Academic 

 Year  
2010­2011 

Global Public Health I: 
An introduction  
7.5 ECTS

Study Guide

Umeå International School of Public Health 
Epidemiology and Public Health Sciences 
Public Health and Clinical Medicine 
Umeå University 
Sweden 
 
 
2010 
UMEÅ UNIVERSITY
Department of Epidemiology and Public
Health August 2010

Dear student,

Welcome to the course Global Public Health: an introduction.

The teaching on the course is given during the three weeks: Sep 6-10, Sep 27-Oct 1
and October 18-22.

We will start the first course week at 1 pm on Monday Sep 6 in lecture room 135,
Building 9A, at the University Hospital Area, see attached map.

A preliminary schedule is enclosed. There will be a written exam on November 4.

Also, we have attached the course syllabus in which you also find the course
literature.

If you have any questions you are very welcome to contact us.

Once again – welcome to the course!

Miguel San Sebastián Sabina Bergstén

Course Coordinator Course Administrator
090-785 2974
  sabina.bergsten@epiph.umu.se 

  or
Lena Mustonen
Course Administrator
090-7852933
  lena.mustonen@epiph.umu.se 

       
 
UMEÅ UNIVERSITET, S-901 85 UMEÅ Telephone: +46-90-785 29 33 Telefax: +46-90-13 89 77

Global Public Health I – Study Guide 2010/2011

 TIMETABLE (1) 

First course week (36), September 6-10, 2010

Room Monday 6/9

08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

135 C L Introduction to C Introduction to

O U the course O the public health
F N F field
F C F
E H E
E E
All
U Janlert
Tuesday 7/9
08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

135 Health in a global C Social L Group work: C Group work:

context O determinants of U World Health O World Health
F health N Chart F Chart
F C F
E H E
E E
J Kinsman J Kinsman
U Janlert M San Sebastian M San Sebastián M San Sebastián
Wednesday 8/9
08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

135 Inequities in C Highlights of L Introduction to C

health O public health in U course project O
F Sweden N F
F C F
E H E
E E
J Kinsman
M San Sebastian L Weinehall M San Sebastián
Thursday 9/9
08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

914 Poverty and C Poverty and L Group work C Presentations:

health O health (cont) U “WHO Report” O “WHO Report”
F N F
F C F
E H E
E
J Kinsman E
J Kinsman
M San Sebastian M San Sebastian M San Sebastián M San Sebastián
Friday 10/9
08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

914 Measuring health C Paper discussion: L World Health C

in public health O Globalization and U Chart (Group O
F health N work F
F C presentation) F
E H E
E E

J Kinsman
U Janlert J Kinsman M San Sebastian
 

 
 TIMETABLE (2) 

Second course week (39), September 27-October 1, 2010

Room Monday 27/9

08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

135 C L Health systems: C Introduction to

O U an introduction O health economics I
F N F
F C F
E H E
E E
AK Hurtig C Löfgren
Tuesday 28/9
08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

244 Human rights C Climate change L Oral public C

and ethics O and public health U health O
F N F
F C F
E H E
E E
AK Hurtig M San Sebastian R Preet
Wednesday 29/9
08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

135 Child health C Nutrition and L Preparation of C

O public health U course projects O
F N F
F C F
E H E
A Ivarsson E
M San Sebastian E
Thursday 30/10
08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

135 Reproductive C Health promotion L From the field: C

health O U Adolescent O
F N pregnancies in F
F C Ecuador F
E H E
E E
U Högberg J Kinsman I Goicolea
Friday 1/10
08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

1 Gender C Gender L C
perspectives in O perspectives in U O
public health F public health N F
F (cont) C F
E H E
E E

A Sörlin A Sörlin
 
 
 
 
 
 

Global Public Health I – Study Guide 2010/2011

 TIMETABLE (3) 

Third course week (42), October 18-22, 2010

Room Monday 18/10

08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

135 C L Health C From the

O U information O field: Verbal
F N systems F autopsies
F C F
E H E
E E
P Byass Ed Fotrell
Tuesday 19/10
08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

135 Armed conflicts C Paper L Preparation of C

and public O discussion U course projects O
health F N F
F C F
E H E
E E
M San Sebastian M San Sebastian
Wednesd. 20/10
08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

135 Health in old age C Introduction to L Presentation of C

O health U course projects O
F economics II N F
F C F
E H E
E
J Kinsman E
KG Sahlén C Löfgren M San Sebastian
Thursday 21/10
08.30 10.00 10.30 12.00 13.00 14.30 15.00 16.30

