Public Health and Aging CBHS 6626 Spring Semester 2012 2 semester hours of credit (not repeatable) Thursdays, 2:00-3:50 p.m., Education 2 North 2301

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CBHS 6626

Syllabus (
11/30/2013
) page
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22

Public Health and Aging
CBHS 6626


S
pring

Semester 20
1
2

2 semester hours of credit (not repeatable)

T
hur
sdays,
2
:00
-
3
:50
p
.m.,
Education 2
Nor
th
2
301

Instructor

Lucinda (Cindy)
Bryant, PhD MSHA MBA


Ass
ociate

Professor,
Department
s

of Community
&
Behavioral
Health

and Health Systems, Management & Policy
,
C
olorado School of Public Health

Office: Building 500, 3
rd

floor, Room E3340


E
-
mail:

lucinda.bryant@uc
denver
.edu


Phone:

(303)

724
-
4394 (office)


(720) 982
-
1192 (cell)


Fax:

(303)
724
-
4476


Office hours:
Thurs
days
before

class

or by appointment

Getting Started: Let’s Go!

The purpose of this course is to introduce you to
:


1.

F
actors across the social
-
ecological spectrum that affect population patterns of
health
,

disease
, and risk factors

in older adults
;

and

2.

Appropriate responses by

pu
blic health
,

aging services

and the research
community

to promote healthy aging.

Relevant

components

include
both community and behavioral factors and health
systems and policy issues such as
health status; personal
characteristics

(including
socio
demographic factors);
physical, economic, social and policy environments
;

and the
availability and
use of health
-
related, often community
-
based
services.

Course
Objectives

By the end of the course students will be able to:

1.

Identify the major issues
concerning health and well being in an aging population

2.

Describe the public health and aging services networks and their roles

3.

Critically examine
materials relevant to

gerontological public health

4.

Articulate how public health can address health issues in a
n aging population

To ach
ieve these objectives, we will
read and discuss relevant literature, c
onduct a fieldwork
environmental audit of walkability and assess

its

potential impact on policy
, and

review and
discuss public health issues important to older adult health.

Class Structure

The course is structured for participatory learning. Each class session usually will contain a
didactic presentation, related to the current topics but not
summarizing the readings
,
but w
e will spend much of our time
exploring,
analyzing, discussing, critiquing, and
synthesizing.
Students also will complete a hands
-
on fieldwork project.

I understand that life and business responsibilities exist, but I expect

you (and me
also, of course) to make every effort to attend class, be prepared, and actively
participate in discussions.
Please let me know in advance
if you
cannot attend

a
class, and
we will determine how best to assure that you miss as little as possi
ble
. The
advance notice of course does

n
o
t apply to e
vent
s beyond your control.

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Public Health
Competencies

The
COLORADO SCHOOL OF PUBLIC HEALTH

has established areas of competency
expected of MPH graduates. This course will address the following
subsets of these areas,
especially as they relate to health promotion and delivery of services for older adults:

BASIC PUBLIC HEALTH SCIENCE SKILLS
/CROSS
-
CUTTING COMPETENCIES

1.

Define, assess and report on the physical and mental health status of populations
,
determinants of health and illness, and factors contributing to health promotion and
disease prevention.


3.

Identify relevant and appropriate data and information sources.

6.

Communicate effectively both in writing and orally.


7.

Effectively present accurate de
mographic, statistical, programmatic and scientific
information for professional and lay audiences.

8.

Identify and address ethical issues that arise in public health practice and research.

18.

Analyze determinants of health and disease using an ecological
framework.

CONCENTRATION
-
SPECIFIC

CORE COMPETENCIES (expected of all MPH graduates)

CBHE3

Evaluate the social and community factors related to the health of communities,
assess community health needs, and identify potential interventions that consider
unique cultural settings.

CBHE4

Identify the causes of social and behavioral factors that affect health of
individuals and populations.

EHOH3

Specify approaches for assessing, preventing and controlling environmental
hazards that pose risks to human health

and safety.

EPID3

Describe a public health problem in terms of magnitude, person, time and place.

EPID8

Draw appropriate inferences from epidemiologic data

HSMP2

Demonstrate an understanding of factors influencing access to and utilization of
health servi
ces

HSMP4

Identify and interpret public health laws, regulations, and policies related to
specific health programs and the delivery of health services.


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Course materials

Journal readings and other materials will be made available
to you
on

eCollege

or occasionally handed out in class.
There are several books that you should own
:


Prohaska T., Anderson, L.A.,
Binstock, R.H. (
March

2012).

Public Health for an Aging Society
. Johns Hopkins University Press. ISBN
9781421404356
[when available]


Please note that this new version of an older text has not yet
become available
. The
publisher (and editors) currentl
y predict a March release (amazon.com has the
paperback version available for preorder now). Drs. Prohaska and Anderson, colleagues
in the CDC Healthy Aging Research Network, have kindly offered to supply us with
material on a chapter
-
by
-
chapter basis whi
le we wait.

Klinenberg, E. (2002).
Heat wave: A social autopsy of disaster in Chicago
. Chicago:
University of Chicago Press. ISBN 0226443221.

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Course Requirements


A.

P
articipation
and

discussion (
2
0

points

maximum
)

We will devote
substantial
class time to discussion,
interpretation, and debate of ideas presented in readings
and lectures.
T
he syllabus
specifies some

discussion
topics; you are encouraged to develop additional relevant
topics and questions

in areas that interest you
.


Please
assume that everyone has read the materials and
therefore use our discussion time less to summarize the
key content than to expand and explore perspectives.

Discussions should not focus on a regurgitation of the readings but concentrate on compari
ng
and contrasting viewpoints expressed in the readings, integrating materials across the course,
and exploring the readings’
applicability to

your
public health
research
and practice
interests
. You are
expected

to participate actively in discussions, deb
ating issues and ideas
with vigor
(and back
-
up references)
while treating
individuals

with respect.

B.

Short assignments (20 points maximum total)

1) Description of “your” older adult

(
5

points

maximum
; due February
2
)
.
We will
begin the course with an exploration
into what people mean by
“aging.”

