. "Cart before horse: Theory, practice and professional image in American public health, 1870-1920." Journal of the History of Medicine, 1974, 29: 55-73.

  • Tomes, Nancy. "The private side of public health: sanitary science, domestic hygiene, and the germ theory." Bulletin of the History of Medicine, 1990, 64: 509-539.

  • Mullan, Fitzhugh. "Don Quixote, Machiavelli, and Robin Hood: Public health practice, past and present." American Journal of Public Health, 2000, 90(5): 702-706.

    B.III.

  • Duffy, John. The Sanitarians, pp. 205-316.

  • Duffy, John. "The American medical profession and public health: From support to ambivalence." Bulletin of the History of Medicine, 1979, 53(1): 1-22.

  • Brandt, Allan M.; Gardner, Martha. "Antagonism and accommodation: Interpreting the relationship between public health and medicine in the United States during the 20th century." American Journal of Public Health, 2000, 90(5): 707-715.

  • Berliner, Howard S. "Whither public health?" Health Policy and Education, 1980, 1: 177-186.

  • Fee, Elizabeth. "Designing schools of public health for the United States." in A History of Education in Public Health, p. 153-194.

  • Allukian, Myron, Jr. "Forging the future: The public health imperative." American Journal of Public Health, 1993, 83 (5): 655-660.

  • Legnini, Mark W. "Developing leaders vs training administrators in the health services." American Journal of Public Health, 1994, 84 (10): 1569-1572.

  • Evans, Caswell A., Jr. "Public health: Vision and reality." American Journal of Public Health, 1996, 86 (4): 476-479.

  • Stevens, Rosemary. "Public health history and advocacy in the money- driven 1990's." American Journal of Public Health, 1996, 86(11): 1522-1523.

  • Brown, E. Richard. "Leadership to meet the challenges to the public's health." American Journal of Public Health, 1997, 87(4): 554-557.

  • Gebbie, Kristine M. "The public health workforce: Key to public health infrastructure." American Journal of Public Health, 1999, 89(5): 660-661.

  • Levy, Barry S. "Preventive medicine in the 21st century: Challenges and opportunities." American Journal of Preventive Medicine, 1999, 16(4): 363-366.

  • Ludmerer, Kenneth M. Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care. N.Y.: Oxford University Press, 1999. Pp. 370-399.

  • Relman, Arnold S. "The crisis of medical education in America. Why Johnny cann't operate." The New Republic, 2000, October 2: 37-43.

FEBRUARY 6-13

C.I-II The Evolution of Health Care Facilities and Managed Care: Their Impact on Public Health

  1. Discuss the historical evolution of the modern hospital.

  2. Describe distinctive features of the modern hospital at the peak of its influence.

  3. Examine the reasons for the creation and the failure of alternative health care facilities in the 19th and 20th centuries.

  4. Examine the relationship of hospitals to public health in America. Is there a relationship?

  5. Discuss the origins and current status of managed care.

  6. How does managed care impact on public health policy decision making and visa versa?

Reading Assignment

    C.I.

  • Rosenberg, Charles E. "The origins of the American hospital system." Bulletin of the New York Academy of Medicine, 1979, 55: 10-21.

  • Rosenberg, Charles E. "Looking backward, thinking forward: The roots of the hospital crisis. "Transactions and Studies of the College of Physicians of Philadelphia, 1990, 12: 119-126.

  • Rothman, David J. "The hospital as caretaker: The almshouse past and intensive care future." Transactions and Studies of the College of Physicians of Philadelphia, 1990, 12:127-150.

  • Rosenberg, Charles E. "Social class and medical care in 19th century America: The rise and fall of the dispensary." in Sickness and health in America, 1985, pp. 273-286.

  • Starr, Paul. The Social Transformation of American Medicine, pp. 420-449.

    C.II

    Videotape on managed care in Pittsburgh.

  • Light, Donald W. "Corporate medicine for profit..." Scientific American, 1986, 255 (6): 38-45.

  • Bischof, Ralph O.; and Nash, David B. "Managed care: Past, present, and future." Medical Clinics of North America, 1996, 80 (2): 225-244.

  • Mechanic, David. "Topics of our times: Managed care and public health opportunities." American Journal of Public Health, 1998, 88 (6): 874-875.

  • Massey, Steve. "Anatomy of a bankruptcy: The rise and fall of Allegheny General Hospital." Pittsburgh Post-Gazette Reprint, Sunday, January 17, 1999.

  • Annas, George J. "a national bill of patients' rights." New England Journal of Medicine, 1998 (338:10): 695-699.

  • Callahan, Daniel. "Managed care and the goals of medicine." Journal of the American Geriatrics Society, 1998 (46): 385-388.

  • Rodwin, Marc A. "Conflicts of interest and accountability in managed care: The aging of medical ethics." Journal of the American Geriatrics Society, 1998 (46): 338-341.

