Postgraduate Course: Public Health Policy (PGSP11315)
Course Outline
| School | School of Social and Political Science |
College | College of Humanities and Social Science |
| Credit level (Normal year taken) | SCQF Level 11 (Postgraduate) |
Availability | Not available to visiting students |
| SCQF Credits | 15 |
ECTS Credits | 7.5 |
| Summary | This course explores the role of public policy in meeting population health objectives. Key themes include the financing and delivery of health care, the social determinants of health, and the health impacts of economic, social and political processes beyond the state level. Organised efforts to protect and promote health are one of the key functions of government in most high-income countries, with the health sector representing a substantial area of public expenditure as well a significant source of employment. Yet policies affecting health extend beyond the traditional domain of health care to include decisions and actions in other sectors (including finance, industry, employment and education) and the influence of non-state actors including commercial companies, consumer groups, NGOs and other civil society organisations and networks. This course will examine the challenges confronting policy-makers and practitioners in developing and implementing effective public health policy.
Through a combination of seminars, case-studies and presentations, students are introduced to the dynamic and complex character of contemporary health policy, and provided with conceptual and analytical tools for understanding and engaging with the policy process. This course builds on skills and concepts introduced in other MPP core courses (including Politics of Public Policy, Economics of Public Policy and International Dimensions of Public Policy) with specific reference and application to health-related policy. |
| Course description |
I. Introduction to public health & health policy
1. What is public health?
This session will introduce the concept of health and its determinants, reviewing different perspectives and introducing a public health approach to policy, incorporating collectivism, equity, community participation and social justice.
Seminar: Definitions and determinants of health
Baggott R (2000). Ch 1: 'Analysing public health', pp 1-14 in Public Health: Policy and Politics, Basingstoke: Palgrave Macmillan
Evans RG, Stoddart GL (1990). Producing health, consuming health care. Social Science & Medicine 31(12):1347-1363.
Navarro V (2007). What is a national health policy? International Journal of Health Services 37(1):1-14.
Pomerleau & McKee (2005) Ch 1: 'The emergence of public health and the centrality of values', in Pomerleau J and McKee M (eds). Issues in public health, pp 7-23
2. Social determinants of health
This unit will demonstrate the extent of inequalities in health and explore the determinants of health and health inequalities. It expands on theories of inequity, including behavioural/cultural, psychosocial, material and lifecourse approaches.
Seminar: Why do poor people behave poorly?
Graham H (2007). 'Social determinants of health and health inequalities', in Unequal Lives: Health and socioeconomic inequalities. Maidenhead: Open UP.
Lynch JW, Kaplan GA, Salonen JT (1997). Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. Social Science & Medicine 44(6):809-819
Graham H, Inskip HM, Francis B, Harman J (2006). Pathways of disadvantage and smoking careers: evidence and policy implications. Journal of Epidemiology & Community Health 60(Suppl II):ii7-ii12
Stuckler D, King L, McKee M (2009). Mass privatisation and the post-communist mortality crisis. Lancet 373: 399-407.
II. Public health and health systems
3. Health systems & health inequalities
This unit will examine the contribution health systems can make in tackling health inequalities through, for example, addressing inequities in health care provision, re-focusing resources on primary care and informing/ facilitating inter-sectoral action.
Seminar: The NHS Quality and Outcomes Framework
Black N and Gruen R (2005) Understanding health systems. Maidenhead: Open UP.
Nolte M, McKee M and Wait S (2005) 'Describing and evaluating health systems'. In Bowling A and Ebrahim S (eds). Handbook of health research methods. Maidenhead: Open UP.
Marmot M (2007) 'Achieving health equity: from root causes to fair outcomes.' Lancet: 370: 1153-63.
Navarro V et al (2006) Politics and health outcomes. Lancet; 368: 1033-7.
4. Health system models
This unit will explore the questions of what health systems are, what they comprise, and how they can be defined and classified. The dimensions of financing, provision and regulation, which define the activities of healthcare systems, will be introduced.
Seminar: Describing the health systems of England, Germany and the US
Blank, R.H. and Burau, V. (2010), Comparative Health Policy, Palgrave Macmillan.
Ham, C (2009), Health Policy in Britain, Palgrave Macmillan.
Mossialos, E et al (eds) (2002) Funding health care: options for Europe. Buckingham: Oxford University Press.
Saltman, R, Rico, A,, Boerma, W, (2005), Primary Care in the Driver's Seat: Organizational Reform in European Primary Care (European Observatory on Health Systems & Policies), Oxford University Press.