1 Mental health: C Paper L Presentation of C

an international O discussion U course projects O
perspective F N F
F C F
E H E
E
J Kinsman E
G Kullgren J Kinsman M San Sebastian
Friday 22/10 10.00 10.30 12.00 13.00 14.30 15.00 16.30
08.30

1 Presentation of C Course L C
course projects O evaluation U O
F N F
F C F
E H E
E E
J Kinsman J Kinsman
M San Sebastian M San Sebastian
 
 
 
 
 
 

 
   LECTURES   

WEEK 1

Introduction to the field of public health (U Janlert)  

Learning objectives:
 To acquire knowledge about and to be able discuss the concept of public health.
 To be oriented about the historical use of the concept public health.
 To be familiar with different definitions of health.
 To know the differences between ill-health, disease and sickness.
 To be able to differentiate between micro and macro perspectives in health.

Essential reading:
1. Handouts.

Additional reading:
1. Kickbush I, Payne L. Constructing global public health in the 21st century, 2004.

Health in a global context (U Janlert) 

Learning objectives:
 To be oriented about the global distribution of health.
 To be familiar with the most important health determinants.
 To be able to discuss why females live longer than males.
 To know about global burden of disease and DALY.

Essential reading:
1. Handouts.
2. Health transition; pp: 123-136. In Lindstrand A, Bergström S, Rosling H, Rubenson B, Stenson B,
Tylleskär T. Global Health: an introductory textbook. Narayana Press, Denmark; 2006.
3. Beaglehole R, Bonita R, Horton R, Adams O, McKee M. Public health in the new era: improving health
through collective action. Lancet 2004; 363: 2084-86

Social determinants of health (M San Sebastian) 

Learning objectives:
 To understand the meaning of social determinants of health.
 To be able to distinguish different approaches to explain disease distribution.
 To understand the pathways through which social conditions influence health.
 To be aware of how the social determinants of health have been applied in different countries.

Essential reading:
1. Marmot M. Social determinants of health inequalities. Lancet 2005; 365: 1099-104.
2. Health determinants; pp: 53-98. In Lindstrand A, Bergström S, Rosling H, Rubenson B, Stenson B,
Tylleskär T. Global Health: an introductory textbook. Narayana Press, Denmark; 2006.

Global Public Health I – Study Guide 2010/2011

Additional reading:
1. WHO; Commission on social determinant of health. Closing the gap in a generation. Final report. 2008.
http://www.who.int/social_determinants/thecommission/finalreport/en/index.html.

Inequities in health: an introduction (M San Sebastian) 

Learning objectives:
 To be aware of the historical background to health inequalities.
 To be able to distinguish between health inequalities and health inequities.
 To understand the extent of health inequities.
 To be able to discuss how inequities affect health.
 To be able to reflect on the causes of health inequities.

Essential reading:
1. Braveman P, Gruskin S. Defining equity in health. Journal of Epidemiology and Community Health 2003;
57: 254-258.
2. Woodward A, Kawachi I. Why reduce health inequalities? Journal of Epidemiology and Community
Health 2000; 54(12): 923-9.

Additional reading:
1. WHO. Priorities for research to take forward the health equity policy agenda. Bulletin of the World
Health Organization 2005; 83(12): 948-953.

Highlights of public health in Sweden (L Weinehall) 

Learning objectives:
 To get an general understanding and knowledge of Swedish public administration is designed and how it
works
 To gain insight into how national public health policies can be developed and implemented
 To get an overview of the Swedish national public health policy

Essential reading:
1. Wall S, Persson G, Weinehall L. Public health in Sweden: facts, visions and lessons. In Global Public
Health: a new era. Chapter 4. Beaglehole R, Bonita R (eds). Oxford: Oxford University, 2003.

Poverty and health (M San Sebastian) 

Learning objectives:
 To be able to identify different definitions of poverty, how to measure it and look at the trends in
poverty.
 To understand some of the links between poverty and health.
 To gain an understanding of how economic policies changes affect health.
 To be aware of the current ways of tackling poverty and health.

Essential reading:
1. Rowson M. Poverty and health. Student British Medical Journal 2001; 9: 180-2.
2. What is development?; pp: 9-52. In Lindstrand A, Bergström S, Rosling H, Rubenson B, Stenson B,
Tylleskär T. Global Health: an introductory textbook. Narayana Press, Denmark; 2006.

Suggested additional reading:

 
1. People´s Health Movement, Medact, Global Equity Gauge Alliance. Holding to account: global
institutions, transnational corporations and rich countries: Aid and Debt relief. In Global Health Watch.
Zed Books Ltd: London, 2005. pp: 322-38.