To encourage you to think about your
own
perceptions, you
will write a short paper
(
3

pages)
for the second class
in which you
carefully and richly
create a fictitious older
person

(age 70 or older)
,
with

detail
s

of his/her

demographic,
family and social,
economic, and
health
and functional
status

characteristics
as well as
any
other
information about the person

that seems relevant

and interesting
.
You may
create an entirely fictitious person or
base your description
on

som
eone you know or have known
.


2) Changing d
emographics (5 points maximum
; due
February 1
6
)
.
Details

will be
posted on
eCollege
.

3
) Your o
lder adult
’s

benefits (5 points maximum
; due
February 2
3
)
. Calculate your
older adult’s estimated Social Security benefits
,

and select
Medicare health and prescription plan
s

for him/her.
Explore other available benefits.
Details
and
suggested

resources
will be posted on
eCollege
.

4
)
Your o
lder
adult
’s

budget
(5 points maximum
; also
due
February 2
3
)
.
Create a budget for your older adult.
Details
and
suggested

resources
will be posted on
eCollege
.

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C.

Environmental audit p
roject

(
30

points

maximum
)

Using a walkability audit tool
and instructions
that I will provide, you
(in 2 or more
groups depending on class size)
will assess a

Denver
/Aurora

neighborhood. You
then will
collaboratively

prepare written
and oral
report
s

that describe

your
findings concerning
characteristics of
the physical and built environment that
could affect

older adults’

health and healthy behaviors

and
that
suggest
potential
policy responses
.
We
may
have the opportunity to provide information and policy
recommendations to
the

community
.

You may conduct
your sections of
the audit
singly or in
small groups to fit your schedules
, but the
analysis and
written
(10
-
15 pages)
and
oral reports
must
be
collab
orative efforts
.
More complete instructions for this project will be
posted on
eCollege
, and we will
devote class time to
review
ing

the tool and
organizing the audit.
You
r

written report
s

will be due on
May 3
, and you will
present and
discuss
them

during class
that day.


D.

Final exam (
30

points

maximum
)

The
take
-
home
exam
, which will be posted on
eCollege

on
May 1
0
,

will
be
due

in the relevant eCollege dropbox
by

midnight

May
17

(exam week)
.
The exam likely will ask you to identify a small number of issues addressed
in the course and propose responses to them, so be thinking about your
choice of topics during the semester.

E.

Summary of assignments

Date Due

Projec
t

Maximum Points

continuous

Participation

20

various

Description of older adult and related exercises;
demographics exercise

20

May 3

Report (~ 10
-
15 pages written + oral
presentation) based on environmental walkability
audit, with potential policy
responses

30

May
17

(
midnight
)

Final exam

30

Total points


100


Grading

Assignments will be evaluated on a graduate
-
level grading scale:

90
-
100% (A/A+)
good
-
to
-
excellent

80
-
89% (B
+/B/B
-
) fair

70
-
79% (C
+/C/C
-
)
not graduate
-
level quality*

<70% failing


The rules for incomplete gra
des are complex; if they become an

issue,
let’s talk.

*
Although the MPH program considers a grade of C or better passing for an elective course, if a
C brings your GPA below 3.0 you must do whatever it takes to raise your GPA to 3.0 or higher.

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Writing
and submitting written assignments

Please use at least 11 point type

with
standard

line spacing.
S
ubmit

materials electronically

to

the
eCollege
dropbox

th
at I will create for each written assignment and the
final exam.
I will respond electronically as well
.
You may want an additional
hard copy to facilitate
your
in
-
class discussion.
The quality of your writing
matters, both in this course and in all succeeding academic and professional
endeavors; consult with a good editor if you need that sort of help.
The
Writing Center at UCD
provides one
-
on
-
one assistance to students
(
http://www.
ucdenver.edu/academics/colleges/CLAS/Centers/writing/Pages/
TheWritingCenter.aspx
)
.

I
expect clear writing and careful proofreading and editing; egregious
errors may affect your grade on a project
.
Assignments are due
by

the beginning

of class on
the spec
ified dates
. Extensions may be granted but only for truly unavoidable circumstances
and
(un)
natural disasters.

Academic Honesty

All students are expected to abide
by
the
h
onor
c
ode
s

of the Colorado School of Public Health.
Unless otherwise instructed, all of your work in this course should represent completely
independent work. Students are expected to familiarize themselves with the
Student Honor
Code

that can be found
in

the
Stud
ent Resources Section

of the CSPH website

at

http://www.cudenver.edu/Academics/Colleges/PublicHealth/students/StudentAffairs/StudentRes
ources/Documents/ColoradoSPH_StudentHonorCode.pdf
.
Any student found to have
committed acts of misconduct (including, but not limited to cheating, plagiarism, misconduct of
research,
and
breach of conf
identiality
) will be subject to the procedures outlined in the CSPH
Honor Code.

In our field(s) we often r
efer to what others have done and written. That is not only acceptable
but encouraged. Just be sure that you cite others’ contributions. In work for this class, if you
are referring to an assigned text or article, a brief in
-
text citation (e.g., (Jones
& Moon 1987) or
“Jones & Moon (1987) said”) is sufficient. If you draw on other materials (a good thing,
especially as
they relate

to your areas of interest), then please provide a more complete
reference

including Web address if relevant
. If you have an
y questions about what is or is not
permitted,
ask.


Special Needs

If you have special needs and wish to
request accommodations,
please

contact the Office of
Disability Resources &

Services (DRS) located in Building 500 of the Anschutz Medical
Campus, Room W1103 (West wing

of the first floor, Room 1103).
Their staff will assist in
determining reasonable accommodations as well as coordinating the approved
accommodations.

Contact in
formation:

Phone (303) 724
-
5640

Fax

(303)
724
-
5641

Please also talk
with
me

about any needs or concerns.

Electronics Courtesy

Computers and electronic notepads can reduce paper wastefulness
and ease note
-
taking. Please, however, silence all
electronic devices
when you enter the classroom and refrain from unrelated Web surfing
,

email management
, and other electronic activities

during class
.


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Course Outline

UNIT I.

