Workbook
This workbook forms the basis of your tutorial discussions for weeks 3-7. The workbook is set up in three sections: 1) a reading; 2) short answer questions; and 3) a critique.
You need to complete the first two sections PRIOR to attending the tutorial class.
Your critique is based on the tutorial class discussions. If you do not complete the reading and short answer questions prior to attending the tutorial class, you will not be able to participate in discussions which will impede your ability to undertake the critique.
While you will need to submit the entire workbook, it is the critique part of the workbook that is mostly graded as part of your assessment.
Week 3
Why do we need to consider the history of public health? Well, while history can’t exactly repeat itself, in that it is not possible for the same circumstances and actors to collide in exactly the same configuration as the past (different people and different places necessarily mean events will never be the same), there are lessons from the past that we can learn to help avoid unwanted events. This week we focus on what we can learn from the industrialisation of Britain in the 19th century to help us negotiate similar economic and other upheavals.
First of all you need to read the following article. This is quite an old article, but Simon Szreter outlines a fundamental argument that remains relevant today. Here he applies his learning to 21st century China.
Szreter, S 1999, ‘Rapid economic growth and ‘the four Ds’ of disruption, deprivation, disease and death: public health lessons from nineteenth-century Britain for twenty-first China?’ Tropical Medicine and International Health, vol. 4, no. 2, pp. 146-152.
From this reading, provide answers to the following questions:
In your own words, outline what is meant by the 4Ds:
Disruption:
Deprivation:
Disease:
Death:
The article mentions the 1848 Public Health Act. This is a key historical milestone in public health. However, the passage of legislation did not result in the anticipated changes in health. Why do you think so much energy was given over initially to laying water mains to houses but not to sewage and drainage?
In preparation for your tutorial class (face-to-face or online) discussion, write down four ideas you can take from this reading to apply to the current concern regarding technology (robots and IT) taking over manual and white collar jobs over the coming two decades. Are we experiencing another period of significant disruption?
You need to write a short critique of the tutorial class discussion which is the part of the workbook activity that is assessed for your grade. A critique is a detailed analysis of something. This means you cannot simply describe the discussion or copy down the main points of the discussion. You need to think about the discussion and write a concise, coherent and logical appraisal of the discussion. For example, the following key points may be written down summarising a discussion:
• Rates of Yellow Fever soured in USA cities throughout the 19th century due to a lack of basic water and sanitation infrastructure
• Up until the 1930s a lack of political will halted attempts to eliminate mosquitos that carry Yellow Fever
• When legislation was passed in various states and cities, the laws were not enforced and were of limited use (sourced from Duffy 1992).
A critique requires you to have an understanding of the context to be able to make sense of these dot points. So an example of a critique may be:
The strong ideology of individualism associated with the USA throughout the nineteenth and early twentieth century meant that industry needs and desires were always prioritised over the rights of ordinary citizens. This resulted in Yellow Fever rates souring due to the lack of water and sanitation infrastructure until after the 1930s; decades after similar infrastructure had been installed in Britain. Furthermore, even when laws were passed, they were not enforced for fear of harming the economic interests of businesses who would be required to pay taxes in order to pay for the necessary infrastructure.
Use this space to write down the main discussion points from your tutorial class for this week:
Now write your critique. It should be approximately 200 words.
Reference
Duffy, J 1992, The sanitarians: a history of American public health, University of Illinois Press, Illinois.
Week 4
Following on from last week’s focus on history, this week we pay more attention to the various models of public health associated with the various eras. When we talk about models of public health, we are referring to the main ideas and worldviews, or ideology that influenced and directed the attention of those who practiced public health. While the medical profession has dominated public health for many years, public health has quite an eclectic past. For example, in the early part of the 19th century, French ‘hygienists’ were often chemists interested in occupational health hazards (La Berge 1992). As such, we are able to see influences from environmental health, social justice and community development, and epidemiology as well as medicine.
First of all you need to read the following article. This reading is a chapter from a book that presents a new model of public health developed by the authors. While the author’s model hasn’t necessarily gained a lot of attention, they do provide a broad overview of the different models and ways of thinking that have influenced public health over the past 200 years.
Raynor, G & Lang, T 2012, ‘The received wisdom of public health’, in Ecological public health: reshaping the conditions for good health, Routledge, Oxon, pp. 67-103.
From this reading, provide answers to the following questions:
In your own words, outline the five models:
Sanitary-environmental:
Social-behavioural:
Bio-medical:
Techno-economic:
Ecological public health:
McKeown’s analysis is mentioned in this reading as well as in your textbook reading from last week
(Baum 2015). Using both readings, write down what the McKeown’s thesis consists of and why Simon Szreter has criticised this thesis.
In preparation for your tutorial class (face-to-face or online) discussion, write down four points related to the usefulness of models of public health: why they exist and how they can direct practice.
You need to write a short critique of the tutorial class discussion which is the part of the workbook activity that is assessed for your grade.
Use this space to write down the main discussion points from your tutorial class for this week:
Now write your critique. It should be approximately 200 words.
