Course: Integrating Social and Behavioral Theory into Public Health: Foundations/Macro-Mezzo Levels

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Topic Readings
Session 1: Introduction Required reading

Berkman LF, Glass T, Brissette I, Seeman TE. From social integration to health: Durkheim in the new millennium. Soc Sci Med. 2000 Sep;51(6):843-57.

Davison KK, Werder JL, Lawson CT. Children's active commuting to school: current knowledge and future directions. Prev Chronic Dis. 2008 Jul;5(3):A100.
An example of an intervention designed to target multiple levels of an ecological model

Reference reading

Link BG, Phelan J.  Social conditions as fundamental causes of disease.  Journal of Health and Social Behavior, Vol. 35, Extra Issue: Forty Years of Medical Sociology: The State of the Art and Directions for the Future (1995):80-94.
Challenges the focus on "proximal" causes and asserts that these causes are only modifiable if one attends to the more distal context.

Sweatt DJ. Experience-dependent epigenetic modifications in the central nervous system. Biol Psych 2009;65:191-197.
Technical in spots, but a nice description how the interplay between genes and the environment is thought to impact patterns of behavior.

Beauchamp D.  Public Health as Social Justice.  Inquiry 13:3-14, 1976.

McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988 Winter;15(4):351-77.

Session 2: Personal Health Behavior Change Required reading

Kreuter MW, Green MC, Cappella JN, et al. Narrative communication in cancer prevention and control: a framework to guide research and application. Ann Behav Med 2007;33:221-235.

Suggested reading

Newman TB. The power of stories over statistics. BMJ 2003;327:1424-1427.

Pennebaker JW, Seagal JD. Forming a story: the health benefits of narrative. J Clin Psychol. 1999 Oct;55(10):1243-54. James Pennebaker is perhaps the best known researcher whose work has linked narratives with health status.

Sharf BF. Out of the closet and into the legislature: breast cancer stories.  How narratives about one disease have shaped policy. Health Affairs 2001;1:213-218.
Session 3: Culture Required reading

Choudhury S, Kirmayer LJ.  Cultural neuroscience and psychopathology: prospects for cultural psychiatry.  Prog Brain Res 2009;178:263-283. This paper makes the huge point that culture is not "merely" a set of definitions and meanings for the world around us, but that it also influences the cognitive processes that we come to use when faced with a task or a social situation.  It also has a nice discussion about distinctions between the concepts of culture, ethnicity, and race.

Olafsdottir S, Pescosolido BA. Drawing the line: the cultural cartography of utilization recommendations for mental health problems.  J Health Soc Behav 2009;50:228-244. This is a very nicely written paper that looks at the interplay of culture (and particular beliefs and the nature and meaning of various kinds of problems) and utilization of medical services. We are used to seeing this sort of analysis applied to non-Western cultures, but not so much our own. The introduction and discussion are particularly useful for integrating several concepts that come up in the course.

Recommended readings

Angel R, Thoits P.  The impact of culture on the cognitive structure of illness.  Culture Med Psychiatry 1987;11:465-494. The paper provides more detail on how body states are noticed, labeled, valued, and ultimately given their significance for one's social role.

Jenni OG, O'Connor BB.  Children's sleep: an interplay between culture and biology. Pediatrics. 2005 Jan;115(1 Suppl):204-16. Even supposed "biologic" processes are shaped by culture; culture biases our view of what is "normal."  This is a great paper if you have children and worry about their sleep patterns (or your own for that matter).

Session 4: Culture (Lab Session) Required/additional reading

Kleinman A, Eisenberg L, Good B. Culture, illness, and care.  Ann Int Med. 1978;88:251-258. A "classic" paper setting out the concept of explanatory models and the difference between disease and illness.

Groleau D, Young A, Kirmayer LJ.  The McGill Illness Narrative Interview (MINI): An interview schedule to elicit meanings and modes of reasoning related to illness experience.  Transcultural Psychiatric 2006;43:671-691. This paper has a nice set of definitions of "explanatory model" and related concepts. 

Session 5: Socioeconomic Status and Health Required reading

Marmot MG. Status syndrome: a challenge to medicine. JAMA 2006;11:1304-7. This paper is a commentary but it serves as a good orientation to the on-going discussion about income inequality and health status - see the "Fair Society" web material in the suggested reading for the latest work from Marmot's group.

Dixon J, Banwell C. Theory driven research designs for explaining behavioural health risk transitions: The case of smoking. Soc Sci Med 2009;68:2206-2214. An application of three "competing" sociologic theories as to how health risk behavior comes to be more concentrated in lower SES groups.

