Public Health and Public Policy

The objective of this course is to provide an introduction to the principles and methods of epidemiology, defined as the study of the distribution and determinants of disease in populations. Lectures, problem sets, and outside reading will cover ecologic, case-control, cohort, and experimental studies. Topics to be discussed will include study design, measures of disease risk, sources of bias, methods of controlling for extraneous factors, principles of screening, and interpretation of data. Illustrations will include classic and contemporary examples in acute and chronic disease.

This is the first part of a two-part course. Registration is required separately for each part of the course.

The objective of this course is to provide an introduction to the principles and methods of epidemiology, defined as the study of the distribution and determinants of disease in populations. Lectures, problem sets, and outside reading will cover ecologic, case-control, cohort, and experimental studies. Topics to be discussed will include study design, measures of disease risk, sources of bias, methods of controlling for extraneous factors, principles of screening, and interpretation of data. Illustrations will include classic and contemporary examples in acute and chronic disease.

This is the second part of a two-part course. The completion of the first part (PBHL 317) is required before taking the second part. Registration is required separately for each part of the course.

The purpose of this course is to provide an introduction to the social factors that impact individual and population health. The course presents students with theories and evidence supporting multiple underlying determinants of health in populations. We consider how health is affected by a variety of determinants, and we will explore how social influences affect population health. Social influences include socioeconomic status, environment, policy, gender, race, sexual orientation, and neighborhood quality. We examine structural factors that impact population health in the United States, and we explore the potential for structural interventions to address health inequities and improve population health outcomes.

This course will provide an overview of topics that are important for the understanding of global health from an infectious disease perspective. Students will be exposed to subjects ranging from the biological characteristics that increase the chance of a pathogen causing a pandemic, the basics of epidemiology of infectious disease transmission, One Health and the environment, public health preparedness, scientific communication before and during a pandemic, and international policy and response. Historic examples, scientific literature, and current news will be used to illustrate these topics.  Students will have the opportunity to explore these aspects of infectious diseases in depth throughout the course through the development of a multi-part term paper on a selected infectious disease.

Global health has traditionally focused on communicable, or infectious, diseases. However, 71% of all deaths globally can be attributed to non-communicable diseases, such as cardiovascular diseases, cancers, and diabetes. Eighty percent of all cardiovascular deaths occur in low- and middle-income countries. The burden of non-communicable diseases is also unequally distributed within high-income countries. This course aims to provide an overview of the epidemiology, etiology, and interventions for non-communicable diseases among the world’s disadvantaged populations. We will not only focus on populations in low-resource settings but also on ethnic minority groups and migrant populations living in high-income countries, such as the US and Europe. Students will learn to use data to debunk misconceptions in global health, to examine social, environmental, lifestyle, and genetic causes of non-communicable diseases in diverse populations, and to evaluate and critique interventions.

Global Health is described as “an area for study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide” (Koplan J, 2009. Lancet. 373:1993). During the course, a broad snapshot of global health will be presented, providing students with insight into the challenges currently facing global health. Students will also gain an understanding of why tackling global health issues is such an important endeavor with the potential to reduce poverty, build stronger economies, and promote peace. Students will not only be exposed to the major communicable and non-communicable diseases posing a profound effect on health (especially within the developing world), but will also learn how socioeconomic and demographic differences can influence the burden of disease. A number of other critical underlying factors, including environmental, behavioral, and cultural influences, will be also presented. Through the use of case reports from around the world, the course will explore how research findings are transferred into policy and practice. Students will be encouraged to understand that solving global-health problems requires the input of multiple disciplines. To emphasize this point, speakers will be drawn from diverse fields, including the sciences, ethics, economics, and diplomacy. An interactive group exercise will be part of the course.

Environmental health is the branch of public health that deals with the human health effects of exposure to chemical, physical, biological, and psychosocial agents in the community, workplace, and at home. Environmental health as a discipline includes the fields of medicine and epidemiology as well as ecology and environmental policy. Environmental health scientists focus on recognizing, studying, and mitigating the impacts of chemical, physical, and biological agents as well as on understanding how human behavior and actions (and inactions) impact the environment. The field of environmental health is multidisciplinary and relies on team-science approaches. The course surveys the essential scientific components and control strategies of major environmental health problems.