AGING AND THE AGING POPULATION IN THE UNITED STATES

Overview
: During this first unit we will set the stage for examining
outcomes and risk factors
associated with aging and beginning to define the role of public health
.
We first will “walk
through” the course, briefly review the history
and some theories
of gerontology, and begin to
build a toolkit of resources.
We then

will talk about aging (what it is and what it is not),
what
“normal” and “usual
/pathologic
” a
ging look like,
and
how we talk about aging
.

January 2
6
:

Introduction

General t
opics



Getting
acquainted: What i
s your interest in aging?





Introduction to course: rules & regs, structure, requirements, course outline



A brief history of gerontology

and
some

aging

theories


Activity
/Discussion

#1: Think of
people

you think
are

aging/did age well
or poorly.
What characteristics of th
ose

pe
ople
contribute to your perceptions?

Lecture #1: Introduction to the course

Lecture #2: Brief h
istory of gerontology, aging theories

Activity #2: Intro to environmental audit

N
ext week
:



Short paper

(basis

also

for subsequent activities
)
:
create
and write a short paper
about
a fictitious older person
.
See “Course Requirements”
and eCollege
for details.

February
2
:

What is aging?


Assignment due
:
Short paper

General topics



What do we mean by “aging”

and

by “being old”
?



Demographics of aging in the United States



How do we talk about aging?


Discussion

#1
:
What do we mean by aging
, by being old
?


How do you know that
someone is old?


What characteristics make you think so?

Why?


Lecture #
1
:
The demography and biology of aging:
Who i
s aging and how?

Lecture #
2
: How do we talk about aging?


Discussion #2: First impressions of

Heat Wave



Readings

Required readings

Gawande, A. (2007). The way we age now [Annals of Medicine].
The New Yorker
,

April
30, 2007, 50
-
9.

Klinenberg, E. (2002). The spectacular city: news organizations and the representation
of catastrophe. In
Heat wave: A social autopsy of disaster in Chicago
. Chicago:
University of Chicago Press, Chapter 5, 185
-
224. [
Probably a good
idea to read
through the book, then go back to specific chapters as assigned
.]

Journalists Exhange on Aging. Survey on Style (Summer 2007
).
Age Beat

24. Available
at:

http://www.medinaassociates.com/agebeatsurvey.pdf
.


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Additional readings and references

Centers for Disease Control and Prevention and
t
he Merck Company Foundation.
The
State of Aging and Health in America.
Interactive version available at:
http://apps.nccd.cdc.gov/SAHA/Default/Default.aspx


National Institute on Aging.
Growing Old
er

in America: The Health and Retirement
Study
. [NIH Publication No. 07
-
5757], 2007. Available at
:

http://www.nia.nih.gov/health/publication/growing
-
older
-
america
-
health
-
and
-
retirement
-
study


Luo, Y., Xu, J., Granberg, E., Wentworth, W.M. (2011). A longitudinal study of social
status, perceived discrimination, and physical and emotional health among older
adults.
Research on Aging

xx(x), 1
-
27.
Published online before print
December 14,
2011
, doi:
10.1177/0164027511426151.

Resource materials

Centers for Disease Control and Prevention
.
The State of Mental Health and Aging in
America
.

Available at:
http://apps.nccd.cdc.gov/MAHA/MahaHome.aspx


World Health Organization.
Webpage on Aging
.

Available at:
http://www.who.int/topics/ageing/en/

Trends in health and aging.
National Center for Health Statistics.

Available at:
http://www.
cdc.gov/nchs/ppt/aging/aging_english.ppt



Aging in the Americas
Conference Series
. Available at:
http://www.utexas.edu/lbj/caa/index.php

Administration on Aging. National Center on Elder Abuse. Ageism webpage. Available
at:
http://www.ncea.aoa.gov/main_site/library/cane/CANE_Series/CANE_agesism.aspx

National Institut
e

on Aging

(2008).
Making
y
our
p
rinted
h
ealth
m
aterials
s
enior
f
riendly
.
Available at:
http://nacanet.nia.nih.gov/HealthInformation/Publications/srfriendly.htm



N
ext week
:




Discussion

of “compression” theories

UNIT II.

CHALLENGES TO HEALTHY AGING

Overview
: The
second

section of the course will examine risk factors associated with aging
healthily or not, using the social
-
ecological framework to organize
the
material
.

We will

identify
the issues and discuss the role of public health
.

During one week’s class we will prepare and
train fo
r environmental audit fieldwork.

February
9

E
pidemiology of aging


General t
opics



Social
-
ecological framework



Epidemiology of

aging




Chronic diseases and conditions



Function and d
isability

Lecture #
1
: What factors affect aging? A social
-
ecological framework

Lecture #
2
:
Chronic disease, d
isability and modifiable risk

Discussion #1: Compression of
morbidity/mortality/disability




What does “compression of morbidity” mean?



What supports the concept?



What contradicts the concept?

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What effect might compression of morbidity/mortality/disability have at different
social
-
ecological levels (individual, econ
omic, community, etc.)?

Readings

Required readings

Satariano, W.A. (2006). Aging, health, and the environment: an ecological model. In
Satariano, W.A.
Epidemiology of Aging
. Sudbury MA: Jones and Bartlett Publishers,
Chapter 2, 39
-
84.

Link, B.G., Phelan, J. (1995). Social conditions as fundamental causes of disease.
Journal of Health & Social Behavior

(extra issue), 80
-
94.

Branch, L.G., Meng, H., Guralnik, J.M. (2011). Disability and functional status. In T.R.
Prohaska, L.A. Anderson,
R.H. Binstock (eds).
Public Health for an Aging Society
.
Baltimore MD: Johns Hopkins University Press, Chapter 6.

Hughes, S.L., Ory, M.G., Seymour, R.B. (2011). Behavioral risk factors and evidence
-
based interventions. In T.R. Prohaska, L.A. Anderson, R.H.

Binstock (eds).
Public
Health for an Aging Society
. Baltimore MD: Johns Hopkins University Press, Chapter
7.

Discussion topic readings

Fries, J.M. (2005). Frailty, heart disease, and stroke: the compression of morbidity
paradigm.
American Journal of
Preventive Medicine

29(5S1):164

168.

