Ho 100: Health of Under Served Communities



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HO 100: Health of Under Served Communities
Spring 2007 Friday: 9:00 a.m. – 12:00 noon SL 108
Ralph Casas, Pharm.D., Ph.D. • (562) 860-2451 Ext. 2565 • email: rpcasas@cerritos.edu


Course Description: HO 100 provides an overview of the dynamics and processes underlying the health profiles of underserved communities. Population projections, population characteristics, birth rates and outcomes, causes of death and death rates, patterns of reportable diseases, services utilization, patterns of immigration, health insurance, provider training, risk behaviors, and chronic diseases are explored.
General Statement of Purpose: A primary goal of HO 100 is to transform your personal experience with health into an educational goal of attaining a career in the health-care professions (medicine, dentistry, nursing, pharmacy, public health, optometry, or other allied health-care professions).
Learning Objectives: HO 100 has three learning objectives:

  • To introduce the history of communities that are under-represented in medicine.

  • To present the current health and social conditions facing URM communities.

  • To explore the paths from post-secondary school to health-care professional careers.


Texts:

  • HO 100 Class Reader

  • Bodenheimer, Thomas S. and Kevin Grumbach. Understanding Health Policy: A Clinical Approach, 4th edition


Recommended Texts: (To be placed on reserve in the library)

  • Hayes-Bautista and Chiprut, Healing Latinos: Realidad y Fantasia

  • Hayes-Bautista, David E. La Nueva California: Latinos in the Golden State. University of California Press, 2004

  • Alvord and Van Pelt, “The Scalpel and the Silver Bear”


Office Hours: Wednesday, 12:00 – 1:00 pm; Thursday morning, 9:00 – 10:00 am and by arrangement. Office hours are set aside to help students who have been faithful in doing their work; office hours are not set aside to re-teach the class to students who have missed a class. If you have an emergency that needs discussion, if you are confused, if you want assistance, if you need a letter of recommendation, if you would like to talk about your academic program—drop by the office. You always are welcome!
Instructional Methods: Most classes are conducted in a seminar format where you will have an opportunity to interact with your classmates in both small and large group activities. Discussions are crucial to the success of the course. Please come to class on time and ready to participate. This means read all assignments and prepare for the discussion topics outlined. Guest lectures will be followed by a question-and-answer session during which your participation is essential.

Learner Responsibilities—Basic Commitments:


  • You are here because you chose to be. Therefore, I expect that you will care about the topics, want to do well, and know you can succeed.

  • You agree to come to every session on time, prepared and ready to engage in active discussion.

  • You know you can bring questions about the material to the professor(s) and that you need to double check if any comments or standards are unclear.

  • You will take advantage of all legitimate help, such as librarians, peer tutors, dictionaries, handbooks, and office hours.

  • Because it takes time to produce anything of worth, you are prepared to spend at least two hours outside this seminar working on the material for each hour you spend in the classroom.


Class Guidelines

  • Cell phones: Are disruptions to the class. They will be turned off before every class. Calls will NEVER be answered in class!!! This includes excusing yourself from the room to take the call. No call is that important to disrupt your involvement, your classmate’s, or the instructor’s. If you are expecting an emergency phone call, you must let me know prior to class.




  • Attendance: Attendance is mandatory. Excused absences are deaths in the family, approved educational field trips or school activities and/or medical reasons. You must provide documentation to receive an excused absence. Arriving late to class or leaving early will result in a deduction of participation points for each occurrence. Absences on presentation days will result in double the deduction.




  • Due Dates: All assignments will be announced and explained sufficiently prior to due dates, allowing ample time to be completed and prepared. If you cannot attend class the day an assignment/ presentation is due or an exam is scheduled, you must make alternate arrangements to get the assignment to me (e.g., a trusted friend). Note: As stated previously, absences and thus missed exams, presentations, or assignments are excused only in case of emergencies; and can only be made up in these instances. If possible, assignments may be turned in early. (If you have concerns, difficulties, or problems completing any assignment, please see me prior to the due date. I am here to ensure your success as a student!




  • Academic Honesty and Plagiarism: Quizzes, presentations and exams are individual assignments and are graded as such; therefore, it is expected that they will be completed as individual work. Cheating or any form of academic dishonesty are grounds for disciplinary action and will result at minimal in the failing of the course. (Plagiarism can encompass more than just copying off another student. Plagiarism describes the act of using any idea, quote, or piece of information that you borrowed from another source without giving that source credit. This means that even if you do not directly quote someone, if they gave you the information behind your idea, you must give them credit!)