Measuring health in public health (U Janlert) 

Learning objectives:
 To be familiar with basic health measures as mortality, life expectancy, morbidity and self-perceived
health.
 To know the strengths and weaknesses of different methods of health assessments (questionnaires,
examinations, register).
 To be aware of the strengths and weaknesses of health proxy measures, indirect survey and ecological
data

Essential reading:
1. Handouts.
2. Health indicators; pp: 99-122. In Lindstrand A, Bergström S, Rosling H, Rubenson B, Stenson B,
Tylleskär T. Global Health: an introductory textbook. Narayana Press, Denmark; 2006.

Global Public Health I – Study Guide 2010/2011

WEEK 2
 

Health systems: an introduction (AK Hurtig) 

Learning objectives:
 To acquire knowledge about the structures of health systems.
 To be oriented about the role of health systems in promoting health and equity.

Essential readings:
1. Handouts
2. Chapter 1. Why do health systems matter? In WHO (2000). The World Health Report 2000. Health
Systems: improving performance. Geneva: World Health Organisation.
3. Health policy and health systems; pp: 265.287. In Lindstrand A, Bergström S, Rosling H, Rubenson B,
Stenson B, Tylleskär T. Global Health: an introductory textbook. Narayana Press, Denmark; 2006.

Introduction to health economics (C Löfgren) 

Learning objectives:
 To be able to acquire an overview of the field of health economics: how this concept is defined and what
type of research questions that are covered within the field.
 To be able to acquire an understanding of central concepts in the field of economics such as economic
versus financial costs, opportunity cost, marginal analysis and efficiency.
 To understand the basics of the most common health economic evaluation methods.

Essential reading:
1. What are economics and health economics? Chapter 1. In Wonderling D, Gruen R, Black N;
Introduction to health economics. Open University Press, England: 2005. Available at:
http://site.ebrary.com/lib/umeaub/
2. Meltzer MI. Introduction to health economics for physicians. Lancet 2001; 358: 993-98.

Human rights and ethics (AK Hurtig) 

Learning objectives:
 To be able to define the basic concepts of health and human rights.
 To be able to discuss the links between public health and human rights

Essential reading:
1. Handouts.
2. Hunt P. The human right to the highest attainable standard of health: new opportunities and challenges.
Transactions of the Royal Society of Tropical Medicine and Hygiene 2006; 100: 603-607.

Climate change and public health 

Learning objectives:
 To understand global environmental change and its potential impacts.
 To know the current situation of international agreements related to environment.

Essential reading:
1. McMichael AJ, Beaglehole R. The changing global context of public health. Lancet 2000; 356: 495-9.

Additional reading:

 
1. McMichael AJ, Friel S, Nyong A, Corvalan C. Global environmental change and health: impacts,
inequalities, and the health sector. BMJ 2008; 336: 191-4.
2. People´s Health Movement, Medact, Global Equity Gauge Alliance. The wider health context:
Climate change. In Global Health Watch. Zed Books Ltd: London, 2005. pp: 193-206.

Oral public health (R Preet) 

Learning objectives:
 To understand what oral/dental public health is.
 To be aware of the magnitude of impact of oral diseases.
 To be well acquainted with Common Risk Factor Approach and be able to appreciate why oral health
is an integral part of general health.
 To be aware of oral health inequalities.
 To be knowledgeable about oral health prevention and promotion interventions.

Essential reading:
1. Handouts

Additional reading:
1. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral disease
and risks to oral health. Bulletin of the World Health Organization, 2005; 83: 661-669.
2. Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st
century – the approach of the WHO Global Oral Health Programme. Community Dentistry and Oral
Epidemiology 2003;31 Suppl 1:3-24.

Child health (A Ivarsson) 

Learning objectives:
 To be knowledgeable about the child health situation globally and changes over time.
 To be well acquainted with child health determinants.
 To be familiar with preventive measures that would make a difference.
 To be able to discuss the statement “children’s health, the nation’s wealth”.

Essential reading:
1. Basch PF. Textbook of international health. Oxford: OUP, 1999, pp. 170-234.
2. Blair M, et al. Child public health, Oxford:OUP, 2003.
3. The World Health Report 2005: Make every mother and child count (www.who.int/whr).

Suggested additional reading:

1. The Lance series on i) Child survival I-V (2003), ii) Neonatal survival 1-4 (2005) and iii) Child
development in developing countries 1-3 (2007).
2. The State of the Worlds children 2006: Excluded and Invisible (www.unicef.org).
3. National Research Council and Institute of Medicine. Children’s health, the nation’s wealth. Assessing
and improving child health. Washington D.C: The National Academic Press, 2004.