This course will serve as an introduction to alcohol and its effects across the lifespan, with emphasis on examining how alcohol use and the risk for alcohol-related problems change over a person’s lifespan. This course is taught at the graduate level and is designed to help students understand the importance of preventing, diagnosing, and treating alcohol misuse and alcohol use disorders. It is also designed to help students understand how various stages of development have different risks for problematic drinking behaviors, while the lifespan-development approach will give students a framework from which to work. Topics will include: epidemiology of alcohol use; neurobiology of addiction; genetics of alcohol, fetal alcohol spectrum disorders; binge drinking; health consequences of drinking (including liver disease and various cancers); prevention of alcohol use disorders; treatment of alcohol use disorder (AUD); and, medications management. Lectures will include discussions of the latest alcohol research findings and evidence-based practices, with ample time allowed for questions and answers at the end.

The social and behavioral sciences in public health address the behavioral, social, and cultural factors related to individual and population health and health disparities over the course of life. Research and practice in this area contributes to the development, administration, and evaluation of programs and policies in public health and health services to promote and sustain healthy environments and healthy lives for individuals and populations.

This course provides an analysis of the current organizational arrangements and patterns for provision and financing of medical care services in the U.S. Specifically, topics would include: the medical care process, policies, and factors which affect need, access, and use of services; factors affecting supply and distribution of health professionals and health facilities; current issues pertinent to these healthcare services; factors related to healthcare costs; quality assessment and assurance; and, financing of care through health insurance and governmental programs. Additionally, the course covers the various components of the U.S. healthcare system over the entire continuum of care. Attention will be given to private and public financing mechanisms, the forces of market competition, government regulation, and the impact of health policy on key stakeholders.

This course provides an analysis of the current organizational arrangements and patterns for provision and financing of medical care services in the U.S. Specifically, topics would include: the medical care process, policies, and factors which affect need, access, and use of services; factors affecting supply and distribution of health professionals and health facilities; current issues pertinent to these healthcare services; factors related to healthcare costs; quality assessment and assurance; and, financing of care through health insurance and governmental programs. Additionally, the course covers the various components of the U.S. healthcare system over the entire continuum of care. Attention will be given to private and public financing mechanisms, the forces of market competition, government regulation, and the impact of health policy on key stakeholders.

Government agencies and private organizations have implemented multiple health programs. Usually, labor and resources are spent developing and implementing these programs. But, how do we know if public needs are being addressed? How can we tell if it works? If it does work, how well does it work? If it does not work, what is the reason for it? Can it be fixed? The answers to these questions are at the heart of program evaluation. This has led to program evaluation rapidly gaining visibility and prominence as an objective basis for program and policy decision making. This course will introduce students to program evaluation approaches and methodological tools that can be used to evaluate public health programs and research.

Government agencies and private organizations have implemented multiple health programs. Usually, labor and resources are spent developing and implementing these programs. But, how do we know if public needs are being addressed? How can we tell if it works? If it does work, how well does it work? If it does not work, what is the reason for it? Can it be fixed? The answers to these questions are at the heart of program evaluation. This has led to program evaluation rapidly gaining visibility and prominence as an objective basis for program and policy decision making. This course will introduce students to program evaluation approaches and methodological tools that can be used to evaluate public health programs and research.

Cancer screening aims to detect the disease at a stage when it is asymptomatic and curable. This course will introduce students to the theory and practice of cancer screening in the United States. Students will learn to draw conclusions about the benefits and harms of screening for cancer, given available evidence from epidemiologic studies and clinical trials. Issues surrounding screening for breast, colorectal, lung, cervical, and prostate cancer will be covered; other cancers will be covered if time permits. Class sessions will include lectures as well as student-led discussions.