Kinsella, K.G. (2005). Future longevity


demographic concerns and consequences.
Journal of the American Geriatrics Society

53:S299
-
303.

Manton, K.G., Gu, X., Lamb, V.L. (2006). Change in chronic disability from 1982 to

2004
-
2005 as measured by long
-
term changes in function and health in the U.S.
elderly population.
PNAS

103(48):18374
-
9.

Freedman, V.A.,Martin, L.G., Schoeni, R.F., Cornman, J.C. (2008). Declines in late
-
life
disability: the role of early
-

and mid
-
life fac
tors.
Social Science and Medicine

66:1588
-
1602.

Seeman, T.E., Merkin, S.S., Crimmins, E.M., Karlamangla, A.S. (2010). Disability trends
among older Americans: National Health and Nutrition Examination Surveys, 1988

1994 and 1999

2004.
American Journal of P
ublic Health

100:100
-
7.

Parker, M.G., Thorslund, M. (2007). Health trends in the elderly population: getting better
and getting worse.
The Gerontologist

47(2
):
150
-
8.

Westendorp, R.G.J. (2006). What is healthy aging in the 21
st

century?
American Journal
of
Clinical Nutrition

83(2):404S
-
409S. (Just the section “Longer well or poorly
longer?”) Available at:
http://www.ajcn.org/cgi/content/full/83/2/404S


Additional readings and references

Verbrugge, L.M., Jette, A.M. (1994). The disablement process.
Social Sc
ience &
Medicine

38:1
-
14.


Bryant,L.L.; Shetterly,S.M.; Hamman,R.F. (2002). Modifiable risks of incident functional
dependence in Hispanic and non
-
Hispanic white elders: The San Luis Valley Health
and Aging Study.
The Gerontologist

42
:
690
-
7.


N
ext week
:




Changing demographics activity
:


See “Course Requirements” and
eCollege

for

details.

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February 1
6

Why is aging
an important

public health

issue
?

Assignment due: Changing demographics activity

General topics



Why is aging an important issue for public
health?



Population perspective



Variability
,

d
iversity
, and disparities



Population
-
level effects of changing demographics

Lecture #1: Population health perspective

Discussion #1: Effects of changing demographics

Lecture #2:
Variability and diversity

Discussion #2:
P
ublic health issues and the roles of public health

related to aging

and diversity

Lecture #3:
Intro to t
ime value of money

(for budget assignment)

Readings

Required readings

Rose, G. (1985). Sick individuals and sick populations.
International Journal of
Epidemiology

14(1):32
-
8.

Frieden, T.R. (2010). A framework for public health action: the health impact pyramid.
American Journal of Public Health

100:590
-
5.

Hartley, D. (2004). Rural health disparities, population health, and rural

culture.
American Journal of Public Health

94:1675
-
8.

Discussion topic readings

Klinenberg, E. (2002). The
city of extremes
. In
Heat wave: A social autopsy of disaster in
Chicago
. Chicago: University of Chicago Press,
Introduction
,
14
-
36
.

Additional
readings

Rose, G. (1992). Prevention for individual
s and the ‘high risk’ strategy.

In
The
S
trategy
of
P
reventive
M
edicine
. New York: Oxford University Press; Chapter 4, 29
-
52.

Rose, G. (1992). “The population strategy of prevention.” In
The
S
trategy of

Preventive
M
edicine
. New York: Oxford University Press; Chapter 7, 95
-
106.

Sarto, G.E. (2004). The gender gap: new challenges in women’s health.
Sexuality,
Reproduction & Menopause

2(1), 9
-
14.

Kelley
-
Moore, J., Ferraro, K. (2004). The Black/White disability gap: Persistent Inequality
in later life?
Journal of Gerontology Social Sciences

59B, S34
-
43.

N
ext week
:




Benefits and budget activities:

See “Course Requirements” and
eCollege

for

details.


February 2
3

Socioeconomic status; h
ousehold

structure;

work

and retirement

Assignment due: Benefits and budget activities

General topics



Income, wealth, poverty
,
economic security



Social status



Work and retirement

Lecture #1:
Socioeconomic status and
social class

Discussion #1:
Individual economics of aging (b
enefits and budgets
)

CBHS 6626

Syllabus (
11/30/2013
) page
11

of
22

Lecture #
2
:
Work and retirement

Guest presenter: Ken S
cott

MPH

Activity #1:
Brief intro to

audit materials

Readings

Required readings

Wallace, S.P. (2011). Social determinants of health inequities and health care in old age.
In T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds).
Public Health for an Aging
Society
. Baltimore MD: Johns Hopkins University Press, Chapter 5.

Krieger,N.; Willia
ms,D.R.; Moss,N.E. (1997). Measuring social class in US public health
research: concepts, methodologies, and guidelines.
Annual Review of Public Health

18:341
-
78.

The Elder Economic Security Initiative
:
The Elder Economic Security Standard Index for
Colorado
. Available at:
http://www.wowonline.org/documents/COElderIndex.pdf

Frank, J.C., Weiss, J. (2011). Public health workforce: preparing for an aging society. In
T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds).
Public Health for an Aging
Society
. Ba
ltimore MD: Johns Hopkins University Press, Chapter 13.

Ilmarinen, J.E. (2001). Aging workers.
Occupational and Environmental Medicine

58:546
-
52.

Silverstein M. (2008). Meeting the challenges of an aging workforce.
American Journal
of Industrial Medicine

51:269

80.

National Institute for Occupational Safety and Health. (2009). The worklife initiative.
DHHS (NIOSH) Publication No. 2009
-
146

Flippen, C., Tienda, M. (2000). Pathways to retirement: Patterns of labor force
participation and labor market exit am
ong the pre
-
retirement population by race,
Hispanic origin, and sex.
Journal of Gerontology

55B, S14
-
27.

Gallo, W., Bradley, E., Siegel, M., Stanislav, K. (2001). Health effects of involuntary job
loss among older workers: Findings from the Health and Ret
irement Survey.
Journals of Gerontology:Social and Psychological Sciences

55B(3), S131
-
140.


