UMEÅ INTERNATIONAL SCHOOL

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1 UMEÅ INTERNATIONAL SCHOOL OF PUBLIC HEALTH Master Programme in Public Health - Programme and Courses Academic year Public Health and Clinical Medicine Umeå International School of Public Health Epidemiology and Global Health Umeå University Sweden

2 The challenge of Public Health Recent years have seen major developments in our understanding of health, but although factors behind disease may be better understood today, basic underlying causes such as poverty often preclude major advances. Public health therefore must use a multidisciplinary approach, including both social sciences and medicine, and the combined use of qualitative and quantitative methods, to further evaluate and influence communities' health. Public health is a multi-disciplinary field of study in which research from several areas have come together to develop methods to use for improving the general health of the population. The purpose of the programme Umeå University offers two degree programmes in public health, one that comprises 60 ECTS credits (1 year) and one that comprises 120 ECTS credits (2 years). The courses in these programmes provide the knowledge and proficiency necessary for graduates to employ a scientific approach and to utilise effective methods for exploring and improving public health. The programme also forms an important point of departure for further studies for a research career in the public health fields. For whom is the programme intended? The courses are meant for persons who plan to work with the planning, organisation and evaluation of health and medical care or in environmental health units, as well as for those who are already working in the field. The programme is also aimed at persons preparing for research training. The courses are equally suitable for people working in certain capacities in local authorities, and for employees in social security or in health care administration. Other participants might be working in environmental and occupational health, in dentistry or in nursing training. [1]

3 Programme content The one year programme: The one year programme comprises 60 ECTS credits. In the graph below the courses in the one year programme are illustrated. These courses are described further down in this brochure (from page 4). There are seven content courses in the one year programme. In addition to this students write a master thesis comprising 15 ECTS credits. Students are encouraged to identify and plan their master thesis topic in advance. This may be done in collaboration with an employer or organisation that the student is affiliated with. Students that come from other countries than Sweden, and choose to do an empirical thesis, may consider doing their data collection in their home country. The School must approve all decisions concerning thesis research and topic. The two year programme: The first year of the two year programme is the same as in the one year programme (see above). In the second year students take the courses illustrated on the next page. The courses are described further down in this brochure (from page 4). [2]

4 Taking the one or two year programme? The choice between taking the one or two year programme is very flexible. You can apply for the one year programme and still continue to take the second year and thereby get the second year degree. You can also apply for the two year programme but decide to take a one year degree after the first year [3]

5 Course overview First year courses fall semester Global Public Health Credits: 10 ECTS This course in global public health is an introduction to graduate studies in public health. The combination of rapid socioeconomic, demographic and global environmental changes, and their potential health impacts, requires a broad conception of the determinants of population health. A range of current health issues are analysed such as environmental health, mother and child health, communicable and non-communicable diseases. The course also explores how the actors, context, processes and content of health policy are changing as a result of globalisation. The students will apply the knowledge by developing a case study from their own countries. describe the changing demographics and epidemiological patterns globally understand the various drivers and forms of global change define key concepts such as global change and globalization cite a range of examples of global health issues in terms of their impacts on human health within the fields describe the main actors in global health define the concepts of health policy, global public goods and global health governance describe the main challenges for responding effectively to global health challenges through improved global health governance, effective health policies and health service delivery Qualitative Methodology, part 1 The course is grounded in a phenomenological research tradition focusing on the human being as a subject. The course gives an introduction to the theoretical origins of qualitative research, i.e. the roots in the interactionist and phenomenological paradigms of social sciences. The course gives an overview of qualitative research design and discusses the combination of qualitative and quantitative approaches in relation to public health research. describe and understand the theoretical origins of qualitative research [4]

6 explain different qualitative research designs and their relation to data collection methods explain and discuss the requirements for performing qualitative research interviews, focus group discussions and observations evaluate and discuss qualitative research articles on the basis of their research design Biostatistics, part I The core of this course is the data generation process and the point of view is the research question. Based on that a hypothetical model is formulated and possible study designs discussed. outline a hypothetical model for a research question summarise data in tables and diagrams select the proper measurement of central tendency, dispersion and association and perform the computations select the proper sampling method and estimate the sample size understand basic statistical test theory and compute confidence intervals and statistical test for parametric distributions discuss the interpretation of the computed basic confidence intervals and statistical tests Epidemiology Credits: 10 ECTS The course starts with an overview of basic concepts of epidemiology as quantitative research method in public health. Concepts of the research process are discussed, proceeding from the formulation of problems, via hypothesis formulation, operationalisation and data collection to analysis, interpretation and reporting. Basic measures and analytical methods for epidemiological analysis are discussed and applied in exercises. There is practical training in the use of micro-computers and suitable software for planning, data-management and analysis. Throughout the course, various fields of application of epidemiologic methods are presented and discussed. Focus is on epidemiology in international health, with examples from high, middle and low income countries and the implications for the need of epidemiologic study as well as for the methods used. [5]