5. Health care reform 1 - Financing
This unit will present the ways in which different financing systems can impact on the equity and efficiency of health care. We will also examine the key issues facing financing systems, and the changes in financing regimes that have arisen in response.
Seminar: From voluntary to compulsory insurance: current reform in the US
Oldham, J (2009), 'Achieving large system change in health care'. JAMA: The Journal of the American Medical Association, March 4; 301(9): 965-6
Donaldson C and Gerard K (2005), Economics of health care financing. Basingstoke: Palgrave Macmillan.
Kutzin J (2008) Health financing policy: a guide for decision-makers. Geneva: WHO.
Thomson, S, Foubister, T and Mossialos, E (2009) Financing health care in the European Union: challenges and policy responses. Copenhagen: WHO.
6. Health care reform 2 - Delivery
Internationally, there is a move away from unified state financing and delivery of health care towards delivery through markets. This unit will examine the processes of privatisation and marketisation and analyse their impact on efficiency and quality.
Seminar: Do markets work in health? Purchaser/provider splits in health care
Tritter, J, Koivusalo, M, Ollila, E, Dorfman, P (2009), Globalisation, Markets and Healthcare Policy: Redrawing the Patient as Consumer (Critical Studies in Health and Society), Routledge.
Harrison, M (2004), Implementing Change in Health Systems: Market Reforms in the United Kingdom, Sweden and The Netherlands, Sage.
Burgess S, Propper C and Wilson D (2005) Choice. Will more choice improve outcomes in education and health care? The evidence from economic research, University of Bristol: CMPO
Dixon J, Le Grand J and Smith P (2003) Can Market forces be used for good? London: King's Fund.
III. Public health and global governance
7. Trade liberalisation & public health
This unit will provide an examination of the public health implications of multilateral, regional and (increasingly) bilateral trade agreements. We will consider the extent to which trade agreements can restrict the scope of national governments to promote public health in their jurisdictions, with specific reference to two WTO agreements: the General Agreement on Trade in Services (GATS) and the Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS).
Seminar: Dispute settlement in the WTO: implications for public health
Smith R, Correa C, Oh C (2009) Trade, TRIPS and Pharmaceuticals, Lancet doi:10.1016/S0140-6736(08)61779-1
Jarman H, Greer S (2010). Crossborder trade in health services: Lessons from the European laboratory. Health Policy 94: 158-163.
M Bloche and E Jungman (2003) Health policy and the WTO. Journal of Law and Medicine, 31: 529-545.
Heller L (2009) Regime shifting in the international intellectual property system. Perspectives on Politics March. Vol 7(1):39-44.
8. Globalisation, infectious disease and health governance
In a global economy, health risks are increasingly transborder in character. In this session, we will examine the increased political salience of health within international relations, including the securitisation of public health, and assess key innovation in global health governance via the revised International Health Regulations.
Seminar: Global health security: HIV/AIDS, SARS and pandemic flu
WHO (2007) The World Health Report 2007: A Safer Future - Global public health security in the 21st century, (Geneva, WHO)
Feldbaum H, Lee K, Patel P (2006) The National Security Implications of HIV/AIDS. PLoS Medicine 3(6)e171 http://medicine.plosjournals.org/archive/1549-1676/3/6/pdf/10.1371_journal.pmed.0030171-L.pdf
Fidler D, Gostin L. (2006) The New International Health Regulations: An Historic Development for International Law and Public Health, 34 Journal Of Law, Medicine & Ethics 85
McInnes C, Lee K (2006) Health, security and foreign policy. Review of International Studies 32, 5-23.
9. Non-communicable disease, global change and health governance
This unit will critically examine the most prominent initiative undertaken by WHO to counter health impacts associated with globalisation, the Framework Convention on Tobacco Control (FCTC). This will assess questions of policy coherence between trade and health, examine the role of global civil society, and evaluate the convention as an attempt to regulate the conduct of transnational corporations.
Seminar: Negotiating the WHO Framework Convention on Tobacco Control
Collin J, Lee K (2009). Globalization and the Politics of Health Governance: The Framework Convention on Tobacco Control, pp.219-241 In: Cooper A, Kirton J (eds) Innovation in Global Health Governance: Critical Cases. Avebury Press
Magnusson RS (2007). Non-communicable diseases and global health governance: enhancing global processes to improve health development. Globalization and Health 3:2 doi:10.1186/1744-8603-3-2
Jacob G (2004). Without Reservation. Chicago Journal of International Law 5.
Taylor A, Chaloupka F, Gundon E and Corbett M (2000) 'The impact of trade liberalization on tobacco consumption' in Jha P and Chaloupka F eds, Tobacco Control in Developing Countries, Oxford : Oxford UP, pp: 343-364.