Additional readings and references

Ekerdt, D.J. (2010). Frontiers of research on work and retirement.
Journals of
Gerontology: Social Sciences

65B(1):69
-
80.

March
1

Brain health and p
sychosocial factors

General topics



Cognition



Depression/emotional health



Social support and social isolation



Public health responses

Activity #1: CES
-
D

Activity #2: MMSE

Activity #3: Stroop

Lecture #1:
The public health challenge of
dementia

Guest presenter: Nancy West PhD


Lecture #2 and Discussion #1: Depression and social isolation

Discussion #2: Public health response: HAN Healthy Brain & depression/emotional
health reviews & cognition/chronic condition review

Readings

CBHS 6626

Syllabus (
11/30/2013
) page
12

of
22

Required

readings

Brayne, C. [yes, really] (2007). The elephant in the room


healthy brains in later life,
epidemiology and public health.
Nature Reviews

8, 233
-
9.

Chapman, D.P., Williams, S.M., Strine, T.W., Anda, R.F., Moore, M.J. (2006). Dementia
and its impli
cations for public health.
Preventing Chronic Disease

3(2), 1
-
13.


Morrow
-
Howell, N., Gehlert, S. (2011). Social engagement and a healthy aging society.
In T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds).
Public Health for an Aging
Society
. Baltimore MD:

Johns Hopkins University Press, Chapter 10.

Chapman, D.P., Perry, G.S. (2008). Depression as a major component of public

health
for older adults.
Preventing Chronic Disease

2008 5(1). Available at.
http://www.cdc.gov/pcd/issues/2008/jan/07_0150.htm
.


Step
toe, A., Marmot, M. (2003).
Burden of psychosocial adversity and vulnerability in
middle age: associations with biobehavioral risk factors and quality of life.

Psychosomatic Medicine

65:1029

1037. Available at
http://www.psychosomaticmedicine.org/cgi/reprint/65/6/1029
.

Klinenberg, E. (2002). Dying alone: the social production of isolation. In
Heat wave: A
social autopsy of disaster in Chi
cago
. Chicago: University of Chicago Press,
Chapter 1, 37
-
78.

Additional readings

and references

Steinman, L.E., Frederick
, J.T., Prohaska, T., Satariano, W.A., Dornberg
-
Lee, S., Fisher,
R., et al. for the Late Life Depression Special Interest Project (SIP) Panelists (2007).
Recommendations for treating depression in community
-
based older adults.

American Journal of Preventiv
e Medicine

33(3):175

81.

Centers for

Disease Control and Prevention (2011).

The CDC Healthy Brain Initiative:
Progress 2006

2011
.

Atlanta GA: CDC
.

Accessible from this webpage:
http://www.cdc.gov/aging//pdf/HBIBook_508.pdf



Schnittker, J.

(2007)
.
Look (closely) at all the lonely people: age and the social
psychology of social support.
Journal of Aging and Health

19
(4)
,
659
-
82
.

Skarupski, K., Mendez de Leon, C., Bienias, J., Barnes, L., Everson
-
Rose, S., Wilson,
R., Evans, D. (2005). Black
-
White dif
ferences in depressive symptoms among older
adults over time.
Journal of Gerontology Psychological Sciences
, 60B(3), P136
-
42
.

N
ext week
:




Review
walkability audit materials

March
8

Physical and built environment

Assignment: Review walkability audit materials posted on
eCollege

General topics



Characteristics of the physical and built environment



Neighborhoods



Urban vs rural (non
-
metropolitan)



Wayfinding



Preparation for walkability audit


Lecture #1: Older adults
and the physical/built environment

Activity #1:
Preparation for environmental audit

CBHS 6626

Syllabus (
11/30/2013
) page
13

of
22

Readings

Required readings

HAN walkability audit tool

Satariano, W.A., Ory, M.G., Lee, C. (2011). Planned and built environments in public
health. In T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds).
Public Health for an
Aging Society
. Baltimore MD: Johns Hopkins University Press, Chapter 15.

Macintyre, S.,
Ellaway, A. (2003). Neighborhoods and health: An overview. In
Neighborhoods and health
, Kawachi, I., Berkman, L.F., eds. New York: Oxford
University Press, Chapter 2, 20
-
42.

Klinenberg, E. (2002). Race, place, and vulnerability: urban neighborhoods and t
he
ecology of support. In
Heat wave: A social autopsy of disaster in Chicago
. Chicago:
University of Chicago Press, Chapter 2, 79
-
128.

King, D. (2008).
Neighborhood and individual factors in activity in older adults: Results
from the Neighborhood and Sen
ior Health Study.
Journal of Aging and Physical
Activity

16:144
-
70.

Additional readings and references

Sallis, J.F., Cervero, R.B., Ascher, W., Henderson, K.A., Kraft, M.K., Kerr, J. (2006). An
ecological approach to creating active living communities.
Annual Review of Public
Health

27:297
-
322.

Wood, L., Shannon, T., Bulsara, M., Pikora, T., McCormack, G., Giles
-
Corti, B. (2008).
The anatomy of the safe and social suburb
: An exploratory study of the built
environment, social capital and residents’ percep
tions of safety.
Health & Place

14:15

31.

Geller, A.M., Zenick, H. (2005). Aging and the environment: a research framework.
Environmental Health Perspectives

113(9), 1257
-
62.

Hartley, D. (2004). Rural health disparities, population health, and rural culture.
American Journal of Public Health

94:1675
-
8.

Sharkey, J.R. (2009). Measuring potential access to food stores and food
-
service places
in rural areas in the U.S.
American Jo
urnal of Preventive Medicine

36(4S):S151
-
5.

Health, United States, 2001, with urban and rural chartbook
. Washington DC: National
Center for Health Statistics. Available at:
http://www.cdc.gov/nchs/data/hus/hus01.pdf


Health, United States, 2010
(
without

the urban and rural chartbook) is

available at
http://www.cdc.gov/nchs/data/hus/hus10.pdf

M
aterials to prepare for environmental walkability audit

Audit tool

Map example


Next week
:




Your older adult’s caregiving needs

UNIT III.