7 Focus in this course is on methods of epidemiologic study design, analysis and interpretation. Validity is a central concept and random error and bias are dealt with throughout. Special attention is paid to the problem of confounding and the ways of avoiding confounding in design and analysis. Epidemiological and statistical principles for epidemiological analysis are discussed and practised. In all parts of the course students work with applied exercises, training the use of computers and suitable software for planning, data-management and analysis. Throughout the course, various fields of application of epidemiologic methods are presented and discussed. This includes epidemiology of cardiovascular diseases, cancers, in reproductive health, in studies of outbreak and spread of infections, and the role of epidemiology in health systems research. After completion of the course, a student with a pass grade should be able to plan a simple epidemiologic study independently. Her knowledge and ability should include: the basic concepts of population based epidemiological research characteristics of and differences between the most common study designs the use of common measures of occurrence of states of health or disease the use of the most common effect measures operationalisation of a research question interpretation and communication of results critical appraisal of research reports selection of a study design appropriate to the research question validity aspects of different design options confounding control in study design selection and application of appropriate methods of data analysis confounding control in epidemiological analysis interpretation and communication of results critical appraisal of research reports [6]

8 First year courses spring semester Health Systems: Organization and Financing The course is started with a discussion of the basic tools in an economic analysis of people's health and health care. On the basis of this, the building blocks of health systems: organisation, regulation, financing and delivery are covered. Different national health systems are examined and compared to reflect on the values used to implement them. The concept of health systems as social determinants for health, and the necessity of strengthening health systems to address inequality are also discussed. explain basic concepts of health systems organisation. explain basic concepts and relationships in microeconomic theory. explain and summarize how one, using microeconomic theory, can analyze questions relating to people's health and to the financing, production and organisation of health care discuss health systems in the context of different countries discuss the concepts "health systems and rights" and "health systems as social determinants of health" Health Economic Evaluation Methods In the course, the four most common health economic evaluation methods are discussed. These methods are cost analysis, cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis. explain the content of the different health economic evaluation methods discussed in the course explain advantages and drawbacks with the different methods and discuss which method that would be preferable in a given situation review economic evaluations that have been done in health care and discuss strengths and weaknesses in those evaluations. independently make a written plan for a health economic evaluation of a specific intervention in health care [7]

9 Social pathways in global health and health promotion The aim of the course is to enable students to use a social science (sociological) perspective in critical assessment of global public health and health promotion. The focus is on how social theories can help in understanding individual experiences of illness, as well as in the design and evaluation of interventions for health promotion and disease prevention. The interplay between individual experiences of illness and structural power relation and their influence on global public health is central. The course includes social theories applicable on both individual-, group-, and structural levels. Theories focusing on health behaviour, stigma and emotions, body and identity, social capital, and modernity and globalization are some examples of perspectives that are presented and discussed during the course. Describe and understand key concepts of the presented theories Apply appropriate social science concepts, models or theories to public health problems focusing on social pathways in health and health promotion. Evaluate and discuss scientific publications related to social pathways in health and health promotion. [8]

10 Second year courses fall semester Evaluation in Public Health The course is an introduction to methods for evaluation of public health programmes. The course combines concepts and experience from different disciplines in order to facilitate a comprehensive perspective: measures of exposure levels, of positive and adverse health effects caused by the intervention, and of the distribution of health and other effects in the population. explain the content of the different health evaluation approaches discussed in the course explain advantages and drawbacks with the different methods and discuss which method that would be preferable in a given situation review public health evaluations that have been done in health care and discuss strengths and weaknesses in those evaluations make a written plan independently for a health evaluation of a specific evaluation in public health Biostatistics, part 2 The core of this course is the data generation process and the point of view is the research question and the development of a hypothetical model. identify the characteristics of the measurements and select proper analytical method understand the statistical test theory for parametric distribution and compute confidence intervals and statistical test understand the basic statistical test theory for non-parametric distributions and compute statistical tests understand the theory for diagnostic test and life table analysis and compute appropriate measures have a basic knowledge on basic multivariable models use a statistical software for basic statistical analysis [9]

11 Advanced Methods in Epidemiology Epidemiology, the study of the distribution and determinants of health and disease in a population, is a discipline which is of fundamental importance for health research and health practice. The discipline encompasses both the study of general methodology and the attainment of skills and knowledge which are specific to the subject itself. The ultimate aim of epidemiology is to provide a basis for the prevention of disease. The identity of epidemiology id founded on its orientation to Public Health, in contrast to clinical research with its bias towards the individual. The purpose of this course is to impart knowledge of more advanced epidemiology, especially regarding different study designs and sources of errors in epidemiological studies including a discussion of causality, (Rothman s pie model) and it relation to study design. The course also seek to develop skills in the analysis, interpretation and reporting of epidemiological data sets, by use of basic as well as advanced epidemiological analysis including logistic regression and regression methods in survival analysis and appropriate software. Multilevel analysis and its application in epidemiology will be introduced. The participants will also undergo training in critical reading and assessment of epidemiological research reports. Understand the different methodological consideration and approaches within the field such as study design and causality Understand in what situations logistic regression and Cox regression is an appropriate analysis tool and perform and interpret the result of logistic regression and Cox regression Analyse and report sources of errors occurring in an epidemiological study Independently make an analysis of a epidemiological research report. Qualitative Methodology, part 2 The course starts with an overview of qualitative data analysis and trustworthiness of qualitative information. The focus is on the Grounded Theory approach. describe and understand the demands for achieving trustworthiness in qualitative research explain the basic concepts and processes relevant for a Grounded [10]