IV. Health inequalities & public policy
10. Public health interventions
This session will explore interventions aimed at improving health and reducing inequalities. Conceptual models of the determinants of health and health inequalities will be compared with programmes commonly used by governments and other agencies in an effort to address health problems. The effects of these interventions on population health will be considered, including why such programmes may sometimes produce the opposite of their intended effect.
Seminar: Policy approaches to improving health and reducing inequalities
Diderichsen, Evans and Whitehead (2001). The social basis of disparities in health. In Evans et al. (eds). 2001. Challenging inequities in health: from ethics to action. New York: Oxford UP
Calman K. 'Beyond the 'nanny state': Stewardship and public health.' Public Health 2009;123(S): e6-e10
Hill SE, Blakely TA, Fawcett JM, Howden-Chapman P (2005). Could mainstream anti-smoking programs increase inequalities in tobacco use? New Zealand data from 1981-96. Australian & New Zealand Journal of Public Health 29: 279-84
Bauld L, Judge K, Platt S (2007). Assessing the impact of smoking cessation services on reducing health inequalities in England: observational study. Tobacco Control 16: 400-404
11. Public health policy - do we really know what works?
In this final session we will bring together knowledge and concepts from throughout the course to consider the public policy challenge of improving health and reducing inequalities at a population level, reflecting on the UK's experience of a national policy commitment to reducing health inequalities.
Seminar: Evaluating policy efforts to improve health and reduce inequalities
Graham H (2007). Ch 11: 'Unequal lives: policy matters', pp 160-176 in Unequal Lives: Health and socioeconomic inequalities. Maidenhead: Open UP.
Mackenbach JP, Bakker MJ for the European Network on Interventions and Policies to Reduce Inequalities in Health (2004). Tackling socioeconomic inequalities in health: analysis of European experiences. Lancet 362:1409-14.
Macintyre S, Chalmers I, Horton R, Smith R (2001). Using evidence to inform health policy: case study. British Medical Journal; 322:222-5
Davey Smith G, Ebrahim S, Frankel S (2001). How policy informs the evidence. British Medical Journal 322:184-5.
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Entry Requirements (not applicable to Visiting Students)
| Pre-requisites |
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Co-requisites | |
| Prohibited Combinations | |
Other requirements | None |
Course Delivery Information
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| Academic year 2014/15, Not available to visiting students (SS1)
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Quota: None |
| Course Start |
Semester 2 |
Timetable |
Timetable |
| Learning and Teaching activities (Further Info) |
Total Hours:
150
(
Programme Level Learning and Teaching Hours 3,
Directed Learning and Independent Learning Hours
147 )
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| Assessment (Further Info) |
Written Exam
0 %,
Coursework
70 %,
Practical Exam
30 %
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| Additional Information (Assessment) |
70% 3,000-word health policy brief
30% Small-group presentation and participation
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| Feedback |
Not entered |
| No Exam Information |
Learning Outcomes
On completion of this course, the student will be able to:
1. Critically analyse the concept of health and its determinants at a population level, and consider the relevance of these for contemporary public policy
2. Evaluate the role of the health system in promoting health and reducing health inequalities at a population level
3. Analyse and evaluate health systems in terms of their ability to deliver health care efficiently, equitably and with high quality
4. Demonstrate a critical understanding of prominent health sector reform processes and evaluate these with respect to their likely impact on public health
5. Analyse the process and content of health policy, and the impact of international and supranational institutions and other global actors
6. Demonstrate critical awareness of the key drivers of globalisation and the mechanisms by which they impact on public health and policy
7. Understand the challenges confronting policy-makers and practitioners in developing and implementing a public health response in this complex arena
8. Engage in effective group discussion, projects and presentations
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Reading List
- Blank, R.H. and Burau, V. (2010), Comparative Health Policy, Palgrave.
- Cooper A, Kirton J, Schrecker T. (2007) Governing Global Health: Challenge, Response, Innovation Aldershot: Ashgate.
- Graham H (2007). Unequal Lives: Health and socioeconomic inequalities. Maidenhead: Open University Press.
- Pomerleau J and McKee M (eds) (2005). Issues in public health. Open UP.
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Additional Information
| Graduate Attributes and Skills |
Not entered |
| Keywords | Not entered |
Contacts
| Course organiser | Dr Jeff Collin
Tel: (0131 6)51 3961
Email: jeff.collin@ed.ac.uk |
Course secretary | Mrs Lindsay Adams
Tel: (0131 6)50 3315
Email: Lindsay.Adams@ed.ac.uk |
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