Course Syllabus

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Healthcare Strategies for At-Risk Populations 

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Semester & Location:

Fall 2024 - DIS Copenhagen
Type & Credits:

Elective Course - 3 credits
Major Disciplines:

Pre-Medicine/Health Science, Public Health, Public Policy
Prerequisite:

None
Faculty Member:

Priya Ranganath

(current students please use the Canvas Inbox to contact)
Program contact:

Science and Health Department: shsupport@dis.dk
Program Director:

Susana Dietrich
Time & Place:

Mondays and Thursdays, 10:05 – 11:25 in N7-A21

 

Faculty

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Priya Ranganath

Ph.D Student, Center for Alcohol and Drug Research (Aarhus University, 2019-2023).
Master in Sociology (Trinity College Dublin, 2017-2018)
Master in International Business (Monash University, 2007-2009)
Bachelor in Management (Tourism) (University of Technology, Sydney 2002-2005). With DIS since 2022.

 

 

Course Description

In this course, you will study harm reduction, both in theory and practice, as a health care strategy for at-risk populations such as intravenous drug users, undocumented migrants, prisoners, sex workers, and homeless people.

These subpopulations are not easily targeted through conventional programs in health care delivery or health promotion within the general population (e.g. workplace safety, screening programs, vaccination schemes, or visitation to elderly care). Their disproportionate risk and burden of disease often coincide with a social vulnerability and factors such as legal restraints, stigma, or lack of inaccessibility to health care services.

Some of the health care strategies we are going to work with are our Needle Exchange Programs (NEP), social nurses, shelters for homeless individuals, open prisons, decriminalization of drug use and sex work, and health clinics for undocumented migrants.

 

Expected Learning Outcomes

In this class, I will ask you to form small groups and meet up with different informants outside class. These informants all touch upon different parts of harm reduction. The different topics and informants will provide you with specific insight into contemporary issues in harm reduction. These experiences will provide you with information to report and reflect on during group work and workshops and with a foundation for your group report.

Upon successful completion of this course you will be able to:

  • explain different aspects of harm reduction and the different levels of interventions applied to specific at-risk populations.
  • interpret target populations for harm reduction
  • identify how harm reduction translates into practice
  • interpret how harm reduction is perceived among target populations
  • discuss the range and limits to harm reduction interventions and contrast different kinds of health care strategies
  • Understand risk behaviors and how some of the current trends in harm reduction influence health care delivery. 

 

Student Involvement

We are an interactive class to enhance your learning experience. Read and prepare for each class and participate actively. Groups are expected to comment on their research topics to the rest of their class during the course, especially in workshops. Please upload all assignments in Word or PDF on Canvas.

This course draws on a number of sources of information: textbooks, articles from journals, handouts, and information from various websites. Please note that the texts reflect the various disciplines that the course embraces: Public Health, Political Science, Law, and Sociology. In each class, I will have two or more reading questions for the next class that allow you to reflect on or define central topics relevant to the texts coming up.

These questions serve as a guideline when reading the texts for the class.

 

Evaluation and Grading

This course consists of a mixture of lectures, writing assignments, student presentations, field studies, and group work. Please see calendar for deadlines (and announcements for any changes to deadlines).

Assignments

The final grade consists of the following sub-grades:

Assignment Weight
Class participation 5%
Discussion board 15%
'Be the teacher' presentation 20%
Field observations 10%
Burning Issue project 45%
Course reflection 5%
TOTAL 100%

Please see the 'Assignments' page for the contents, instructions and due dates for each assignment.

Assignments and tests are submitted via Canvas. Submissions exceeding the word limit will be penalized by a third of a grade per additional page or part thereof (A- becomes B+, B becomes B- etc.).

Late assignments will be accepted, but your grade will be reduced by 2 thirds of a grade for each day or part thereof that it is late (A- becomes B, B becomes C+ etc.)

A word about grades: we realize that grades are important to you, but try not to let your anxiety about grades deter you from taking intellectual risks and learning just for the joy of learning. Also, we do not grade to punish or reward you, just as our grade is not an indication of our evaluation of you as a person. We grade you to give you our honest assessment of your academic performance at this point in time.

Laptop policy

You are encouraged to bring a laptop or tablet to check the current situation and events related to this course. Your laptops are for note-taking or fact-checking during class. I am relying on your integrity and your respect of this.

For visits outside the campus, especially site visits and guest lectures, please use paper and pen to take notes as using phone or laptops will be distracting. 

Academic Regulations  

Please make sure to read the Academic Regulations on the DIS website. There you will find regulations on: 

 

 DIS - Study Abroad in Scandinavia - www.DISabroad.org

Required Readings

  1. Allen Scott A.; Wakeman Sarah E.; et.al. (2010): Physicians in US Prisons in the Era of Mass Incarceration in I J Prisoner Health, December 2010; 6(3): p. 99-106.Christensen PB, Hammerby.
  2. Biswas Dan; Kristiansen Maria; et.al.(2011): Access to healthcare and alternative health seeking strategies among undocumented migrants in Denmark, BMC Public Health, 11: 560: p. 1-11.
  3. Carter, Wayne, Miller: The Ethics of Harm Reduction in Harm reduction in substance use and high-risk behaviour: international policy and practice, London, Blackwell Pub.
  4. CNN Article Solitary Confinement Psychology (website)
  5. Cole, Jack A.: “Cops say legalize drugs”
  6. Collins SE, Clifassi SL, Logan DE, Samples LS, Somers JM, Marlatt GA: Current Status, Historical Highlights, and Basic Principles of Harm Reduction in (eds. Marlett GA, Larimer ME, Witkiewitz K): Harm Reduction, Pragmatic Strategies for Managing High-Risk Behaviours, The Guildford Press 2012; preface xiii-xv + chapter 1: p. 3-35.
  7. Cuadra, Carin Bjôrngren (2011): Right of access to health care for undocumented migrants in EU: a comparative study of national policies Eu J Publ Health 2011, June 9: p. 1-6.
  8. Dan Biswas, Brigit Toebes, Anders Hjern, Henry Ascher, Marie Norredam (2013), Access to health care for undocumented migrants from a human rights perspective: A comparative study of Denmark, Sweden, and the Netherlands, Health and Human rights 14/2 Pub 2012
  9. Denham, Greg: “Two worlds colliding – or are we just on the same planet”?
  10. European Federation of National Organisations working with the Homeless: Health and Well-being for All – Holistic Health Services for People who are homeless
  11. Fabian, Dalma (2013): Homelessness and Mental Health, FEANTSA Health and Social Protection Policy Officer
  12. Fellner Jamie; Metzner Jeffrey L; et.al.(2010): Solitary Confiment and Mental Illness in U.S. Prisons: A Challenge for Medical Ethics, J Am Acad Psychiatry Law 38: p. 104-8.
  13. Goffman, Erving (1963): Stigma: notes on the management of spoiled identity, Englewood Cliffs, N.J.: prentice-Hall 1963, chapter 1: p. 1-13.
  14. Gozdzik, Agnes; Salehi, Roxana; et.al.: Cardiovascular risk factors and 30-year cardiovascular risk in homeless adults with mental illness.
  15. Healy Catherine; Bennachie Calum; Marshall Raewyn (2012): Harm Reduction and Sex Workers: A New Zealand response: Taking the harm out of the law in (eds. Pates R, Riley D): Harm Reduction in Substance Use and High-Risk Behaviour, Wiley-Blackwell, chapter 19: p. 252-262
  16. Human Rights and Youth homelessness