  • Incompletes: Incompletes will be given only for extremely compelling reasons and when all course requirements and college policies are met.




  • Extra Help: All students are encouraged to seek help when needed. Reading each others work can sharpen editing skills and develop a sense of audience for both parties. It is perfectly legitimate to ask fellow students, loved ones, or professional associates for suggestions. Handbooks and computer programs exist to help you. Each student at Cerritos College is entitled to free tutoring at the tutoring center.




  • Methods of Evaluation: Each student will be evaluated based upon her/his,




  1. Classroom activities: participation in discussions and group work.

  2. Classroom presentations

  3. Completion of assignments

  4. Final exam



Grading system

Response Assignments 75 points *

Web Posts 75 points **

Classwork/Participation 100 points ***

Quizzes 50 points ****

Project/Paper 100 points *****

Presentation 25 points

Final “Exam” 100 points

Self Evaluations 100 points

TOTAL 625 points


* Response Activities will be in the form of written assignments that reflect your responses to the readings or to the speakers.

** When assigned, you are expected to post messages to the HO 100 message board by 2100 the day before class.

*** Points will be earned by students who actively participate in classroom group activities. To earn these points you must be in class and contribute to the group. Points will be deducted based on tardiness or lack of participation.

**** Quizzes are given at the beginning of class. No make-up quizzes will be given.

***** This class does not have a midterm exam. For your project, you are expected to produce a six-page research paper and present your findings to the class by the end of the semester. This paper will be written in several stages, each of which will be handed in and graded. Your research paper will serve as your final project. The system is as follows:


  1. You will first come up with a topic. Although the topic for your paper is open to choice, there are limits. First, you must choose a health related topic that is related to problems encountered in underserved communities; and, you must develop a policy statement or recommendation about the problem you identify.




  1. Decide the most important question you have about that topic and develop a research question. Be specific.




  1. Find at least 10 sources (only 5 of which are from the internet.).




  1. Develop an annotated bibliography. In it you will detail 10 sources you plan to use in writing your paper. This means you must have a reasonable idea of what the sources say.




  1. After reviewing your sources, you will

  1. Define your issue and develop a thesis statement

  2. Decide what you want to say about your issue

  3. Through your research, find out what others say about your issue

  4. Decide why the issue you chose is important to URM communities.




  1. Through careful research, you will turn in a one to two-page outline of your paper (including your thesis statement).




  1. Turn in a rough draft of your paper.




  1. Present your findings to the class




  1. By the beginning of the week 17, you will turn in your final, typewritten copy of your research paper.

While the topic of your research paper is up to you, you will receive a list of questions to be answered in the body of your paper.



Week 1—January 12, 2007

Course Introduction & Orientation

Lecture Topic: Why am I interested in a career in health care?

  • Assignment: email and web posting #1 (_______ / 10 pts)


Readings


Week 2—January 19, 2007

How Do I Learn?

Lecture Topic: Learning Styles and Education

  • Assignment: Worksheet #1 (_______ / 5 pts)

  • Assignment: Web posting #2 (_______ / 5 pts)


Readings

  • Understanding Health Policy, Ch. 2, “Paying for Healthcare”


Week 3—January 26, 2007

Cerritos College: How to get from A to Z

Lecture Topic: Your College Education (Guest Speaker)

  • Assignment: Your Education Plan for Cerritos College (_______ / 5 pts)

  • Worksheet #2 (_______ / 5 pts)


Readings

  • Reference: Hayes-Bautista D. “America Defines Latinos: 1940-1965” Chapter 1. La Nueva California: Latinos in the Golden State. University Press: Fall 2004.


Week 4—February 2, 2007

Health Careers: How do I get there?

Lecture Topic: Available Health Care Professions and Options (Guest speakers)

  • Assignment: Which health career do I choose? (_______ / 15 pts)

  • Assignment: Web posting #3 (_______ / 5 pts)

  • Worksheet #3 (_______ / 5 pts)


Readings

  • “Health professions and how to get into them” (Reader)

  • Understanding Health Policy, Ch. 17, “The Healthcare Workforce”

  • Reference: Hayes-Bautista D. “Latinos Reject America’s Definition: 1965-1975” Chapter 2. La Nueva California: Latinos in the Golden State


Week 5—February 9, 2007

Population Studies

Lecture Topic: Demographics and Culture: 1940-1970

  • Assignment: Worksheet #4 (_______ / 5 pts)


Readings:

  • History of Latinos & African Americans in California”

  • Understanding Health Policy, Ch. 6, “How Healthcare is Organized”

  • Hayes-Bautista D, Hsu P, Perez A, Kahramanian M I, The Latino Majority Has Emerged: Latinos Comprise Over 50% of all births in California. UCLA: Center for the Study of Latino Health and Culture. 2003.