Nutrition, food and public health 

Learning objectives:
 To be able to define malnutrition and describe the trends.
 To be able to examine the links between malnutrition and health.
 To understand the causes of malnutrition.

Global Public Health I – Study Guide 2010/2011

 To be able to identify ways of preventing malnutrition.
 To be aware of the importance of obesity world-wide.
 To understand the relationships between agriculture policies in rich countries and their effects in poor
countries.

Essential reading:
1. Popkin BM. The shift in stages of the nutrition transition in the developing world differs from past
experiences Public Health Nutrition 2002; 5(1A): 205-214.
2. Chopra M, Darnton-Hill I. Responding to the crisis in sub-Saharan Africa: the role of nutrition. Public
Health Nutrition 2006; 9(5): 544–550
3. Chopra M, Galbraith S, Darnton-Hill I. A global response to a global problem: the epidemic of
overnutrition. Bulletin of the World Health Organization 2002; 80(12): 952-958.
4. Nutritional disorders; pp: 177-198. In Lindstrand A, Bergström S, Rosling H, Rubenson B, Stenson B,
Tylleskär T. Global Health: an introductory textbook. Narayana Press, Denmark; 2006.

Additional reading:
1. People´s Health Movement, Medact, Global Equity Gauge Alliance. The wider health context: Food. In
Global Health Watch. Zed Books Ltd: London, 2005. pp: 225-238.
2. Sanders D. Success factors in community-based nutrition programmes. Food and Nutrition Bulletin 1999;
20(3): 307-314.

Gender & Women´s Health & Rights (U Högberg) 

Learning objectives:
 Acquisition of basic knowledge about definitions and concepts of gender, human rights, sexual and
reproductive health in relation to adverse health outcome
 Ability to identify main determinants of sexual and reproductive health
 Understanding the public perspective of unsafe abortions, maternal mortality and STI
 Understanding of strategies for global reproductive health promotion and prevention of disease, injury
and death
 Ability to appreciate global reproductive health problems in different socio-economic settings, cultural
settings from a gender perspective

Essential readings:
1. Definitions and concepts (handout).
2. Grimes DA, Bensen J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah IH. Unsafe abortion: the
preventable pandemic. Lancet 2006; 368(9550): 1908-19.
3. Lindstrand A, Bergström S, Rosling H, Rubenson B, Stenson B, Tylleskär T. Global Health: an
introductory textbook. Narayana Press, Denmark; 2006 (Chapter Sexual and reproductive health; pp: 233-
250).

Additional reading:
1. Make every mother and child count (WHO). http://int/whr/2005/whr2005_en.pdf
2. Mid-level health-care providers are a safe alternative to doctors for first-trimester abortions in developing
countries. WHO/RHR/HRP/08.15. 2008. http://www.who.int/reproductivehealth/publications/
unsafe_abortion/rhr_hrp_08_15/en/index.html
3. WHO Multi-country Study on Women´s Health and Domestic Violence against Women
http://www.who.int/gender/violence/who_multicountry_study/en
4. WHO Publications - Gender Women Health http://www.who.int/gender/documents/en/
5. WHO Publications – Reproductive Health - http://www.who.int/topics/reproductive_health/en/

 
Health promotion (J Kinsman) 

Learning objectives:
 To understand the concept of health promotion, and its origins
 To be able to discuss different ways of promoting health, and to cite real-world examples
 To understand two of the theoretical models that have been used to inform health promotion
activities
 To understand the importance of evaluation in health promotion

Essential reading:
1. Introduction (pp 1-6): Health promotion – Planning and strategies (2004). Keith Tones and Jackie
Green. London: Sage Publications
2. Visit to: http://www.who.int/topics/health_promotion/en/

Gender perspectives in public health (A Sörlin) 

Learning objectives:
 To be able to understand gender perspectives for public health.
 To be aware of the theoretical background to the field of gender and health.
 To be able to discuss gender related health problems in different countries.

Essential reading:
1. Costa J., Silva E. The burden of Gender Inequalities for Society. Poverty in focus 2008; 13: 8-9.
2. Alsop R., Healy P. Gender equality and economic growth- for poverty reduction. Poverty in focus
2008; 13: 14-15. (http://www.undp-povertycentre.org/pub/ IPCPovertyInFocus13.pdf)

Additional reading:
1. Riska E. Women’s health: issues and prospects. Scandinavian Journal of Public Health 2000; 28: 84-
87.
2. Courtenay WH. Constructions of masculinity and their influence on men’s well-being: A theory of
gender and health. Social Science & Medicine 2000; 50(10): 1385-1401.
3. Hammarström A, Ripper M. What could a feminist perspective on power bring into public health?
Scandinavian Journal of Public Health1999; 27: 286-289.
4. WHO 2003. Gender, Health and Tobacco. http://www.who.int/gender/other_health/
Gender_Tobacco_2.pdf.
5. WHO 2004. Gender, Health and Work. http://www.who.int/gender/other_health/
Gender,HealthandWorklast.pdf.
 