  • Fox, Daniel M. "Managed care: The third reorganization of health care." Journal of the American Geriatrics Society, 1998 (46): 3314-317.

FEBRUARY 20-27; March 13

D.I-III Past, Present, and Future Impact of Epidemics on Society and Public Health.

  1. Provide an historical overview of selected major epidemics.

  2. Examine the impact of epidemics on the emergence and growth of public health.

  3. Evaluate the current influence of epidemics, actual and potential, on public health.

  4. Examine the historical antecedents of the current health crises in the area of sexually transmitted disease.

  5. Analyze the interplay of medical, social, religious, and political factors in the AIDS crisis.

  6. Discuss the critical debates surrounding the issues posed by the AIDS' crisis.

  7. Discuss the impact of AIDS on the future of public health.

Reading Assignment

    D.I.

  • Renouard, Yves, "The Black Death as a major event in world history." In The Black Death: A Turning Point in History?, pp. 25-34.

  • Blake, John B. "The inoculation controversy in Boston, 1721-1722." In Sickness and Health in America, 1985, pp. 347-355.

  • Rosenberg, Charles E. The Cholera Years. Chicago: University of Chicago Press, 1987.

  • Risse, Guenter B. " A long pull, a strong pull, and all together: San Francisco and bubonic plague, 1907-1908."Bulletin of the History of Medicine, 1992, 66: 260-286.

  • White, Kenneth A. "Pittsburgh in the great epidemic of 1918." Western Pennsylvania Historical Magazine, 1985 68(3): 221-242.

  • PBS videotape on 1918 influenza epidemic.

    D.II.

  • Brandt, Allan M. No Magic Bullet. New York: Oxford University Press, 1987.

  • Risse, Guenter B. "Epidemics and history: ecological perspectives and social responses." In AIDS: The Burdens of History, pp. 33-66.

  • Musto, David. "Quarantine and the problems of AIDS." In AIDS: The Burdens of History, pp. 67-85.

  • Koop, C. Everett. "The early days of AIDS and I remember them." in AIDS and the Public Debate, 9-18.pp.

  • Rosenberg, Charles E. "What is an epidemic? AIDS in historical perspective." Daedalus, 1989, 118(2): 1-17.

  • Fox, Daniel M. "AIDS and the American health polity: The history and prospects of a crisis of authority." In AIDS: The Burdens of History, pp. 316-343.

  • Rogers, David E. "Report card on our national response to the AIDS epidemic-some A's, too many D's." American Journal of Public Health, 1992, 82(4): 522-524.

  • "Moving along the fault lines of our society." In The AIDS Crisis: A Documentary History. P. 239.

    D.III.

  • Musto, David. "Quarantine and the problems of AIDS." In AIDS: The Burdens of History, pp. 67-85.

  • Fox, Daniel M. "The politics of HIV infection:1989-1990 as years of change." in AIDS: The Making of a Chronic Disease, pp.125-143.

  • Brandt, Allan M. 'AIDS: From public history to public policy." in AIDS and the Public Debate, pp.124-131.

  • Bayer, Ronald. "AIDS, privacy, and responsibility." Daedalus, 1989, Living with AIDS, Part II: 79-99.

  • Bayer, Ronald. "Entering the second decade: The politics of prevention, the politics of neglect." in AIDS: The Making of a Chronic Disease, pp. 207-226.

  • Fox, Daniel M. "The politics of physicians' responsibility in epidemics: A note on history." In AIDS: The Burdens of History, pp. 86-96.

  • Fairchild, Amy L.; and Tynan, Eileen A. "Policies of containment: Immigration in the era of AIDS." American Journal of Public Health, 1994, 84 (12): 2011-2022.

  • "The future of AIDS." In The AIDS Crisis: A Documentary History. Pp. 234-238

  • "Why everyone should care about AIDS." The AIDS Crisis: A Documentary History. Pp. 32-34.

  • "What is the physician's responsibility to prevent his or her patient from infecting others?" The AIDS Crisis: A Documentary History. Pp. 228-229.

  • Fleming, Patricia L.; et. al. "Tracking the HIV epidemic: Current issues, future challenges." American Journal of Public Health, 2000, 90(7): 1037-1041.

MARCH 20-27; April 3

E.I-III Critical Debates in Contemporary Public Health: Goals for 2000

  1. Examine the background to the current cigarette public health crisis in the United States.

  2. Discuss the current public health positions and efforts in dealing with the cigarette health problem in America.

  3. What should public health's role(s) be in addressing the health dangers presented by smoking?

  4. Discuss the historical origins of America's chronically under-served.

  5. Define the concept of the chronically under-served in terms of America's health care system.

  6. Examine the challenge to public health created by the needs of the chronically under-served.

  7. Examine the evolution and current impact of the health insurance issue on the American health care system.

  8. What should public health's role(s) be in the current health insurance debate?

  9. Can the U.S., despite its long traditions, learn from other Western countries' approach to health insurance?

  10. Discuss the debate surrounding the individual's responsibility for maintaining his/her own health.

  11. Examine the role(s) of health education as part of the American public health movement.

  12. Discuss public health goals for the 1990's.

Reading Assignment

    E.I.