Recommended Reading

Woolf SH, Johnson RE, Phillips RL, Philipsen, M. Giving everyone the health of the educated: an examination of whether social change would save more lives than medical advances. AJPH 2007;97:679-683. The argument is that more lives could be saved by narrowing disparities in access to educational achievement than by investment in more medical care.

Kim D, Kawachi I, Hoorn SV, Ezzati M. Is inequality at the heart of it? Cross-country associations of income inequality with cardiovascular diseases and risk factors. Soc Sci Med. 2008 Apr;66(8):1719-32. Reviews three hypotheses that may explain the relationship of income inequality and cardiovascular disease.

Frank RH: Falling behind: how rising inequality harms the middle class. Berkeley, University of California Press, 2007. The diversion of needed resources into spending on "positional goods" as something that is driven by inequality and that simultaneously exacerbates it.

Fair Society, Healthy Lives: Strategic review of health inequalities in England post-2010.  February, 2010. Marmot and the review panel set out several steps that they feel have the potential to reduce inequalities.

van Lenthe FJ, de Bourdeaudhuij I, Klepp KI, Lien N, Moore L, Faggiano F, Kunst AE, Mackenbach JP. Preventing socioeconomic inequalities in health behaviour in adolescents in Europe: background, design and methods of project TEENAGE. BMC Public Health. 2009 May 8;9:125. This paper sets out the methods for a literature review, but it's a good demonstration of the use of an ecologic model to drive a comprehensive search for reasons behind SES-related differences in health risk behaviors.

Session 6: Socioeconomic Status and Health Chandola T, Kuper H, Singh-Manoux A, Bartley M, Marmot M. The effect of control at home on CHD events in the Whitehall II study: Gender differences in psychosocial domestic pathways to social inequalities in CHD. Soc Sci Med. 2004 Apr;58(8):1501-9.

Session 7: Social Capital and Social Support Required reading

Islam MK, Merlo J, Kawachi I, Lindstrom M, Gerdtham UG. Social capital and health: does egalitarianism matter? A literature review. Int J Equity Health. 2006 Apr 5;5:3. This is a long review article that a) has some good definitions and background on a number of key concepts, and b) addresses the question of whether social capital matters in societies in which there is equal (or equal enough) access to goods and services.

Ware NC, Idoko J, Kaaya S, Biraro IA, Wyatt MA, Agbaji O, Chalamilla G, Bangsberg DR. Explaining adherence success in sub-Saharan Africa: an ethnographic study. PLoS Med. 2009 Jan 27;6(1):e11. This paper suggests that a desire to maintain social support drives HIV treatment adherence in this context because to become seen as hopelessly ill (especially by your own doing) risks being abandoned.

Recommended reading

Putnam R. Social capital measurement and consequences.  ISUMA.2001;(Spring):41-51.

Subramanian SV, Kawachi I, Kennedy BP. Does the state you live in make a difference? Multi-level analysis of self-related health in the US.  Social Science Medicine 2001;53:9-19.

Trigg AB. Deriving the Engel Curve: Pierre Bourdieu and the social critique of Maslow's hierarchy of needs. Rev Social Economy 2004;62:393-406.
The point here is that the definition of "necessary" is determined by one's social class - but here the issue (different from Frank, I think) is that some of these expenditures are "necessary" to keep and build social capital, rather than just self-rated status.

Sampson RJ. The neighborhood context of well-being. Perspect Biol Med. 2003 Summer;46(3 Suppl):S53-64. Summary data from one of the largest studies of city neighborhoods and the social factors that impact health status within them - a focus on collective efficacy.

Session 9: Intervention Illustration: Social Networks Required reading

Latkin CA, Knowlton AR. (2005).  Micro-social structural approaches to HIV prevention: a social ecological perspective.  AIDS Care. 17 Suppl 1: S102-13.

Recommended reading

Foster, G. (2007). Under the radar: Community safety nets for AIDS-affected households in sub-Saharan Africa. AIDS Care 19, S54-S63.

Sandler, J. (2007). Community-based practices: Integrating dissemination theory with critical theories of power and justice. American Journal of Community Psychology, 40, 272-289.

Friedman SR, de Jong W, Rossi D, Touze G, Rockwell R, Des Jarlais DC, Elovich R. (2007).  Harm reduction theory: users' culture, micro-social indigenous harm reduction, and the self-organization and outside-organizing of users' groups. Int J Drug Policy. 18(2): 107-17.

Session 10: Race Required reading

Van Ryn M, Fu SS.  Paved with good intentions: do public health and human service providers contribute to racial/ethnic disparities in health? Am J Public Health. 2003 Feb;93(2):248-55. A good paper because it shows the application of theory and also ties together other aspects of the course

Winkler MA. Measuring race and ethnicity: why and how? JAMA 2004;292:1612-1614. A landmark but somewhat ignored policy statement from a leading journal.

