History 387 Health Environments in Asia
David Ludden (homepage)
THE COURSE
This course explores health environments,the complex of changing conditions that influence human health and its improvement or deterioration. We focus on recent historical dynamics of health environments across Asia (including the Middle East and Africa's Indian Ocean coastal regions) where health conditions are now undergoing dramatic change that affect the majority of the world's poor and young.We consider national contexts in their distinct particularity but also consider research problems comparatively, using data from far-flung regions.
The central goal of the course is to foster student research. With this in view, course content varies each term. We always cover a standard set of topics but consider cases according to student research interests.
RESEARCH
We develop research in stages, starting in the first weeks of class. Students should join the class with some idea of topics they would like to explore. Students do weekly assignments and produce a final project that can consist of a collection of work over the term. Students discuss their work in in class each week. See weekly assignments below for details.
ASSIGNMENTS and GRADING .........................(points and letter grade equivalents)
Grading for the course is based 70% on (seven 10-point) weekly assignments and 30% on the final project. All eight grades include written work and class presentation.
ALL assignments require that DOC or XLS format files be attached to the Blackboard site by 12 noon each Tuesday before class to receive full marks. No extensions. Late work is penalized 2 points. On time delivery allows us to consider student work in class.
Class participation grades appear separately on BlackBoard and preparedness for class discussion of weekly reading topics. We take attendance each week. Every student starts the term with a full 20 point participation credit and starting in Week 3 (when Drop-Add shopping should have settled down), each absence from class costs participation points. Preparedness scores derive from an assessment student responses to questions and informed, thoughtful discussion. If preparedness seems to be flagging, students will get an email on the topic, and continued unpreparedness will bring point deductions.
HISTORY and OTHER DISCIPLINES
Students in all disciplines are welcome to take this course. We pursue an open-ended, multi-disciplinary approach to the study of health environments.
Please note, however, that if you want to use this course to satisfy the History Major research requirement, you must write a twenty-page synthetic final paper based on primary sources. See instructor for details.
Books to Buy At House of Our Own Bookstore, 3920 Spruce
Poverty and Famines: An Essay on Entitlement and Deprivation
by Amartya Sen (Oxford University Press 1983)
Randall Packard, White plague, black labor: tuberculosis and the political economy of health and disease in South Africa. (Berkeley, 1989).
Veena Talwar Oldenburg, Dowry Murder: The Imperial Origins of a Cultural Crime (Oxford, 2002)
2006 Spring Term
Weeks. Dates. Topics. Reading. Assignments
NOTE: Access to many online reading links below is restricted to PennCard holders)
* marks mandatory reading. All others optional
1. Jan. 10.
Introduction.
Health...... Health Environments.... in Asia (maps 1, 2,3,4)
Elements of Health Environments and Enduring Problems for Research
A Framework of Causal Connections
2. Jan. 17.
The Political Economy of Health: Entitlement, Markets, and State Policy.
Read:
*Sen,Poverty and Famines. Focus on 1943-4 Bengal and 1974 Bangladesh.
3. Jan. 24.
The Importance of Location: Nature, Resources, Occupation, in City, Country, Forest, Desert
Read:
*Sen, Poverty and Famines. Focus on Sahel and Ethiopia.
Stephen Devereux, "Sen's entitlement approach: critiques and counter-critiques." Oxford Development Studies, 29, 3, 2001
4. Jan. 31. Research Step 1 (keywords gleaned from last week class discussion)
Library research session with Laurie Allen in Glossberg Room in Lippincott Library at 4PM.
To prepare for the library session, compose a paragraph or two describing a research topic idea that will serve as your starting point for independent research. This is just a starting point. Feel free to explain why this topic interests you. This can be informal, personal prose. Attach it to Blackboard assignment called Research1.
ALSO EMAIL your description of your project --- highlighting its KEYWORDS for searching -- to Laurie Allen (laallen@pobox.upenn.edu). Laurie is available whenever students need library help.
Pay attention and make the most of the Library session. See Research2 Assignment for next week.
5. Feb. 7.
Nutrition and Malnutrition: Chronic Disease, Incapacity, and Healthy Life Expectancy (HALE).
Read
*Gerald Keutsch, "The History of Nutrition: Malnutrition, Infection, and Immunity," The Fogarty International Center, American Society for Nutritional Sciences.
*Mark Wahlqyist, on "eco-nutritional disease nomenclature." (PDF) (original Asian Pacific Journal of Clinical Nutrition site, with related articles)
*Chapter Two, "Malnutrition in Asia and the Pacific" (onsite) (local) from The Double Burden of Malnutrition in Asia. (exec summary pdf) (full text) by Stuart Gillespie and Lawrence Haddad
L.Wang, et.al. "Preventing Chronic Diseases in China," Lancet, 386: 2005, 1821-1824.