The policy-making process plays a key role in the sciences and medicine. Initiatives proposed by advocacy groups and decisions made by legislators can influence research funding, disease prevention, healthcare delivery, patient engagement, professional regulations, and workforce infrastructure. This seminar-format course will provide an opportunity to examine current issues drawn from public health, workforce development, healthcare innovation, clinical practice, and biomedical research. Oral presentations and brief written exercises will allow students to further refine their skills in communication, research, analysis, and critical thinking.

This course provides an overview of concepts and issues related to healthcare leadership through competency-based learning. Through the examination of management topics and healthcare situations, students explore the skills and knowledge needed to be successful in a diverse healthcare environment. Topics include: healthcare leadership; organizational design as it relates to the uniqueness of healthcare organizations; managing professionals; and, diversity in the workplace. Day-to-day operational management of healthcare organizations, including hospitals, private practice, ambulatory settings, and specialty services, with a focus on issues influencing the administration of today’s healthcare organizations will be also evaluated. Specifically, attention will be given to those issues that affect the delivery of care, and how decisions are made and can evolve into the development of new initiatives.

This course provides an overview of concepts and issues related to healthcare leadership through competency-based learning. Through the examination of management topics and healthcare situations, students explore the skills and knowledge needed to be successful in a diverse healthcare environment. Topics include: healthcare leadership; organizational design as it relates to the uniqueness of healthcare organizations; managing professionals; and, diversity in the workplace. Day-to-day operational management of healthcare organizations, including hospitals, private practice, ambulatory settings, and specialty services, with a focus on issues influencing the administration of today’s healthcare organizations will be also evaluated. Specifically, attention will be given to those issues that affect the delivery of care, and how decisions are made and can evolve into the development of new initiatives.

Each year, the federal government makes considerable amounts of population health data available to researchers.  In this course, students will gain theoretical and practical knowledge of databases that are frequently used to support population health, health policy and health services research, including the NHANES, NHIS, NEDS, and MEPS.  Understanding and selection of research designs and statistical methods will be reinforced through the review of select manuscripts from the population health, health policy, and health services literature.  Didactic material and problem sets will enable students to use SAS and STATA for preparing datasets, creating customized variables, and conducting common statistical analyses.  Further, students will build and reinforce skills in research question development, project design, data management, statistical analyses, technical writing, and data presentation through a course-long research project.

Evaluators are expected to be proficient in the use of both qualitative and quantitative research methods; however, many persons assigned evaluation tasks have no formal training in designing, collecting, analyzing, and reporting qualitative data. Commonly used qualitative methods in program and policy analysis include document reviews, individual and group interviews, and observations. In this introductory course, we will review the collection, analysis, and reporting of qualitative data used in the evaluation of public health policies and programs.

Logic models are a tool that support designing, planning, changing, monitoring, and evaluating programs. These evidence-based models can be an aid in multiple contexts ranging from basic research programs to community-based initiatives. An added benefit of modeling is that it can enhance stakeholders understanding of the relationship between resources, actions, outcomes, and impacts and thereby aid decision making. In this course, we will discuss how to build and use a logic model for biomedical research and public health programs.

The evaluation of research, particularly biomedical research, has entered a period of intense demand for rigorous methods and actionable results, including economic analyses. Several years ago, the NIH convened an expert external panel to consider the broad area of assessing the value of biomedical research. The panel put forward an overarching assessment and measurement framework that included healthcare costs as an output and healthcare-related costs savings as an outcome. Challenges and opportunities exist in meeting this demand. Two distinct perspectives are important: one is the perspective of a grantee or principal investigator who uses economic variables to establish the need and predicted outcomes for basic or applied research for specific observed health conditions, as well as the efficiency and costs of the research; the other perspective is that of the science policy in which the grantor has the need to establish research priorities and evaluate research program efficiency and costs. In this introductory class, students will learn the foundations of health economics and econometric modeling and will apply them to the evaluation of biomedical research and public health programs.