PRACTICE
,
POLICY
,
AND
RELATED ISSUES

Overview
: In the third section of the course
, we will explore

the aging service
s

network,

the
public health network, and health care systems

that may respond to the challenges to healthy
aging that we have identified. W
e

will examine the
ir

structures

and

roles

and policies related to

them

as they deal with an aging population
.
W
e
then
will discuss some ethical issues
.

March
15

Aging
services
network

General topics



Structure of aging services network


CBHS 6626

Syllabus (
11/30/2013
) page
14

of
22



Collaboration with public health



Caregiving

Lecture

#1
: Aging services network and interactions with public health

Lecture #2
:
Formal and informal c
aregiving

Discussion

#1:
What caregiving needs and responsibilities might your older adults
have?
Time to work on project and
presentations

Readings

Required readings

Administration on Aging.
Summary of the Affordable Care Act and Opportunities for the
Aging Netw
ork
. Available at:
http://www.aoa.gov/AoARoot/Aging_Statistics/docs/AoA_Affordable_Care.pdf

Gitlin, L.N., Schulz, R. (2011). Family caregiving of older adults. In T.R. Prohaska, L.A.
Anderson, R.H. Binstock (eds).
Public Health for an Aging Society
. Balti
more MD:
Johns Hopkins University Press, Chapter 9.

Discussion topic readings

Pinquart, M., Sorensen, S. (200
3).
Associations of
s
tressors and

u
plifts of
c
aregiving

w
ith
c
aregiver
b
urden and
d
epressive

m
ood:

a

m
eta
-
a
nalysis
.
Journal of
Gerontology:
Psychological Sciences

58B
(2),

P112

28
.

Pinquart, M., Sorensen, S. (2005). Ethnic differences in stressors, resources, and
psychological outcomes of family caregiving: A meta
-
analysis.
The Gerontologist

45(1), 90
-
106.

Feinberg, L.F., Newman, S.L.
(2004). A

study of 10 states since passage of the National
Family Caregiver Support Program: policies, perceptions, and program development.
The Gerontologist 44(6), 760
-
9.

National Caregiver Support Program. Available at:
www.agingcarefl.org/caregiver/NationalSupport

Additional readings

and references

Administration on Aging. About AoA. Available at:
http://www.aoa.gov/about/about.asp


Administra
tion on Aging.
Historical evolution of programs for older Americans
. Available
at:
http://www.aoa.gov/AoA_programs/OAA/resources/History.aspx


March 22

Spring Break: no class

March 29

Aging as a public policy issue: Future of entitlement programs

General topics



Medicare/Medicaid



Social Security

Lecture

#1:
Future of entitlement programs

Guest Lecturer: Adam Atherly PhD


Readings

Required readings

Buchner, D.M. (2011). Public health policy successes. In T.R. Prohaska, L.A. Anderson,
R.H. Binstock (eds).
Public Health for an Aging Society
. Baltimore MD: Johns
Hopkins University Press, Chapter 11.

Stone, R.I., Benson, W.F. (2011). Financing and organi
zing health and long
-
term care
services for older populations. In T.R. Prohaska, L.A. Anderson, R.H. Binstock (eds).
Public Health for an Aging Society
. Baltimore MD: Johns Hopkins University Press,
Chapter 3.

CBHS 6626

Syllabus (
11/30/2013
) page
15

of
22

Binstock, R.H. (2011).
Resource allocation in an aging U.S. society.
In T.R. Prohaska,
L.A. Anderson, R.H. Binstock (eds).
Public Health for an Aging Society
. Baltimore
MD: Johns Hopkins University Press, Chapter 18.

Feldstein, P.J. (2006). Medicare. In P.J. Feldstein.
The Poli
tics

of Health Legislation: An
Economic Perspective

[3
rd

edition]. Chicago: Health Administration Press, Chapter
9, 269
-
92.

Centers for Medicare and Medicaid Services. Medicare program


general information:
overview. Available at:
http://www.cms.hhs.gov/MedicareGenInfo/


Centers for Medicare and Medicaid Services. History: overview. Available at:
http://www.cms.hhs.gov/History/


Centers for Medicare and Medicaid Services. Medicaid program


general information:
overview. Available at:
http://www.cms.hhs.gov/MedicaidGenInfo/


N
ext week

preparation
:




Elder abuse: prevalence, reporting, preventing

April
5

Public health
network; public health
issues related to older adults

General topics



Public health network



Falls prevention



Elder abuse

Lecture #1: Public health network

Lecture #
2
:
Falls prevention

Guest Lecturer: Carolyn DiGuiseppi

MD MPH PhD

Discussion #1
: Elder abuse

and what to do about it


Readings

Required readings


Fried, L.P. (2010). What are the roles of public health in an aging society? In T.R.
Prohaska, L.A. Anderson, R.H. Binstock (eds).
Public Health for an Aging Society
.
Baltimore MD: Johns Hopkins University Press, Chapter 2.

National Association of Chronic Disease Directors (2009).
Meeting the Challenges of an
Aging Society: The Experience of State Health Departments
. Available at:
http://www.chronicdisease.org/nacdd
-
initiatives/healthy
-
aging/related
-
resources/Aging_Society_SHD.pdf

Kaiser Family Foundation (2011). Medicare policy fact sheet: Medicare spending and
financing. Available at: http://www.kff.org/medic
are/upload/7305
-
06.pdf

Discussion readings (elder abuse)

Abbey, L. (2009). Elder abuse and neglect: when home is not safe.
Clin Geriatr Med

25,
47

60.

Cooper, C., Selwood, A., Livingston, G. (
2008).
The prevalence of elder abuse and
neglect: a systematic review.
Age and Ageing

37,
151

160.

Krienert, J.L., Walsh, J. A., Turner, M. (2009). Elderly in America: a descriptive study of
elder abuse examining National Incident
-
Based Reporting System (NIBRS) d
ata,
2000
-
2005.
Journal of Elder Abuse & Neglect

21,4, 325
-
345.

Donohue, W.A., Dibble, J.L., Schiamberg, L.B. (2008). A social capital approach to the
prevention of elder mistreatment.
Journal of Elder Abuse & Neglect
, 20, 1, 1
-
23.