12 Theory based analysis explain and discuss the main differences and similarities between Grounded Theory, and other qualitative approaches evaluate and discuss qualitative research articles on the basis of their analytical approach perform a Grounded Theory analysis of own or teacher provided qualitative information Social and gender inequalities in global health The aim of the course is to enable students to use a social science (sociological) perspective in critical assessment of the unequal distribution of health between individuals, groups and populations. Theories focusing on social inequalities related to class, gender and ethnicity will be in focus and presented and discussed during the course. The lectures will be structured around material, cultural/behavioural, psycho-social, life-course and policy explanations for the relationships of social inequality to health. Describe and understand key concepts of the presented theories Apply appropriate social science concepts, models or theories to relevant public health problems focusing on inequalities in health. Evaluate and discuss scientific publications related to social inequality in health. Chronic Disease Epidemiology This course is designed to provide graduate students with knowledge on major chronic diseases and skill on applying various epidemiologic methods to design and conduct epidemiological studies on chronic diseases. This course covers an overview of chronic diseases burden, and various researches and surveillance activities to prevent and control their burden. The concept of risk factors and chronic diseases outcome will be introduced and studies to measure risk factors burden will be discussed. Different methodological issues in measuring risk factors across cultures and settings will be introduced. Students will have a chance to learn about life course perspective in chronic disease epidemiology. Several common chronic diseases will be presented during the course, and the discussion will cover their cause and risk factors, both genetic and environmental, as well as [11]

13 their prevention and control strategies. The role of heritable causes in chronic disease burden and future possible preventive strategies using genetic techniques will be introduced. Students will have the chance to learn about the use of methods such as verbal autopsy and capture-recapture methods in studying chronic disease epidemiology. Research activities related to chronic disease, both in developed and developing countries, will be used as case study. Understand the development of chronic disease burden and the prevention and control activities Describe, understand and able to design, conduct, analysis and evaluate methods to ascertain the association between risk factors and chronic diseases Appraise evidence for chronic diseases and their risk factors intervention Advanced Topics in Health Economic Evaluation Methods The course will start with a discussion about welfare economics and economic evaluation. The arguments for adopting a welfarist versus an extra-welfarist approach as well as questions about how to convert individual utilities into monetary values will be covered. explain which different ethical approaches there are to economic evaluation of health and health care and motivate the choice of these approaches explain and discuss different ways of treating costs for health and health care in economic evaluations, and explain how one can model the course of a disease in a population and discuss how this can be used in economic evaluations explain and discuss how uncertainty is being considered in economic evaluations, review economic evaluations that have been done in health care with respect to the main questions that have been focused [12]

14 Second year courses spring semester Social Epidemiology Social epidemiology applies to the disciplinary approach of epidemiology examining and understanding the contributions of social circumstances and processes to the patterns of health and ill health in populations. The course will explore both the specific theories explaining the relation between the social phenomena and health as well as its methodological tools. Special emphasis will be given to the concepts social position, income inequality, social cohesion and networks. Practical approaches on how to measure individual socioeconomic position and area deprivation indexes and how to explore its relationship with health will be provided. explain the main theoretical and conceptual frameworks within social epidemiology. understand the different methodological consideration and approaches within the field. be aware of the current debates within the field and to discuss critically the strengths and weaknesses of the positions. independently make an epidemiological analysis of social disparities in health. Health Care Management The course will discuss various aspects of management in both health care systems and healthcare organisations. Five different topics will be discussed during the course: management basics, specifics of management in health care, health care human resource management, resource and financial management, and business aspects of health care management. All topics will be given from international perspective, with direct examples from health care practices in different countries. Students are encouraged to critically evaluate the given material, reflecting on the health care practice in their own country. Teaching methods include lectures, discussions, group works, leadership training, and an extensive course project. understand and discuss various aspects of management in health care, [13]

15 conduct business planning, understand financial management and accounting materials, understand principles of total quality management and strategic human resource management. Public Health Informatics Public Health Informatics is an often neglected field in public health methodology studies, where focus traditionally has been on statistical methods and issues of study design. This course deals with organisation, validity and maintenance of data and databases, with special focus on the needs of longitudinal studies and hierarchic data analysis. The course content is relevant to both research and routinely collected data in public health services in both high-income and low-income countries, with many examples from experience in the latter type of setting. Validity and representativeness of sampling and data collection are also discussed. understand the public health and community related applications of database management understand and able to assess the validity and representativeness of sampling and data collection [14]

16 Department of Public Health and Clinical Medicine Umeå International School of Public Health Epidemiology and Global Health Umeå University, SE Umeå, Sweden Telephone , Telefax: