Title: Social Determinants of Health from a Global Perspective
Keywords: socio economic status
Health systems
Health indicators
Health Policy (incl. advocacy)
Country: Spain
Institution: Spain - Barcelona Institute for Global Health - University of Barcelona
Course coordinator: Dr. Lucy Anne Parker
Dr. Ildefonso Hernández Aguado
Date start: 2021-09-28
Date end: 2021-10-06
About duration and dates: 2 weeks; 1 day pre-reading prior to beginning of the course is included. The last date is the deadline to submit one of the assessment components that needs to be completed out of class at the end of the module
Classification: advanced optional
Mode of delivery: Face to face
Course location:
Barcelona Institute for Global Health - University of Barcelona
C/ Rosselló, 132 (7th floor)
08036 Barcelona, Spain
ECTS credit points: 3 ECTS credits
SIT: 3 ECTS, 75 h SIT

1. Hours of tutored projects and work (not face to face): 5 hours
2. Hours of independent study (not face to face and not tutored): 46 hours
3. Hour of face to face study: 24 hours
4. Total = 75 hours
Language: English
Description: At the end of the course students will be able to:

1. Discuss the characteristics of the main determinants that influence the health of populations from different areas of the planet

2. Appraise the distribution of health and its determinants at global level and make relevant comparisons between regions and countries.

3. Analyze the key factors that explain the global health inequalities and their relevance in the design of policies and interventions to tackle their impact in the population.
Assessment Procedures: Students will be assessed both individually and in groups.

1) Individual micro-essay (50% of final grade): The students will prepare a micro-essay on health determinants. Choice of topic on social health determinants is open to the student with guidance from the course coordinators. The micro-essay should be uploaded to the Virtual Campus before 4 days after the end of the course.

The instructions for the students and the rubric for this component are available in Annex 1 and 2.

2) Group work (30% of final grade): This component will consider presentation and discussion of an assigned project. The last day of class the different groups will present their project and will submit a written report via the virtual campus.

3) Individual multiple-choice online test (20% of final grade): Questions will address essential reading materials and topics covered in class. The multiple-choice test should be completed at home and submitted before 5 days after the end of the course.

The different assignments compensate for the final grade.

Resit: Students who have not reached the minimum pass grade of 5 out of 10 will have a second opportunity to pass the module. Re-evaluation will involve a new micro-essay (60%) and an exam on the essential readings with 3 open questions requiring short text answers, max 200 words (40%).
Content: Week 1:

• Session 1: Global health determinants and equity.
This session provides a brief overview of some of key introductory concepts that should be well established before continuing the module. Examples of unjust and preventable differences in health indicators within and between populations will be examined. Students will discuss the different levels of causality as to why individuals may be sick or healthy, or why some populations may be more prone to diseases than others. Class debate on G Rose’s 1985 paper (see essential reading) and its relevance today in the Global Health arena.
Lecturers: Ildefonso Hernández Aguado & Lucy Anne Parker

• Session 2: Conceptual framework of the social determinants of health and equality.
This session uses the example of tobacco smoking to build a model of the social determinants of health and equality. The globalisation of the tobacco epidemic, and differences in the prevalence of tobacco use among and between countries will be discussed to illustrate the multiple levels of causation. The WHO Framework Convention on Tobacco Control (WHO FCTC) will be analysed.
Lecturers: Ildefonso Hernández Aguado & Lucy Anne Parker

• Session 3: Policy implications of the social determinants of health.
This session will take an in-depth look at some of the key challenges in implementing policies in defence of population health. Following on from session 2, using the example of tobacco smoking, Prof Hernandez-Aguado will provide an insider’s view of the implementation of the Smoking ban in Spain. Debate will focus on the development, implementation and evaluation of policies to improve the health of populations through action on the social determinants of health.
Lecturers: Ildefonso Hernández Aguado & Lucy Anne Parker

• Session 4: Focus on Global Health Governance.
This session introduces some of the main actors in global health governance. Students will work in groups to explore influence of philanthropic organizations on the independence of multilateral institutions and agenda setting in the global health arena, and the role of Public-Private Partnerships in promoting global health. Organisation of group work for session 8.
Lecturers: Ildefonso Hernández Aguado & Lucy Anne Parker

• Sessions 5: Employment and Health inequities: Theories and methods. A descriptive and analytical approach
This session will analyse the importance of efficient and fair employment on population health. A guest lecture will draw on experiences from research.
Lecturer: Joan Benach