  • Murphy D E. “ New California identity predicted by researchers: Most newborns in state are now Hispanic” The New York Times, Monday, February 17, 2003.


Learning Objectives:

  • Students will understand the basic demographic dynamics of fertility, mortality and population migration.

  • Students will learn how Latino and African American demographic dynamics differ from non-Hispanic whites.

  • Students will learn why and how the URM communities grew in the late 20th Century.

  • Students will explore and discuss the policy implications of URM population growth.


Week 6—February 16, 2007

School Holiday – No Class

  • Assignment: Web posting #4 (_______ / 5 pts)


Readings:

  • Understanding Health Policy, Ch. 7, “How Healthcare is Organized”

  • Reference: Hayes-Bautista D. “Washington Defines a Minority:1965-1975” Chapter 3. La Nueva California: Latinos in the Golden State


Week 7—February 23, 2007

URM Physician Shortage

Lecture Topic: URM Provider Shortage

  • Assignment: Web posting #5 (_______ / 5 pts)

  • Assignment: TOPIC Due today (_______ / 10 pts)


Readings:


  • “Latino & African American Physician Shortage” (Reader)

  • Understanding Health Policy, Ch. 12, “The Quality of Healthcare”

  • Olivo, Antonio “Study Shows Shortage of Latino MDs in California” Los Angeles Times 19 Jan. 2000, Metro Section B.

  • Hayes-Bautista, David E. and Stein, Robert M. “A Shortage That’s Killing Latinos,” Los Angeles Times 1 Oct. 2000.

  • Prolo, Donald J. “Federal Rules Create Looming Physician Shortage,” San Jose Mercury News, 7 Nov. 2001, 11B.



Learning Objectives:

  • Students will learn how the URM physician shortage developed.

  • Students will understand the policy implications of the provider shortage

  • Students will analyze proposals to address the provider shortage.


Week 8March 2, 2007

Epidemiology

Lecture Topic: Epidemiology and the Latino Epidemiological Paradox

  • Assignment: Review of Sources Due today (_______ / 10 pts)


Readings:

  • Latino & African American Health Profile”

  • Understanding Health Policy, Ch. 3, “Access to Healthcare”

  • Hayes-Bautista, D.E.; Hsu, Paul; Iniguez, D.; Hayes-Bautista, M.; Stein, R.M. “Health and Medicine in the Southwest: A Window to the U.S. in 2050” Medicine in the Américas, 2000, 1(1): 4-12.


Learning objectives:

  • Students will understand the basic epidemiological concepts: such as mortality rate, age adjustment and relative risk.

  • Students will learn the components of the currently used minority health disparity model including: risk factors and adverse health outcomes.

  • Students will learn about the Latino epidemiological paradox.


Week 9March 9, 2007

Health & Culture: Introduction to the Health Care Delivery System

Lecture Topic: Health and Acculturation; Theories of Acculturation and Assimilation

  • Assignment: Essay: “How does culture influence who I am?” (_______ / 20 pts)

  • Assignment: web posting #6 (_______ / 5 pts)

  • Assignment: Research Question(s) Due today (_______ / 10 pts)


Reading:

  • Hayes-Bautista, D.E. “ Research on Culturally Competent Health Care Systems: Less Sensitivity, More Statistics” American Journal of Preventative Medicine.

  • Hayes-Bautista, D.E. “Want to Live Longer? Look to the Latino Lifestyle” Los Angeles Times 18 March 1997.

  • Hayes Bautista, David E. and Rodriguez, Gregory “Cultural Assimilation Is Bad for Your Health” Los Angeles Times 17 Dec. 1995.

  • Reference: Hayes-Bautista D. “Latinos Define Latinos: 1975-1990” Chapter 4. La Nueva California: Latinos in the Golden State


Learning Objectives:

  • Students will learn differences between acculturation and assimilation

  • Students will learn the classic concept of acculturation as a straight line process

  • Students will be familiarized with segmented acculturation


Week 10March 16, 2007

Research and Policy

Lecture Topic: Research and Policy

  • Assignment: web posting #7 (_______ / 5 pts)

  • Assignment: Self-Evaluation (_______ / 50 points)


Readings:


  • Huntington, S. “The Hispanic Challenge” Who are We. Ed. Huntington, Samuel. Simon & Schuster, Inc., N.Y., 2004.