Ploeg, J., Fear, J., Hu
tchison, B., MacMillan, H., Bolan, G. (2009). A systematic review
of interventions for elder abuse.
Journal of Elder Abuse & Neglect
, 21, 3, 187
-

210.


Additional readings and resources

CBHS 6626

Syllabus (
11/30/2013
) page
16

of
22

Colorado Department of Human Services.
Protective
Programs De
scriptions
.

Available
at
http://www.colorado.gov/cs/Satellite/CDHS
-
SelfSuff/CBON/1251582068463


Centers for Disease Control and Prevention.
El
der
M
altreatment
. Available at
http://www.cdc.gov/ViolencePrevention/eldermaltreatment/index.html


April 12

Public health
interactions with health care systems: practice related
to an aging population

General topics



Geriatric medicine (and long
-
term care)



Palliative and end
-
of
-
life care

Lecture #1

and Discussion #1
: Geriatric medicine and end
-
of
-
life care


public health
perspectives

Guest lecturer: Cari Levy MD, Division of Health Care Policy and Research, University
of Colorado Denver


Readings

Required readings

National Quality Forum (2011).
Multiple Chronic Conditions Measurement Framework

[draft report for commentin
g]. Available at:
http://www.qualityforum.org/Projects/Multiple_Chronic_Conditions_Measurement_Fr
amework.aspx?section=PublicandMemberComment2011
-
12
-
142012
-
01
-
13#t=2&s=&p

[link at bottom of webpage]

Boyd, C.M., Darer, J., Boult, C., Fried, L.P., Boult, L., Wu, A.W. (2005).
Clinical practice
guidelines and quality of care for older patients with multiple comorbid diseases:
Implications for pay for performance.
JAMA

294, 716
-
24.

Besdine, R.

(2005)
.
Cari
ng for older Americans: the future of geriatric medicine.
Journal
of the American Geriatrics Society

53
(6 suppl)
,

S245
-
56
.

Higginson, I.J., Koffman, J. (2005). Public health and palliative care.
Clinics in Geriatric
Medicine

21, 45
-
55.

Rao, J.K., Alongi, J., Anderson, L.A., Jenkins, L., Stokes, G
-
A., Kane, M. (2005).
Development of public health priorities for end
-
of
-
life initiatives.
American Journal of
Preventive Medicine

29(5), 453
-
60.

Stjernsward, J., Foley, K.M., Ferris, F.D. (2007)
. The public health strategy for palliative
care.
Journal of Pain and Symptom Management

33, 486
-
93.

Additional readings and resources

April
19

Public health’s aging perspective: disease prevention and health
promotion

General topics



Public health and the aging population




Community
-
based practice: interventions

Lecture #
1
: Designing community
-
based interventions in older populations: The
proce
ss of translation and dissemination

Guest
Lecturer

via videotape: Thomas Prohaska PhD,
George Mason University
(previously
University of Illinois Chicago
)


Readings

Required readings

CBHS 6626

Syllabus (
11/30/2013
) page
17

of
22

Klinenberg, E. (2002). Emerging dangers in the urban environment. In
Heat wave: A
social autopsy of disaster in Chicago
. Chicago: University of Chicago Press,
Conclusion, 225
-
235.


Prohaska, T.R., Smith
-
Ray, R., Glasgow, R.E. (2011). Translation, dissemination and
implementation issues. In T.R. Prohaska, L.A. Anderson, R.H.

Binstock (eds).
Public
Health for an Aging Society
. Baltimore MD: Johns Hopkins University Press, Chapter
8.

Navarro, A.M., Voetsch, K.P., Liburd, L.C., Giles, H.W., Collins, J.L. (2007)
.

Charting the
future of community health promotion: recommendations
from the National Expert
Panel on Community Health Promotion.
Preventing Chronic Disease

[serial online]
2007 Jul [
viewed 1/
10
/
12
]. Available from:
http://www.cdc.gov/pcd/issues/2007/

jul/07_0013.htm

Additional readings and references

National Council on Aging. Center for Healthy Aging.
Community
P
rograms
. Available
from:
http://healthyagingprograms.org/content.asp?sectionid=8


National Association of Chronic Disease Directors. Healthy Aging Council. Available at:
http://www.chronicdisease.org/nacdd
-
initiatives/healthy
-
aging/healthy
-
aging
-
council

Mangin, D., Sweeney, K., Health, I. (2007). Preventive health care in elderly people
needs rethinking.
BMJ

335:285
-
7.

Preparation for next week
:




Obesity prevention intervention

April
26

Public health research related to an aging population

General topics



Community
-
based
research


Lecture #1: Conducting community
-
based translation and dissemination research

Discussion topic #1: Obesity prevention intervention

Time to work on project and presentations

Readings

Required readings

Furner, S.E., Anderson, L.A. (2011). Assessing the health and quality of life of older
populations: concepts, resources, and systems. In T.R. Prohaska, L.A. Anderson,
R.H. Binstock (eds).
Public Health for an Aging Society
. Baltimore MD: Johns
Hopkins Univ
ersity Press, Chapter 3.

Minkler, M., Blackwell, A.G., Thompson, M., Tamir, H. (2003). Community
-
based
participatory research: implications for public health funding.
American Journal of
Public Health
93, 1210
-
3.

Discussion topic readings

Additional readings and resources

Prohaska, T., Belansky, E., Belza, B., Buchner, D., Marshall, V., McTigue, K., Satariano,
W., Wilcox, S. (2006). Physical activity, public health, and aging: critical issues and
research priorities.
Journal of

Gerontology: Social Sciences

61B(5), S267
-
73.

Preparation for next week
:




Audit report

May 3

Walkability audit

Assignment due: Walkability audit report

CBHS 6626

Syllabus (
11/30/2013
) page
18

of
22

Discussion #1: Walkability audit experiences, results, and policy recommendations


May 1
0

Ethical
issues in research and practice

General topics



Ethical decision
-
making



Research with older adults (COMIRB)



Final reflections on
Heat Wave

Lecture

#1
: Ethical decision
-
making, ethical research


Guest Lecturer: Casey Frank JD

Discussion
#1
: Klinenberg &
Heat Wave

Review and exam preparation

Readings

Required readings

Ethical decision
-
making guidelines

Discussion topic readings

Klinenberg, E. (2002). Governing by public relations. In
Heat wave: A social autopsy of
disaster in Chicago
. Chicago: University

of Chicago Press, Chapter 4, 165
-
84.