Ines Reinhart KBS Wijayaratne, "The Use of Stunting and Wasting as Indicators of Food Insecurity and Poverty"
Assignment: Research2.
Identify one or two research publications, books or articles, that address your topic in one way or another. Write a short essay on the topics of those publications, how the authors handle their topics, and how their work might pertain to yours. You need to start using the library and looking for and reading material that pertains to your topic. See also Research3 below.
6. Feb. 14.
Health Inequality: National Disparities, Economic Growth, and Remediation
Read:
*I.Kawachi and BP Kennedy, The Health of Nations: Inequality is bad for your health. New York, 1999. JAMA Review.
*UN World Social Situation, 2005. Chapter Three, "Trends and Patterns of Inequality," (38pp)(onsite)(local) (full text)(exec summary)
*Peter McIntyre and Robert Menzies, "Immunization: reducing health inequality for indigenous Australians," Australian Medical Journal, 205, 182 (5), 207-208. (local)
*Harold Alderman, Hans Hoogeveen, and Mariacristina Rossi, “Reducing child malnutrition in Tanzania : Combined effects of income growth and program interventions,” Economics and Human Biology, 4, 1, 2006, 1-23.
Eve Blair, Stephen Zubrick and Adele Cox, "The Western Australian Aboriginal Child Health Survey: findings to date on adolescents," Australian Medical Journal, 2005; 183 (8) : 433-435
Nguyen Minh Thang, “In an era of economic growth, is inequity holding back reductions in child malnutrition in Vietnam?” Asia Pacific Journal of Clinical Nutrition; 2003, Vol. 12 Issue 4, p405-410
BBC news. "Health inequality gap widening in Britain."
Assignment: Research3
Using the sources identified in Research2, expand your consideration of your topic to include problems posed by entitlement inequalities. Write a short essay to indicate that you can integrate the problem of inequality -- on any vectors you consider most relevant -- into your research agenda. If your basic research theme is some kind of inequality, consider another kind in this assignment. For instance, if your research focuses on gender, consider income, caste, class, ethnicity, location, or some other vector of inequality.
7. Feb. 21.
Data, Measurements, and Research Strategies. Empirical Patterns and Policy Implications.
Read:
*Colin D Mathers, et. al. “Global patterns of healthy life expectancy in the year 2002,” by (at original site) (local PDF)
*Osman Galal, “Nutrition related health patterns in the Middle East,” Asia Pacific Journal of Clinical Nutrition (HEC Press). 2003, Vol. 12 Issue 3, p337-343. (ABSTRACT only PDF)
*Stanley J. Ulijaszek, “Trends in body size, diet and food availability in the Cook Islands in the second half of the 20th century,” Economics and Human Biology 1, 2003, 123-137.
REF: Search for subjects of interest
DALE and DALY ... WHO DALE statistics ..... WHO stat page ...
Economics and Human Biology...
Free Medical Journals page ... New England Journal of Medicine ... JAMA ... Vaccine
Asian Pacific Journal of Clinical Nutrition (TOC and abstracts) .(full text via Penn Library to 2002 )...
Emerging Infectious Diseases
Assignment: Research4
Identity a body of quantitative or qualitative empirical evidence that you can use to address your research topic. Formulate an hypothesis -- an argument of some kind -- that you can explore using empirical evidence. The simplest solution is to use data that an author of one of your readings has already used. The goal here is to indicate how some specific body of data supports a specific set of conclusions about a particular problem and (perhaps, but not necessarily) a policy choice.
8. Feb. 28.
Gender: Coping, Work, Inequality, Vulnerability, and "Transmission."
Read:
*Bina Agarwal, "Gender Relations and Food Security: Coping with Seasonality, Drought, and Famine in South Asia." (local PDF)
*S.Osmani and A.Sen, "Hidden penalties of gender inequality: fetal origins of ill-health," Economics and Human Biology, 1, 2003, 105-21. (local PDF) (online original site with links)
*H.Yang, et. al. "Workplace and HIV-related behaviors and perceptions among female migrant workers," AIDS Care, Oct. 2005, 17, 7, 819-33.
Amartya Sen, " ... Gender Inequality " ... " "Missing Women," ...
Oldenburg, Dowry Murder: The Imperial Origins of a Cultural Crime
World Sex Ratio Maps
T.Heskith, et. al, "HIV knowledge and risk behavior of female sex workers in Yunnan Province, China: Potential as bridging groups to the general poplation," AIDS Care, Nov. 2005, 17, 8, 958-66.
Assignment: Research5
Write a few paragraphs that apply a gender lens to you research topic. Come to class ready to discuss the implications of gender analysis for your research. If your basic research subject is already gender, you must indicate in this assignment how your specific case study pertains to larger questions and problems of gender studies. For instance, if you are centrally concerned with a gender work issue like sex-work, you might consider another work environment, such as agriculture, or home work; or if you are concerned with problems in one country, you might consider another to engage comparison.
Spring Break. Enjoy!
9. Mar. 14.
Disease: Treatment, Prevention, Technology Options, Water, and Public Health
Read:
*Denise DeRoeck, et. al. "Policymakers’ views regarding the introduction of new-generation vaccines against typhoid fever, shigellosis and cholera in Asia," by. Vaccine, 23, 21, April 2005, 2762-2774. (Full text with links, original site) (PDF local)
Ref: CDC disease listing .. old (archaic) disease names and definitions.
*A.V.Patil, et. al, "Current Health Scenario in Rural India," Australian Journal of Rural Health, 10, 2002, 126-35
T Thompson, et. al, "Providing clean water, keeping water clean: an integrated approach," International Journal of Environmental Health Research, 13, 2003, S89-94.
KM Lokuge et.al. "The Effect of Arsenic Mitigation Interventions on Disease Burden in Bangladesh,"Environmental Health Perspectives, 112,11, 2004, 1172-9
TV Luong, "Deworming children and hygeine intervention," International Journal of Environmental Health Research, 13, 2003, S153-9.
MJ Toole and RJ Waldman, "The Public Health Aspects of Complex Emergencies and Refugee Situations," Annual Review of Public Health, 18, 1997, 283-312.
NY Times on Type 2 Diabetes and insurance priorities.
NY Times on Type 2 Diabetes in East Harlem and Upper East Side
Assignment: Research6
Write a few paragraphs indicating what kind of disease issues are most important for your research environment. This exercise is primarily descriptive: the question is, what sickness issues are MOST important in your particular research context?
In addition, you should also consider how in THIS environment, particular curative, preventive, and ameliorative intervention priorities make sense. For instance, if in your environment, HIV/AIDS is the main issue, then providing clean water would be top priority, which it would if the main problem were shigellosis. If chronic diseases are the main issue, then curative solutions may not be the most logical public health priority.
10. Mar. 21.
Urbanization: Development, Density, Infrastructure, and Population
Read:
*Randall Packard, White plague, black labor. Epilogue.
*Carolyn Stephens, "Health cities or unhealthy islands? The health and social implications of urban inequality," Environment and Urbanization, 82, 2, 1996, 9-31.
*Rainer Gross, "Beyond food and nutrition: how can cities be made healthy?" Asia Pacific Journal of Clinical Nutrition,2002, 11 (supp), S763-6.
AHM Kabir, "Development and Human Rights: Litigating the Right to Adequate Housing," Asia-Pacific Journal of Human Rights and Law, 2002, 1, 97-119.
Eliot D. Sclar, et. al, "The 21st century challenge of slums and cities," Lancet, 365, 2005, 901-903.
Special Issue of Journal of Developing Societies on Bangladesh, edited by Anil Deolalikar
Assignment: Research7
Write a few paragraphs, using appropriate empirical data -- either quantitative or qualitative -- to assess change over time in some feature of a health environment. If you are interested in disease prevalance, changes in prevalence would be an appropriate topic; if your concern is health delivery or inequalities, trends in rates and magnitudes would be good to study. Whatever your topic, changes over time in approaches to issues of concern and to solutions to problems in some specific health environment are good topics. Medical disoveries, scientific breakthroughs, and institutional policy changes are of course important.
One critically important topic would be the history of the creation of a specific health problem as a problem, as we discussed, for instance for the case of AIDS in Southeast Asia and its connection to sex work, heroin, and post-1945 warfare.
11. Mar. 28.
Economic Growth, Structure Adjustment, and Health
Third World Network Report
WHO Commission on Microeconomics and Health
Assignment: Research8: Class presentations and discussion of projects.
PUT ON BLACKBOARD AND BRING TO CLASS outline of final project for discussion. The goal here is to have something ready to discuss that indicates all the elements of your final project. Be prepared to revise this outline -- to add and elaborate elements on the outline -- as a result of class discussion.
IF you want to present outlines in Powerpoint, bring the file to class!
12.Apr. 4.
Assignment: Research9: Class presentations and discussion of projects.
TODAY a COMPLETE DRAFT of final project is due. Post on Blackboard and be ready to discuss it in class. We will discuss half of these drafts today and the other half in two weeks. BUT DRAFTS FROM EVERYONE are due today.
13. Apr. 11. I am away. No class.
14. Apr. 18.
Discussion of second set of Final Project Drafts.
CLOSING TIME: Apr. 25. TUESDAY. 5 PM.
Assignment: Research10
FINAL DRAFT OF FINAL PROJECT DUE by 5PM April 25.
The BB site will close down and no more work will be accepted after 5PM today. Final grades will be posted on BB within one week. NO EXTENSIONS.