  17. Jensen Natasja K.; Norredam Marie; et.al.(2011): Providing medical care for undocumented migrants in Denmark: what are the challenges for health professionals? BMC Health Services Research 2011, 11:154: p. 1-10.
  18. Kara, Siddhart, Sex Trafficking - An Overview
  19. Kawulich, “Participant observation”.
  20. Keogh, Claire; O’Brien; et. al.(2015): Health and use of health services of people who are homeless and at risk of homelessness who receive free primary health care in Dublin
  21. Kilmer JR, Cronce JM, Hunt SB, Lee CM: Reducing Harm Associated with Illicit Drug Use in (eds. Marlett GA, Larimer ME, Witkiewitz K): Harm Reduction, Pragmatic Strategies for Managing High-Risk Behaviours, The Guildford Press 2012; chapter 6: p. 170-200.
  22. Monaghan, Geoffrey (2012): Harm reduction and the role of police services, in Harm Reduction in Substance Use and High-Risk Behavoiur (eds. Pates R, Riley D), Wiley-Blackwell, chapter 6: p. 59-76.
  23. NIDA (2014), Drugs, Brains, and Behavior The Science of Addiction
  24. Nieburg, Phillip; Carty, Lisa: Injection Drug Use in Ukraine the challenges of providing HIV prevention and care
  25. Nutt D, King LA, Saulsbury W, Blakemore C: Development of a rational scale to assess the harm of drugs of potential misuse, The Lancet, 369(9566); 1047-1053, 24.
  26. O’Hara, Pat: “What harm reduction means to me”?
  27. Paraskevis Dimitrios; Nikolopoulos Georgios; et al.: Economic Recession and Emergence of an HIV-1 Outbreak among Drug Injectors in Athens
  28. Pierce LI, Bradshaw CS, et.al.(2005): Screening injecting drug users for sexually transmitted infections and blood borne viruses using street outreach and self-collected sampling, Sex Transm Infect(2012); 81: p. 53-58.
  29. Pleace, Nicholas; Bretherton, Joanne (2013): The case for Housing First in the European Union. A critical Evaluation of concern about effectiveness
  30. Position Statement, Harm Reduction International (2009): “What is harm reduction”? 12-13.
  31. Priebe, Stefan et. al.:Good practice in mental health care for socially marginalised groups in Europe: a qualitative study of expert views in 14 countries. BMC Public Health. 2012, Vol. 12 Issue 1, p248-259. 12p. 1 Chart.
  32. -Prostitution of poverty or sexual self-determination
  33. Enggist Stefan; Red.: Møller Lars: et.al.(2014): (2014): Prisons and Health, Copenhagen, WHO Regional Office, Chapter 1-3, p. 1-18
  34. Rentzmann, William: Prison policy, prison regime and prisoners’ rights in Denmark
  35. Sander, G et. al. (2016). Overview of harm reduction in prisons in seven European countries. Harm Reduction Journal, 13, 28
  36. Silverman, Jay G,; Raj, Anita; et.al.(2011): Sex Trafficking and Initiation-Related Violence, Alcohol Use, and HIV Risk Among HIV-Infected Female Sex Workers in Mumbai, India.
  37. Smith, Peter Scharff (2006): The Effects of Solitary Confinement on Prison Inmates: A Brief History and Review of the Literature, Crime and Justice, Vol. 34, No. 1, p. 441-456.
  38. Spradley, James (1979): Step two - Interviewing an informant and. Step four - Asking descriptive questions: The ethnographic interview. Cengage Learning, Inc, p. 55-67, 78-91
  39. -Universal Declaration of Human Rights
  40. Venn, Jaap, Godinho, Joana (2006): Illicit drug policies and their impact on the HIV epidemic in Europe in (eds. Matic S, Lazarus JV, Donoghoe MC): HIV/AIDS in Europe, Moving from death sentence to chronic disease management, WHO 2006, chapter 3: p. 27-42.
  41. Walthers J, Weingardt KR, Witkiewitz K, Marlatt GA: Harm Reduction and Public Policy in (eds. Marlett GA, Larimer ME, Witkiewitz K): Harm Reduction, Pragmatic Strategies for Managing High-Risk Behaviours, The Guildford Press 2012; p. 359-372.

Course Summary:

Date Details Due