Recommended readings

Bamshad M. Genetic influences on health. Does race matter? JAMA. 2005;294:937-946. We'll use material from this paper in the lecture. Introduces the concept of genetic distance.

Harrell JP, Hall S, Taliaferro J. Physiological responses to racism and discrimination: an assessment of the evidence. Am J Public Health. 2003 Feb;93(2):243-8.

Nobles M. History counts: a comparative analysis of racial/color categorization in US and Brazilian censuses. Am J Public Health. 2000 Nov;90(11):1738-45.

Session 11: Structural Interventions, Advocacy and Strategic Communication Required reading

Cohen DA, Scribner RA, Farley TA.  A structural model of health behavior: a pragmatic approach to explain and influence health behaviors at the population level.  Preventive Medicine. 2000;30:146-154. Some good definitions of structural interventions.

Freudenberg N, Bradley SP, Serrano M.  Public health campaigns to change industry practices that damage health: an analysis of 12 case studies. Health Education and Behavior epub ahead of print, 12 Dec 2007.

Shultz, J. Developing a strategy: advocacy's roadmap. In: Shultz, J. The Democracy Owners' Manual: A Practical Guide to Changing the World, pp. 71-83.

Recommended readings

Jacobson PD, Wasserman J. The Implementation and Enforcement of Tobacco Control Laws: Policy Implications for Activists and the Industry. Journal Health Policy, Politics and Law. 1999;24:567-598.

Use of these "media effects" to create change (in the behavior of legislators and officials) in another "macro" area - health policy.

  • The role of the news media
  • Effects of the news media on public opinion and public policy
  • News frames
  • Introduction to and case studies of media advocacy

Required reading

Dorfman L. Using Media Advocacy to Influence Policy.  Pp. 383-410 in Bensley RJ and Brookins-Fisher J, Community Health Education Methods: A Practical Guide. Boston: Jones and Bartlett, 2003.

Recommended reading

James Curran, "Rethinking media and democracy" in James Curran and Michael Gurevitch, eds.  Mass Media and Society 3rd edition (London:  Arnold, 2001), pp. 120-154
Session 12: Community, Political Action, and Health Required reading

DeMarco V, Schneider GE. Elections and public health. Am J Public Health. 2000 Oct;90(10):1513-4.

Session 13: Introduction to Media Theory and Effects - Situating Communication Within Culture and Health Required readings

Schramm, W. (1971). The nature of communication between humans. In Schramm, W. & Roberts, D., Eds., The Process and Effects of Mass Communication, Rev. Ed. Chicago, IL: University of Illinois Press.

Peters, J.D. (1999). Speaking into the air: A history of the idea of communication. Chicago: The University of Chicago Press, pp. 1-31 (Introduction: the problem of communication).

Recommended readings

Craig, R. (1999). Communication theory as a field. Communication Theory, 9(2): 119-161.

Finnegan, J.R. & Vishwanath, K. (2008). Communication theory and health behavior change: The media studies framework. In Glanz, Rimer and Vishwanath, Health behavior and Health Education: Theory, Research and Practice. San Francisco, CA: Jossey-Bass, pp. 363-387.

Gunther, A. & Storey, J.D. (2003). The influence of presumed influence. Journal of Communication, 53(2): 199-215.

Session 14: Communities and Community Collaboration Required reading

Minkler M. Ethical challenges for the "outside" researcher in community-based participatory research. Health Education and Behavior. 2004;31:684-697.

Cashman SB, Adeky S, Allen AJ 3rd, Corburn J, Israel BA, Montano J, Rafelito A, Rhodes SD, Swanston S, Wallerstein N, Eng E. The power and the promise: working with communities to analyze data, interpret findings, and get to outcomes. Am J Public Health. 2008 Aug;98(8):1407-17.

Recommended reading

MacQueen, K.M., McLellan, E., Metzger, D.S., Kegeles, S., Strauss, R.P., Scotti, R., Blanchard, L., & Trotter, R.T. What is community? An evidence-based definition for participatory public health. AJPH. 2001; 91:1929-1938.

Merzel, C., & D'Afflitti, J. Reconsidering community-based health promotion: Promise, performance, and potential. AJPH. 2003;93: 557-574.

Weijer C, Emanuel EJ. Ethics. Protecting communities in biomedical research. Science. 2000 Aug 18;289(5482):1142-4. This paper has an interesting typology of communities and proposes that different types of communities qualify for different sorts of consideration during the collaborative process.