  • Proctor videotape on smoking and cancer.

  • Benedek, Thomas G. "Does cigarette smoke cause lung cancer? :16-21.

  • Patterson, David T. The Dread Disease: Cancer and Modern American Culture. Ch. 8: "Smoking and cancer." 1987: 201-229.

  • Brandt, Allan M. "The cigarette risk, and American culture." in Readings in American Health Care, 1995: 138-149.

  • The Cigarette Papers. Ch. 11: "Where do we go from here?" 1996: 436-442.

  • Kessler, David A., et. al. "The legal and scientific basis for FDA's assertion of jurisdiction over cigarettes and smokeless tobacco." JAMA, 1997, 277(5): 405-409.

  • Glantz, Leonard H. "Controlling tobacco advertising: The FDA regulations and the first amendment." American Journal of Public Health, 1997, 87(3):446-451.

  • "Dealing with tobacco-the implications of a legislative settlement with the tobacco industry." American Journal of Public Health, 1997, 87(6):906-909.

  • Bartholomew, Anita. "What you don't know about secondhand smoke." Readers Digest, 1997(July): 140-144.

  • Jacobson, Laurie. "The smoke screen: Stars who made smoking an art." Smoke, 1995(fall): 88-96.

    E.II.

  • Muller, Charlotte. "A window on the past: The position of the client in 20th century public health thought and practice." American Journal of Public Health, 1985, 75(5): 470-476.

  • Thomas G. Benedek, M. D.; Jonathon Erlen, Ph.D. "The scientific environment of the Tuskegee Study of Syphilis, 1920-1960." Perspectives in Biology and Medicine, 1999 (August): 1-30.

  • Gamble, Vanessa N. "Under the shadow of Tuskegee: African Americans and health care." American Journal of Public Health, 1997, 87 (11): 1773-1778.

  • Rosner, David. "Health care for the 'truly needy': 19th century origins of the concept." Milbank Quarterly, 1982, 60: 355-385.

  • Courtwright, David T. "Public health and public wealth: Social costs as a basis for restrictive policies." Milbank Quarterly, 1980, 58: 268-282.

  • Numbers, Ronald L. "The third party: Health insurance in America." In Sickness and Health in America, 1985, pp. 233-247.

  • Poen, Monte M. "The Truman legacy: Retreat to medicare." in Compulsory Health Insurance: The Continuing Debate, pp. 97-114.

  • Starr, Paul. "Transformation of defeat: The changing objectives of national health insurance, 1915-1980." in Compulsory Health Insurance: The Continuing Debate, pp. 115-144.

  • Marmor, Theodore R.; and Mashaw, Jerry L. "Canada's health insurance and ours: The real lessons, the big choices." in The Sociology of Health & Illness. 4th ed., pp. 470-480.

  • Feingold, Eugene. "The defeat of health care reform: Misplaced mistrust in government." American Journal of Public Health, 1995, 85 (12): 1619-1622.

    E.III.

  • Knowles, John H. "The responsibility of the individual." from Daedalus (Winter) 1977, Doing Better and Feeling Worse: Health in the United States (Boston: Journal of the American Academy of Arts and Sciences). Also in Conrad and Kern, 2nd edition, 1986, The Sociology of Health and Illness: Critical Perspectives, pp. 358-369.

  • Taylor, Rosemary C.R. "The politics of prevention." In Peter Conrad and Rochelle C. Kern eds., The Sociology of Health and Illness: Critical Perspectives, 2nd edition New York: St. Martin's Press, 1986: pp. 471-484.

  • McKinlay, John B. "A case for refocusing upstream: The political economy of illness." In Conrad and Kern, 2nd edition, 1986, The Sociology of Health and Illness: Critical Perspectives. pp. 484-498.

  • Crawford, Robert. "You are dangerous to your health: Ideology and politics of victim blaming." International Journal of Health Services, 1977, 87: 663-680.

  • Minkler, Meredith. "Health education, health promotion and the open society: An historical perspective." Health Education Quarterly, 1989, 16(1):17-30.

  • Coreil, Jeannie; and Levin, Jeffrey S. "A critique of the life style concept in public health education." International Quarterly of Community Health Education, 1985, 5(2): 103-114.

APRIL 10-17-24

F.I-III Student Papers.

  1. Students' research papers presentations.

No Reading Assignments

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