May
17

Finals week

Assignment due: Take
-
home final

due by noon on
May
1
7

(eCollege dropbox)
CBHS 6626

Syllabus (
11/30/2013
) page
19

of
22

CBHS 6626 Public Health and Aging

Course Summary, Spring 2012

Thursdays, 2:00
-
3:50 p.m., Education 2 North 2301

Date

Topics and Activities (see full syllabus and eCollege for
Readings)

Assignment due

Prep next week

UNIT I.

AGING AND THE AGING POPULATION

IN THE UNITED STATES

January 26

Introduction



Activity/Discussion #1: Think of people you think are aging/did
age well or poorly. What characteristics of those people
contribute to your perceptions?



Lecture #1: Introduction to the course



Lecture #2: Brief history of gerontology, aging theories



Activity #2: Intro to environmental audit


Short paper

February 2

What is aging?

General topics



What do we mean by “aging” and by “being old”?



Demographics of aging in the United States



How do
we talk about aging?




Discussion #1: What do we mean by aging, by being old? How
do you know that someone is old? What characteristics make
you think so? Why?



Lecture #1: The demography and biology of aging: Who is
aging and how?



Lecture #2: How do
we talk about aging?



Discussion #2: First impressions of
Heat Wave

Short paper
(basis also
for subsequent activities):

create and write a short
paper about a fictitious
older person. See
“Course Requirements”
and eCollege for details.

Discussion of
comp
ression
theories

UNIT II.

CHALLENGES TO HEALTHY AGING

February 9

Epidemiology of aging

General topics



Social
-
ecological framework



Epidemiology of aging



Chronic diseases and conditions



Function and d
isability



Lecture #1: What factors affect aging? A social
-
ecological
framework

Discussion:
compression of
morbidity

Changing
demographics

CBHS 6626

Syllabus (
11/30/2013
) page
20

of
22



Lecture #
2
:
Chronic disease, d
isability and modifiable risk



Discussion #1: Compression of morbidity/

mortality/disability


February 16

Why is aging an important public health issue?

General topics



Why is aging an important issue for public health?



Population
-
level effects of changing demographics



Lecture #1: Population health perspective



Discussion #1: Effects of changing
demographics



Lecture #2: Variability and diversity



Discussion #2:
P
ublic health issues and the roles of public
health

related to aging

and diversity



Lecture #3:
Intro to t
ime value of money

(for budget
assignment)

Changing
demographics activity

Benefits

and
budget

February 23

Socioeconomic status; household structure; work and
retirement

General topics



Income, wealth, poverty, economic security



Social status



Work and retirement



Lecture #1:
Socioeconomic status and social class



Discussion #1:
Individual economics of aging (benefits and
budgets
)



Lecture #
2
:
Work and retirement (Ken Scott MPH)



Activity #1: Brief intro to audit materials

Benefits and budget
activities


March 1

Brain health and psychosocial factors

General topics



Cognition



Depression/emotional health



Social support and social isolation



Screening activities



Lecture #1:
The public health challenge of dementia (Nancy
West PhD)



Lecture #2 and Discussion #1: Depression and social isolation



Discussion #2: Public health
response


Review
walkability audit
materials

March 8

Physical and built environment

Review walkability
Caregiving
CBHS 6626

Syllabus (
11/30/2013
) page
21

of
22

General topics



Characteristics of the physical and built environment



Neighborhoods



Urban vs rural (non
-
metropolitan)



Wayfinding



Preparation for walkability audit




Lecture
#1: Older adults and the physical/built environment



Activity #1: Preparation for environmental audit

audit materials

needs

UNIT III.

PRACTICE
,
POLICY
, AND RELATED ISSUES

March 15

Aging services network

General topics



Structure of aging services network



Collaboration with public health



Caregiving



Lecture

#1
: Aging services network and interactions with
public health



Lecture #2
:
Formal and informal c
aregiving



Discussion

#1: What caregiving needs and responsibilities
might your older adults have?

Your older adult’s
caregiving needs


March 22

Spring Break


no class



March 29

Aging as a public policy issue

General topics



Medicare/Medicaid



Social Security

Lecture

#1:
Future of entitlement programs (Adam Atherly PhD)


Elder abuse

April 5

Public health network; public health issues related to older
adults

General topics



Public health network



Falls prevention



Elder abuse



Lecture #1: Public health network



Lecture #
2
:
Falls prevention

(Carolyn DiGuiseppi MD

MPH PhD
)



Discussion #1: Elder abuse and what to do about it

Discussion:
Elder
abuse


April 12

Public health interactions with health care systems

General topics



CBHS 6626

Syllabus (
11/30/2013
) page
22

of
22



Geriatric medicine (and long
-
term care)



Palliative
and end
-
of
-
life care



Lecture #1

and Discussion #1
: Geriatric medicine and end
-
of
-
life care


public health
perspectives

(Cary Levy MD)

April 19

Public health’s aging perspective: disease prevention and
health promotion

General topics



Public health and
the aging population



Community
-
based practice: interventions



Lecture #
1
: Designing community
-
based interventions in
older
populations:
(Thomas Prohaska PhD
)


Obesity
prevention
intervention

April 26

Public health research related to an aging population

General topics



Community
-
based research



Lecture #1: Conducting community
-
based translation and
dissemination research



Discussion topic #1: Obesity prevention intervention



Time to work on project and presentations


Audit report

May 3

Walkability audit



Discussion #1: Walkability audit experiences, results, and
policy recommendations

Walkability audit
report


May 10

Ethical issues in research and practice

General topics



Ethical decision
-
making



Research with older adults



Final reflections on
Heat Wave



Lecture #1: Ethical decision
-
making, ethical research

(tentative
Casey Frank JD)



Discussion #1: Klinenberg &
Heat Wave



Review and exam preparation



May 17

Final exam due by midnight MDT