Section outline

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  • Tuesday, January 10, 2017; 1:00 PM - 3:00 PM

    Lecture:  Introduction to research with diverse populations

    Research in diverse populations requires an understanding of the complex multi-level influences on human health and how these are patterned by sociodemographic characteristics, including race/ethnicity and socioeconomic status. This lecture will provide an introduction to conceptual models for these multi-level influences on health, including the role of a lifecourse perspective, and their relevance to research of all types on human health. This multi-level framework will then provide the structure for the following four lectures of the course, which will review sequential layers of this model. In addition, we will review the history of research in diverse populations and on health disparities, the measurement of socioeconomic status and race, and strategies to optimize recruitment and retention of diverse populations in research studies.

    Faculty: Kirsten Bibbins-Domingo and Christine Dehlendorf

    Location:      Mission Hall 1406

    • Prospectus:

    • Session Slides:

    • Intro Lecture 2017 CLE Dehlendorf File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Required Reading:

    • Gardners tale File
      Not available unless: Your ID number contains 02
    • caulfield race File
      Not available unless: Your ID number contains 02
    • ecology perinatalmortality File
      Not available unless: Your ID number contains 02
    • Quinn SC 2012 Attributes of researchers File
      Not available unless: Your ID number contains 02

    • Assignment:

  • Wednesday, January 11, 3:15 PM - 4:15 PM

    Online Section


    Please join my meeting from your computer, tablet or smartphone.
    https://global.gotomeeting.com/join/170074589

    You can also dial in using your phone.
    United States: +1 (646) 749-3112
    Access Code: 170-074-589

    First GoToMeeting? Try a test session: http://help.citrix.com/getready

  • Tuesday, January 17, 2017; 1:00 PM - 3:00 PM

    Lecture: Multi-level etiologies of health in diverse population, Part 1: Social determinants of health

    Social determinants of health are the conditions in which people are born, grow, work, live, and age, including education, wealth, occupation, neighborhood of residence, and the experience of racism. These factors are increasingly recognized as critical upstream influences that drive individual level health, as well as differences in health across groups. This lecture will provide an overview of what is known about the role of social determinants and their relationship to clinical research.

    Faculty:  Irene Yen

    Location:      Mission Hall 1406

    • Session Slides:

    • Lecture 2 social determinants Jan17 2017 File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Required Reading:

    • Braveman Socioeconomic Status File
      Not available unless: Your ID number contains 02
    • WHO Commission SDH - Read Chapter 5 File
      Not available unless: Your ID number contains 02
    • Massoglia 2008 prison race health File
      Not available unless: Your ID number contains 02

    • Assignment:

    • For week #2 - social determinants Assignment

  • Wednesday, January 18, 3:15 PM - 4:15 PM

    Online Section

    Please join my meeting from your computer, tablet or smartphone.
    https://global.gotomeeting.com/join/170074589

    You can also dial in using your phone.
    United States: +1 (646) 749-3112
    Access Code: 170-074-589


  • Tuesday, January 24, 2017; 1:00 PM - 3:00 PM

    Lecture:  Multi-level etiologies of health in diverse populations, Part 2: Biological determinants, mediators and mechanisms

    One of the most active areas of health disparities research is understanding how social experiences get “under the skin” to influence health. As discussed in previous classes, behavioral factors and clinical care are important mechanisms, but study after study has shown that behaviors and medical care cannot fully explain the magnitude of social inequalities in health. In this class we will review key hypothesized mechanisms via which adverse social experiences change human physiology and have enduring effects on long term health outcomes.  Leading hypotheses include the role of epigenetic changes; dysregulation of stress responses via hypothalamic pituitary adrenal axis alterations; and physiologic triggers of behavioral patterns. We will discuss how these biological mechanisms directly relate to lifecourse models for the determinants of adult health. We will also discuss controversial perspectives on the role of genetic differences in creating social and racial inequalities in health.