  • Hayes-Bautista, David E, “On Being Latino: As American as a Texan” Los Angeles Times 28 March 1999.

  • Reference: Hayes-Bautista D. “Time of Crisis: Proposition 187 and After, 1990-2000” Chapter 5, La Nueva California: Latinos in the Golden State. University Press: Fall 2004.


Learning Objectives:

  • Students will understand the links between politics, policy and healthcare


Week 11March 23, 2007

Communicable Disease

Lecture Topic: Communicable Diseases

  • Assignment: Annotated Bibliography Due today (_______ / 10 pts)


Readings:

  • Communicable Diseases”

  • “The Tuskegee Syphilis Experiment” (Handout)


Learning Objectives:


  • Students will be exposed to basic epidemiological patterns of communicable diseases in URM populations

  • Students will understand Hepatitis in URM children


Week 12March 30, 2007

STIs, HIV & AIDS

Lecture Topic: STI’s and AIDS

  • Video: Latinos & AIDS

  • Assignment: Outline Due today (_______ / 10 pts)


Readings:

  • HIV/AIDS” (reader)

April 6, 2007: Spring Break

Readings:

  • Reference: Hayes-Bautista D. “Creating a Regional American Identity: 2020-2040” Chapter 7. La Nueva California: Latinos in the Golden State. University Press: Fall 2004.


Week 13—April 13, 2007

Cancer


Topic: Cancer

  • Assignment: FIRST DRAFT DUE TODAY (_______ / 10 pts)


Readings:

  • Cancer Statistics” (Handout)

  • Understanding Health Policy, Ch. 11, “The Prevention of Illness”


Week 14April 20, 2007

Chronic Disease

Lecture Topic: Chronic Disease & Community Empowerment
Readings:

  • Diabetes”

  • Bracho, América. “Tamales for Health.” Healing Latinos: Realidad y Fantasía. Ed. Hayes-Bautista, David E. and Chiprut, Roberto. Los Angeles: Cedar-Sinai Health System, 1998, 97-109.

  • Understanding Health Policy, Ch. 13, “Medical Ethics and the Rationing of Healthcare”

  • Reference: Hayes-Bautista D. “Best-Case and Worst-Case Scenarios: California 2040” Chapter 8. La Nueva California: Latinos in the Golden State.


Learning Objectives

  • Students will understand the difference between communicable diseases and chronic diseases

  • Students will learn about the “epidemiological transition” that occurs in developing countries such as Mexico.

  • Students will understand the role of community health workers in controlling chronic diseases.


Week 15April 27, 2007

Domestic Violence, Drug Abuse & Mental Illness

Lecture Topic: (Guest Speaker) Adolescent Violence in the Latino Community: How did violence become a health policy issue?

  • Assignment: Web response (_______ / 5 pts)


Readings

  • Domestic Violence” (Reader)

  • C. Everett Koop, “Violence as a Public Health Issue”

  • "Critical Disparities in Latino Mental Health"(See HO 100 website)

  • African American Community Mental Health Fact Sheet (See HO 100 website)

  • Steve Lopez, “It Can Take a Village to Help the Mentally Ill” (Handout)

  • “About Mental Illness” (Handout)

  • Reference: Hayes-Bautista D. “Latinos Define “American”: 2000-2020” Chapter 6, La Nueva California: Latinos in the Golden State.


Learning Objectives

  • Students will learn that violence is a public health issue.

  • Students will learn about the Latino adolescent male mortality peak

  • Students will understand the continuum of domestic violence

  • Students will understand and discuss basic concepts about mental health


Week 16May 4, 2007

Access to Health Insurance

Lecture Topic: Health Insurance Coverage patterns in California
Readings:

  • Understanding Health Policy, Ch. 15, “National Health Insurance”

  • Brown, E. Richard; Ponce, Ninez; Rice, Thomas, et.al. The State of Health Insurance in California: Findings from the 2001 California Health Interview Survey. UCLA: Center for Health Policy Research, 2002, Ch 2, pp 13-30.

  • Hayes-Bautista, M, Clark, G. “An Evaluation Report of the Health Coverage Access Project”. UCLA: Center for the Study of Latino Health and Culture, 2004.


Learning Objectives:

  • Students will understand barriers to access in

  • g health insurance

  • Students will understand health insurance patterns in different populations

  • Students will understand links between policy and insurance


Week 16May 4, 2007

Topic: Student Presentations



Week 17May 11, 2007

Topic: Student Presentations


Final Draft of Paper Due TODAY
Week 18May 18, 2007

Final Exam


  • Assignment: Self-Evaluation (50 points)


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