• Session 6: Precarious employment: Theory, analysis, evidence, and policies
Continued from session 5.
Lecturer: Joan Benach


Week 2:

• Session7: Gender inequality. Group work Introduction
This first part of this session will take a closer look gender inequality and health. Students should be familiar with the appropriate article from the obligatory reading material in order to participate fully. For the rest of the session students will work in groups of 5 to prepare a case study on the determinants of a specific health problem in a region of the world. Course coordinators will provide a selection of possible topics and assist in the formation of groups.
Lecturers: Ildefonso Hernández Aguado & Lucy Anne Parker

• Session 8: Data sources and tools for exploring the global determinants of health.
Students are advised to bring a laptop computer to this session. This session will focus on sources of information, databases and other tools to explore global health determinants in practice. Information on the micro-essay component of the course evaluation will be provided and students will have the opportunity to explore the different sources of information relevant to their chosen topic for the micro essay and/or group work and can discuss with the course coordinators as required.
Lecturers: Ildefonso Hernández Aguado & Lucy Anne Parker

• Session 9: Health in all policies. The “know-do” gap.
This first part of this session will look at the ‘Health in all policies’ movement. Students should be familiar with the appropriate article from the obligatory reading material in order to participate fully. The second part of the session will consider the need to contextualise knowledge from research to the social and economic realities of the different populations round the planet in order to reduce health inequities.
Lecturers: Ildefonso Hernández Aguado & Lucy Anne Parker

• Session 10: Failing health systems. Group work
This first part of this session will explore the impact of political instability, failing health systems and the devastating consequences of war and conflict. Students will reflect on how the different health determinants discussed in earlier sessions can play a role in outbreaks of acute infectious diseases. Dr Parker will share personal experiences from emergency epidemic response to Cholera and Ebola, and the relevance of the social determinants of health and inequality. Any remaining time will be dedicated to continuing the group work.
Lecturers: Ildefonso Hernández Aguado & Lucy Anne Parker

• Sessions 11 & 12: Presentations of Group Work and Course overview.
In this final session, groups will present their project to the class and there will be a short discussion of each topic. At the end of the session, students will consider the material covered throughout the course in light of the learning objectives presented on day 1, and will have the opportunity to provide feedback for future course improvements.
Lecturers: Lucy Anne Parker
Methods: The course is organized in two-hour sessions. Sessions may involve short Power Point presentations given by the lecturer, but will focus more on discussion and debate of topics and reading material and student-led group work. The lecturers may provide short texts, video clips and other material in addition to essential reading material, which serve to enrich the classroom debates.
Prerequisites: English command for non-native speakers: English TOEFL test 550 or 213 computer-based or 79/80 internet-based or IELTS band 6.0.
Attendance: Maximum of 35 students per course
Selection: Based on CV (elements to consider: bachelor degree, working and volunteer experience) and motivation letter
Fees: 525 € + University taxes (90 Euro approx.)
Scholarships:
None available
Major changes since initial accreditation: There have been no changes in the objectives of the program. The content has been slightly modified to enhance the “advance” aspect of the course, in parallel to the reinforcement of the fundamentals of GH determinants in the core course.
The learning methods have also been reviewed, to make it less lecture-based and more case on discussions and case analysis.
Finally, the assessment has been changed to eliminate student participation, following student’s feedback.
Student evaluation: The course is evaluated every year using both an online confidential questionnaire (using both scoring and open-ended questions) and in-class oral feedback. The score of this course has been consistently between 4.2 and 4.6, out of 5.
Some of the sessions were graded less than 4 due to the low teaching skills of the teacher, who were replaced.
Most criticism from students concentrated on how classroom participation was assessed. Following student’s feedback, the assessment methods have been modified (see above).
Lessons learned: This has been a well-received course from the beginning. However, it had to be revised to make it more advanced and to make sessions less lecture-based and more dynamic. In that sense, changes in the faculty were also needed, as some of the teachers could not adapt well.
tropEd accreditation:
Accredited in November 2014. Re-accredited in June 2019 in Umea, Sweden.
This accreditation is valid until June 2024.
Email Address: nuria.casamitjana@isglobal.org
Date Of Record Creation: 2014-12-08 03:26:22 (W3C-DTF)
Date Of Record Release: 2018-06-21 16:50:10 (W3C-DTF)
Date Record Checked: 2019-08-09 (W3C-DTF)
Date Last Modified: 2021-09-08 12:18:59 (W3C-DTF)