Reference
La Berge, 1992, Mission and method: the early nineteenth-century French public health movement,
Cambridge University Press, Cambridge.
Week 5
One of the consequences of the dominance of the biomedical model of public health is the embracing of evidence-based-practice, called here evidence-based public health (EBPH). EBPH emerged from the idea of evidence-based-medicine (EBM) in the 1990s, but there are important differences between thinking about evidence within a medical context and that within public health. This week we look at the movement towards EBPH, while next week we will consider the counter narrative to EBPH, that of practice-based-evidence.
First of all, you need to read the following article. This reading is a chapter from a book that explores EBP within public health. It is one of several books that were released onto the market around the same time, representing how this idea gained quite a bit of attention around a decade ago.
Brownson, RC Fielding, JE, Maylahn, CM 2009, ‘Evidence-based public health: a fundamental concept for public health practice’, Annual Review of Public Health, vol. 30, no. 1, pp. 175-201.
From this reading, provide answers to the following questions:
In your own words, outline the four domains that influence decision making in public health:
Environmental and organisational contexts:
Population characteristics:
Resources:
Best available evidence:
The reading notes the similarities and differences between EBPH and EBM. What are the differences and why is it EBM cannot be wholly applied to public health?
In preparation for your tutorial class (face-to-face or online) discussion, write down four points related to the different types of evidence used in public health and why we need to think carefully about what evidence is collected and how it is used.
You need to write a short critique of the tutorial class discussion which is the part of the workbook activity that is assessed for your grade.
Use this space to write down the main discussion points from your tutorial class for this week:
Now write your critique. It should be approximately 200 words.
Week 6
The attention given to evidence-based-medicine from the 1990s provided an interesting insight into the significant gap between research and practice; that it could take years from when research identified an intervention that worked and when this was implemented into general practice. While this gap has been focused on in recent years through initiatives such as Knowledge Translation, a counter narrative to evidence-based-practice is that of practice-based-evidence. This week we consider this counter narrative and why it has been put forward.
First of all, you need to read the following articles. These readings provide an outline of why practice-based-evidence has been put forward as an alternative to evidence-based-practice.
Green, L 2008, ‘Making research relevant: if it is an evidence-based practice, where’s the practicebased evidence?’, Family Practice, vol. 25, no. Supp 1, pp. i20-i24.
Buchanan, DR 2015, ‘Tensions between the conduct of randomised controlled trials in health promotion research and the role of autonomy in human health and well being’, Health Promotion Journal of Australia, vol. 26, pp. 263-268.
From these readings, provide answers to the following questions:
In your own words, outline:
The various steps required to go from funding research to the findings being implemented into practice:
What the barriers are for translating research into practice:
What assumptions underpin evidence-based-practice:
Green (2008) outlines three remedies. How do these provide a counter narrative to the EBPH narrative?
In preparation for your tutorial class (face-to-face or online) discussion, write down four points related to autonomy and its implications for public health research and practice.
You need to write a short critique of the tutorial class discussion which is the part of the workbook activity that is assessed for your grade.
Use this space to write down the main discussion points from your tutorial class for this week:
Now write your critique. It should be approximately 200 words.
Week 7
The social ecological model of health (SEMH) is cited extensively as forming the foundation of thinking in a number of public health fields over the past twenty years. However, the SEMH has not been without controversy, nor have the concepts contained in the model always been readily translated into practice. This week we are focusing on how the SEMH has transpired within health promotion, although you should be able to see how the criticisms and issues can be readily seen in other fields in public health.
First of all, you need to read the following articles. These two articles have the same lead author and represent an ongoing conversation around how the SEMH has been used and could be used to guide health promotion work. Please note, these articles have been written from an American context where the terms health education and health promotion have often been used interchangeably. This is not the case in Australia or other countries which differentiate between health education (primarily aimed at changing behaviour through information giving) and health promotion (as described in the Ottawa Charter).
Golden, S & Earp, JA 2012, ‘Social ecological approaches to individuals and their contexts: twenty years of Health Education & Behaviour health promotion interventions’, Health Education & Behaviour, vol. 39, no. 3, pp. 364-372.
Golden, S, McLeroy, K, Green, L, Earp, JA, Lieberman, L 2015, ‘Upending the social ecological model to guide health promotion efforts toward policy and environmental change’, Health Education & Behaviour, vol. 42, no. 1S, pp. 8S-14S.
From these readings, provide answers to the following questions:
In your own words, outline the different levels of the SEMH:
Intrapersonal:
Interpersonal:
Institutional:
Community:
Policy:
How does the ‘inside-out’ SEMH differ from the original thinking in the 2012 article?
In preparation for your tutorial class (face-to-face or online) discussion, write down two points related to what is missing from the conceptualisation and discussion of the SEMH in the two Golden readings. Why do you think these points need to be considered?
You need to write a short critique of the tutorial class discussion which is the part of the workbook activity that is assessed for your grade.
Use this space to write down the main discussion points from your tutorial class for this week:
Now write your critique. It should be approximately 200 words.