    Faculty:  Kirsten Bibbins-Domingo and Maria Glymour

    Location:      Mission Hall 1406

    • Session Slides:

    • Slides for Biological Mechanisms Lecture File
    • Lecture3BiologicalMechanismsv8 File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Required Reading:

    • Lecture5 BiologicalMechanisms ReadingReflectionsAssignment File
    • Gruenewald Seeman AllostaticLoad File
    • HertzmannBoyceAnnualReviews File
    • Weaver MaternalProgramming Epigenetic NatureNeuroscience File

    • Resources:

    • Assignment:  

      Questions Related to Week 3 Readings:

      1. Weaver et al propose that among rats, maternal behavior towards newborn pups influences their cortisol response to stress via epigenetic mechanisms that change the expression of glucocorticoid receptor gene for the rest of the pup’s life.  They argue that because epigenetic patterns are established at specific developmental periods, there is extreme time sensitivity to when the pup is exposed to particular maternal behaviors (licking and grooming, in this case), and maternal behavior before or after that sensitive period window is not as important.   Do you think this mechanism is relevant in humans?  If so, what behaviors are most analogous to “maternal licking and grooming”? 

      2.  Provide a brief proposal for a study that would allow you to assess whether epigenetic modifications in humans in response to maternal behavior influence subsequent health of the human (feel free to choose any health or behavioral outcome you think you can do this with, e.g., dementia or depression or smoking). Bonus if you can explain how you would approach this if we assume that the relevant epigenetic changes are tissue specific and occur in the brain. 

      3. Gruenewald, in contrast to Weaver, emphasizes the cumulative effects of SES adversity on a multi-system allostatic load measure.   Do you think that the Gruenewald findings are consistent, inconsistent, or unrelated to the Weaver findings?  Explain. 

       4. Hertzmann and Boyce argue that “it is not genes or environment, nor is it genes and environment, but rather it is gene-by-environment interactions that influence developmental trajectories.”  To what extent do you think that GxE interactions can contribute to major disparities along racial/ethnic, socioeconomic, or geographic dimensions?

    • Assignment Due Date:  January 24th at 12:00pm

  • Wednesday, January 25, 3:15 PM - 4:15 PM

    Online Section

    Please join my meeting from your computer, tablet or smartphone.
    https://global.gotomeeting.com/join/170074589

    You can also dial in using your phone.
    United States: +1 (646) 749-3112
    Access Code: 170-074-589


  • Tuesday, January 31, 2017; 1:00 PM - 3:00 PM

    Lecture: Multi-level etiologies of health in diverse populations, Part 3: Behavioral mechanisms

    Human behavior – from what we eat, to whether we exercise, to who are friends are- has a clear, and often measurable, impact on health. Research on differences in health across groups often points to differences in behaviors as underlying causes. In this lecture, we will review what is known about the role of behavior in producing differences in health across groups and relate these differences to the social determinants of health.

    Faculty:  Irene Yen and Christine Dehlendorf

    Location:      Mission Hall 1406

    • Behavioral Factors File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Required Reading:

    • social determinants of unhealthy behaviors File
      Not available unless: Your ID number contains 02
    • Adverse Childhood Experiences and adult health behaviors File
      Not available unless: Your ID number contains 02
    • self control 2000 File
      Not available unless: Your ID number contains 02
    • Arreola 2013 - agency sexual activity HIV File

    • Assignment:

    • assignment #4 for behavioral determinants session - correct

    • Assignment Due Date:  January 31st at 12:00pm

  • Wednesday, February 1, 2017. 3:15 PM - 4:15 PM

    Online Section

    Please join my meeting from your computer, tablet or smartphone.
    https://global.gotomeeting.com/join/170074589

    You can also dial in using your phone.
    United States: +1 (646) 749-3112
    Access Code: 170-074-589


  • Tuesday, February 7, 2017; 1:00 PM - 3:00 PM

    Lecture:  Multi-level etiologies of health in diverse populations, Part 4: Health systems and health care determinants

    While the social determinants of health are key in determining who gets sick, health care access and quality is key to determining the outcome of illness.  This class will review how ethnic/racial (and other) health care disparities play out in the highly complex US health care system.  We will discuss the contributions of provider bias, health system structural inequities, and segregated care to health care disparities while also examining how fundamental assumptions about the role of the individual, family, and society play out in the care of acute and chronic illness. Finally, we will review the experience of quality improvement programs in mitigating health care disparities.

     

    Faculty:  Alicia Fernandez

    Location:      Mission Hall 1406

    • Session Slides:

    • HCD Lecture 2017 CLE File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Required Reading:

    • Hidden Curriculum Brooks File
      Not available unless: Your ID number contains 02
    • Li Y.JAMA.2011.Lect.2pdf File
      Not available unless: Your ID number contains 02
    • DISTANCE Interpreter JGIM File
    • iom on health disparities.020601 File
    • pnas.201516047 pain article File

    • Assignment:

    • Health care disparities homework File

    • Assignment Due Date:  February 7th at 12:00pm

  • Wednesday, February 8, 3:15 PM - 4:15 PM

    Online Section

    Please join my meeting from your computer, tablet or smartphone.
    https://global.gotomeeting.com/join/170074589

    You can also dial in using your phone.
    United States: +1 (646) 749-3112
    Access Code: 170-074-589


  • Tuesday, February 14, 2017; 1:00 PM - 3:00 PM

    Lecture: Multi-level etiologies of health in diverse populations, Part 5: Social policy

    Many policies regulating areas such as housing, income security, education, criminal justice, environmental safety, or discrimination strongly influence health and health disparities, even though health was not the primary or original focus of these policies.  In other words, the most important policies affecting health may not be health policies at all, but rather policies that shape the multilevel determinants of health. Health researchers with multilevel frameworks are rapidly focusing research attention to formally evaluate how these policies influence health and health inequalities and provide evidence to policymakers about unanticipated health consequences of diverse policies. In this class we will discuss examples of such policies and approaches to rigorously evaluating the health impacts of policies.

     

    Faculty: Maria Glymour

    Location:      Mission Hall 1406

    • Session Slides:

    • Lecture6SocPolicy2016 File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Required Reading:

    • Adler et al JAMA brief of NAM report File
    • Osypuk et al social policies File
      Not available unless: Your ID number contains 02
    • Ludwig et al Neighborhoods and obesity File
      Not available unless: Your ID number contains 02
    • Rehkopf et al EITC File
      Not available unless: Your ID number contains 02

    • Assignment:

      Please post in the forum or email to Maria if you are not able to post. 

      •Identify a policy that is not usually intended to be a health policy but that you think may have important health implications.
      •Describe why an evaluation of that policy is informative (primarily about the policy, or primarily a test of hypothesized mediators?)
      •Specify the outcomes and populations you think most affected or least affected by the policy.
      •Propose a study design to evaluate the policy
      –Describe biggest challenge to implementing and drawing inferences about the impact of the policy on health

    • Assignment Due Date:  February 14th at 12:00pm

  • Wednesday, February 15, 3:15 PM - 4:15 PM

    Online Section

    Please join my meeting from your computer, tablet or smartphone.
    https://global.gotomeeting.com/join/170074589

    You can also dial in using your phone.
    United States: +1 (646) 749-3112
    Access Code: 170-074-589


  • Tuesday, February 21, 2017; 1:00 PM - 3:00 PM

    Lecture: Basic measurement issues in health disparities research

    How do we describe the magnitude of health disparities, or decide whether health disparities are getting smaller or larger?  Although it may sound simple, there are many different approaches to quantifying disparities, and sometimes they give very different insights.  In this class we will compare some approaches, such as focusing on absolute versus relative inequalities and how to choose a reference category. We will also address some basic concepts in measurement of variables in health disparities research.  Rigorous, reproducible measurement protocols are essential to scientific progress, but many key variables in health disparities research are controversial to define or difficult to measure, such as segregation, racism, or social capital.  We will discuss some strategies to overcoming these measurement challenges and to give health disparities research a strong scientific grounding.

    Faculty:  Maria Glymour

    Location:     Mission Hall 1406

    • Session Slides:

    • Measurementv4-2017 File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Required Reading:

    • Krieger EverydayDiscrimination File
      Not available unless: Your ID number contains 02
    • Harper and Lynch reading on measuring health disparities only read exec summary File
      Not available unless: Your ID number contains 02
    • Capistrant et al-2014-Journal of the American Geriatrics Society File

    • Assignment Due Date:  February 21st at 12:00pm

  • Wednesday, February 22, 3:15 PM - 4:15 PM

    Online Section

    Please join my meeting from your computer, tablet or smartphone.
    https://global.gotomeeting.com/join/170074589

    You can also dial in using your phone.
    United States: +1 (646) 749-3112
    Access Code: 170-074-589


  • Tuesday, February 28, 2017; 1:00 PM - 3:00 PM

    Lecture:  Basic analytic issues in HDR

    Given the complex social and biologic context in which health disparities are manifested, research in this areas requires nuanced application of statistical concepts related to confounding, mediation, moderation, and clustering. In this lecture, we will highlight aspects of statistical analysis of particular relevance to health disparities, including how to quantify disparities and evaluate determinants of inequalities, how to best build multivariate models, how to investigate race/SES interactions, principles of sub-group reporting and statistical power in health disparities research, as well as an overview of multilevel analyses.

    Faculty:  Mahasin Mujahid

    Location:     Mission Hall 1406

    • Session Slides:

    • USCF Guest Lecture Basic Analytic Issues 2017 File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Required Reading:

    • Lorch mediation File
    • Headen EM File
    • Merlo multilevel File

    • Assignment:

      Please post in the Forum.

      1. What are the different ways to account for SES in an analytic model when investigating racial/ethnic health disparities? (Hint: you should have three options). Discuss the interpretations/implications of each approach as it relates to the interest in understand health disparities by race/ethnicity. Draw a DAG for each option and reference it in your response (you do not have to post this!).
      2. Think about multilevel influences on a health outcome of interest to you. Discuss how you would study this, including measurement and analytic approaches you would use to account for exposures across multiple levels.
      3. Respond to one other person's post on the forum with a comment or suggestion.

    • Assignment Due Date:  February 28th at 12:00pm

  • Wednesday, March 1, 3:15 PM - 4:15 PM

    Online Section

    Please join my meeting from your computer, tablet or smartphone.
    https://global.gotomeeting.com/join/170074589

    You can also dial in using your phone.
    United States: +1 (646) 749-3112
    Access Code: 170-074-589


  • Tuesday, March 7, 2017; 1:00 PM - 3:00 PM

    Lecture: Strategic science in health disparities research

    Doing research that has an impact on our understanding of and ability to address health disparities requires being strategic about what research questions to ask and how to disseminate the results. This lecture will provide guidance on how to ensure your research has the greatest possible impact, including discussions of how to do research that is policy relevant, how to communicate one’s results to the media and public, and how to translate research results into policy.

     

    Faculty:  Kirsten Bibbins-Domingo

    Location:      Mission Hall 1406

  • Wednesday, March 8, 3:15 PM - 4:15 PM

    Online Section

    Please join my meeting from your computer, tablet or smartphone.
    https://global.gotomeeting.com/join/170074589

    You can also dial in using your phone.
    United States: +1 (646) 749-3112
    Access Code: 170-074-589


  • Tuesday, March 14, 2017; 1:00 PM - 3:00 PM

    Lecture: Doing research to reduce health disparities

    While all health disparities research has a common goal of addressing pervasive and unjust differences in health outcomes, the research methods that can be employed to accomplish this goal are diverse. In this lecture, we will review the “three generations” of health disparities research – from description to intervention – and discuss toolbox of research approaches that can be used to answer questions relevant to health disparities across these generations, including qualitative methods, implementation research, patient-centered outcomes research, and community based participatory research.

     

    Faculty: Christine Dehlendorf

    Location:      Mission Hall 1406

    • Session Slides:

    • HD research 2017 CLE File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Required Reading:

    • barbershop File
      Not available unless: Your ID number contains 02
    • annurev-publhealth-031210-101136 File
      Not available unless: Your ID number contains 02
    • cliff-analogy File
      Not available unless: Your ID number contains 02

    • Optional Reading:

    • Racism and Health Interventions ABS 2013 0 File

    • Assignment:

    • March 14th Homework Assignment

    • Assignment Due Date:  March 14th at 12:00pm

  • Wednesday, March 15, 3:15 PM - 4:15 PM

    Online Section

    Please join my meeting from your computer, tablet or smartphone.
    https://global.gotomeeting.com/join/170074589

    You can also dial in using your phone.
    United States: +1 (646) 749-3112
    Access Code: 170-074-589


  • Tuesday, March 21, 2017; 1:00 PM - 3:00 PM

    Lecture: Student presentation

    Each of you will give a short presentation to share with us something about how the material in this class has or will inform your work. This can really be anything, but examples would include application of the socioecological model to your area of research, measurement or analytic issues, and how to think strategically about your area of research.

    Each presenter will have 5 minutes, with a few minutes for questions, so you should only prepare 3-5 slides. In addition to this presentation, the final project will be a 1-2 page paper where you can expand a bit more on this topic.

    Please send me your slides by midnight on Sunday, March 19th so I can compile them all and we can be as efficient as possible (my email is christine.dehlendorf@ucsf.edu).

    Faculty: Christine Dehlendorf

    Location:      Mission Hall 1406

    • Session Slides:

    • Session Audio/Video Recording (Access restricted to registered students):

    • Watch URL

    • Required Reading:

    • Optional Reading:

    • Assignment:

    • Assignment Due Date:  March 21st at 12:00pm