Global Public Health I – Study Guide 2010/2011

WEEK 3

Health information systems (P Byass) 

Learning objectives:
 To be able to understand the scope of Public Health Informatics.
 To be able to understand that a wide variety of health scenarios depend on the availability of appropriate
information.
 To be able to understand the limitations of many sources of health information.

Essential reading:
1. Handouts.

Armed conflicts and public health 

Learning objectives:
 To be aware of the magnitude of the armed conflicts.
 To be able to examine risk factors and consequences of these conflicts.
 To be able to identify the links between armed conflicts and public health.

Essential reading:
1. Banatvala N, Zwi AB, Public health and humanitarian interventions: developing the evidence base. British
Medical Journal 2000; 321: 101-105.
2. Lang S, Kovacic L, Sogoric S, Brborovic O. Challenge of goodness III: public health facing war. Croatian
Medical Journal 2002; 43(2): 156-65.

Additional reading:
1. People´s Health Movement, Medact, Global Equity Gauge Alliance. The wider health context: War. In
Global Health Watch. Zed Books Ltd: London, 2005. pp: 253-66.

Health in old age (K Sahlen) 

Learning objectives:
 To understand the worldwide demographic situation.
 To be able to reflect upon health in old age in your own country and worldwide, today and in the future.
 To be able to discuss how ageism can influence the health situation in different contexts.

Essential reading:
1. Handouts.

Mental health: an international perspective (G Kullgren) 

Learning objectives:
 To be aware of the importance of mental health problems with special reference to developing countries.
 To be able to understand the situation of mental health services in developing countries, the gap between
burden and budget and between needs and treatment.
 To be aware of the cultural influence on mental illness.

 
 To be able to describe and critically discuss social and other determinants for mental health problems
in developing countries.

Essential reading:
1. WHO. Investing in mental health. http://www.who.int/mental_health/en/.

Additional reading:
1. WHO. Mental Health: new understanding and new hope. World Health Report. WHO: Geneve, 2001.
2. WHO. Project Atlas: Resources for Mental Health and Neurological disorders.
http://globalatlas.who.int/globalatlas/default.asp.

Global Public Health I – Study Guide 2010/2011

 COURSE EVALUATION 

Group work and paper discussions

It is a course requirement to be present and take part in group work and paper discussions during the course.
Papers should be read before the discussions. If you are not able to attend you need to inform the course
organizers.

Course project
The task in the course project is to compare some aspects of the public health situation in your country with
the corresponding situation in another country. Normally you work two and two, but you could also be three
in a group.

Your comparison should include both a descriptive part (giving data about the situation regarding some
aspects of public health) and an analytic one (trying to explain the differences in terms of e.g. economic and
political situation, population structure, geographical and historical conditions, etc.).

You should concentrate on a specific problem (e.g. child health, violence, HIV/AIDS, etc.).

Sources for your work are material and knowledge that each of you have from your different countries,
information from other course participants, official information in year books, statistical lists, information
from the websites on Internet, books, journal articles, etc. Many of the international health organizations
(WHO, UNDP, UNICEF, etc.) have produced statistical reports with valuable data.

You will present your work orally during the third course week. Your presentation should take approximately
15 minutes. All students are supposed to ask questions and comment upon your work and it is a requirement
to be present during the fellow students´ presentations. We recommend making the presentation using a
Power Point presentation (Maximun 12 slides).

Written examination
This exam is taken on the 8th of November. The exam is a mixture between medium and short open
questions related to the material covered during the course. You will find examples of previous exams on the
courseweb.

Final grade
The grading scale is Fail, Pass, and Pass with distinction for both the written exam and the course project. In
order to be awarded Pass for the course, the grade Pass is required both for the written exam and course

 
project. In order to be awarded Pass with distinction for the course, the grade Pass with distinction is
required for the written exam and pass or pass with distinction for the case study.

Umeå International School of Public Health

Epidemiology and Public Health Sciences
Department of Public Health and Clinical Medicine Umeå University, SE-901 85 Umeå, Sweden
Telephone +46 90 785 27 69, Telefax: +46 90 13 89 77 http://www.umu.se/phmed/epidemi/

Global Public Health I – Study Guide 2010/2011