The public funding of research includes many discrete components: setting research priorities; securing funds; funding research infrastructure; selecting and funding meritorious projects; conducting research; monitoring research progress; communicating research findings; and, training researchers. This survey course is deigned to review theories, methods, and practices in program and policy evaluation as they relate to research, particularly publicly funded biomedical research. The full range of the evaluation hierarchy (needs assessment and program planning, feasibility and implementation evaluation, process evaluation, and outcome and impact evaluation) will be considered as students will be guided to develop a comprehensive framework for the evaluation of federally funded biomedical research.

Whether you’re a scientist, engineer, or health professional interested in a career in science and technology policy or a researcher who’s interested in improving how they describe the potential societal implications of their research, you need better understanding of science and technology policy. You also need to understand the key principles involved in evaluating programs, analyzing potential public policies that might respond to societal implications, and then communicating your results to policymakers and the public.

Policy analysis provides a systematic process to analyze public policy options to respond to a societal challenge such as COVID-19, climate change, and homelessness.  It involves identifying the underlying problem, key decision makers, stakeholders, policy question, and policy options.  These options are then analyzed to identify which is likely to be the most effective, efficient, equitable, and ease of political acceptability.  Once that analysis is concluded, the analyst makes a recommendation based on those criteria.  The analyst then communicates the results to policymakers and the public.

Benefit-cost analysis, cost-effectiveness analysis, and risk analysis are quantitative techniques used to support the assessment of effectiveness, efficiency and equity in the policy analysis process.  More than any other analytical technique they are critical in policymaker decision-making as benefit-cost is required by executive orders or regulations and risk-based regulations and enforcement activities -- particularly those related to the environment, health, worker safety, transportation, privacy/security, and energy policy.

While policy analysis focuses on the future, program evaluation looks at the past performance of a program to see if it has met its societal goals,  how it can be improved, and whether funding for that program should be continued.  

Whatever the source of funding for your program, you'll likely be asked to evaluate it on a regular basis.  And when developing a proposal for funding, one common element requested is how you will evaluate the program to determine if it is successful in achieving the proposed outcomes.  

And when doing a policy analysis, your first step is to understand the "status quo."    That is, what is the current program and how well does it work according to the 4E's: effectiveness, efficiency, equity, and ease of political acceptability.  Based on this information, you can develop policy options to respond to what does not work well in the current program while maintaining those elements that do work well relative to the desired societal outcome.

Science and medicine are often thought of as life-saving, life-changing, and pillars of which we measure progress. However, we must always keep in mind the darker implications of tomorrow's scientific advancements. In this course you will learn to have a more holistic view of science and medicine by studying these topics through a national security lens. Students will have the opportunity to further their knowledge in the sciences while also learning new skills found in the national security field. Some of the subjects covered include chemical and biological weapons, industrial espionage, and climate change, all presented within a national security theme.

When it comes to national security, America must be prepared for more than just acts of terrorism, climate change, nuclear proliferation, and the other hot button issues. America’s public health and the health of global citizens is also a pressing concern. In this course, you will learn to have a more holistic view of the health industry by viewing it through a national security lens. Not only will you further your knowledge on health topics but you will gain new skills while working through these issues as a national security analyst. Some of the subjects covered include communicable diseases, the transnational nature of health issues, drug/alcohol abuse, inadequate access to health services, and more; all presented with a national security theme.

We live in times of evidence-based medicine, where we use the best evidence available to make decisions about patient care and healthcare interventions at population level. But what is the best evidence available? Usually a research question is studied more than once, often by independent research teams in different locations. In many instances, the results of these multiple small studies are diverse and conflicting, making it difficult to draw a conclusion regarding the answer to the question under study. That’s where systematic reviews come in. Systematic reviews integrate and synthesize the results of several independent studies on a given research question in order to provide a summary of the literature that can inform practice. Moreover, systematic reviews may reveal heterogeneity in results, leading to new research hypotheses about sources of such heterogeneity. Systematic reviews can be qualitative or quantitative. Meta-analysis, top-ranking in the hierarchy of evidence, is a statistical procedure that in some cases can be applied to a quantitative systematic review.