Course Syllabus

 

Course Description

Health is not equally distributed across populations. Social position, working conditions, economic resources, and other structural factors shape people's health from early life through old age. Understanding how these inequalities develop, accumulate, and persist over time is one of the central challenges of public health research.

This course introduces epidemiology as one of the cornerstones of public health science and uses it as a methodological lens to study how social and structural conditions affect health across the life course. Students will learn the core concepts and reasoning of epidemiology, including measures of disease occurrence, study designs, risk estimation, and the critical assessment of evidence. A key focus is understanding what different study designs can and cannot reveal about the causes of health inequalities, and why the choice of method matters for the conclusions we draw.

The course draws extensively on Danish health registers, which link population-level data on health, social conditions, and life events across time. These registers represent a unique scientific resource that has placed Denmark at the forefront of epidemiological research internationally. Students will gain an understanding of their content, structure, and application, as well as their limitations.

By the end of the course, students will be able to read and critically appraise epidemiological literature, understand the public health implications of health inequality research, and appreciate why studying health as a life course phenomenon requires both rigorous epidemiological methods and careful thinking about the social context in which health is produced. Course goals will be accomplished through assigned readings, class lectures and exercises, presentations by accomplished guest lecturers, site visits, and discussion of state-of-the art published papers.

 

Expected Learning Outcomes

After successful completion of this course, students will be able to:

• Define and understand the fundamental concepts of epidemiology
• Distinguish between types of epidemiological study designs, and critically evaluate their strengths, limitations, and appropriate application in public health
• Calculate and interpret basic measures of occurrence and association and interpret the results
• Gain an understanding of the unique resources that Danish health registers represent for epidemiological research in Denmark
• Apply epidemiological thinking to critically read and appraise articles in medical literature
• Analytically assess collection and analysis of data, and evaluate the relevant hypotheses
• Discuss the public health implications of epidemiological data and research

 

 

Faculty

Bertina Kreshpaj Ph.D. Epidemiology (Karolinska Institutet, Sweden, 2022). M.Sc. Public Health (Lund University, Sweden, 2017). B.Sc. Physiotherapy (University of Perugia, Italy, 2014).  Assistant Professor in Occupational and Social Epidemiology at the Copenhagen Health Complexity Center, Department of Public Health, University of Copenhagen.

 

Approach to teaching

Different teaching formats will be used. The course may be a mix of interactive lectures, class discussions, group work, student presentations and peer feedback. Traditional theoretical knowledge acquisition will be combined with problem-based learning techniques. A major part of the course will be based on debating issues, and students are expected to engage actively in oral presentations, discussions, group work and exercises. Slides will be shared after each class. 

 

Expectations of Students 

• Use of phones in class is not allowed, except as a calculator during exercises as specified. Laptop use is allowed for group and project work.
• Reading must be done prior to the class session; a huge part of the class is dependent on discussions in class.
• Students need to be present and participating to receive full credit. The final grade will be affected by unexcused absences and lack of participation. Remember to be in class on time!
• Classroom etiquette includes being respectful of other opinions, listening to others and entering a dialogue in a constructive manner.
• Students are welcomed to ask relevant questions in regards to the material covered or any other aspect of the course.

 

Evaluation and Grading

To be eligible for a passing grade, you must complete all of the assigned work.

The factors influencing the final grade and the proportional importance of each factor is shown below:

Component	Weight
Attendance & Participation	15%
Mid-term exams: Individual Conference Poster and Peer Feedback (10%) Cross-National Critical Appraisal (15%)	25%
Individual Assignment: Critical Appraisal	20%
Group project (presentation in class and take home paper) Presentation in class 20% Research paper in groups 20%	40%

 

Attendance 

You are expected to attend all DIS classes and activities when scheduled, and attendance will actively be monitored in each class. Absences will jeopardize your grade and your standing at DIS. Excused absences include only serious illness and participation in religious holidays.

If you miss multiple classes, the Director of Academic Support, and the Director of Student Affairs will be notified and they will follow-up with you to make sure that all is well. In the case of multiple absences, you will need to provide a doctor’s note.

Missing class: You must always notify your instructor about an absence a reasonable time in advance. Each failure to notify your faculty of an absence in advance will result in a deduction of 2 points off your final participation grade.

Attendance is a crucial part of your learning and your participation grade.

Participation

Participation in class requires arriving on time and being prepared in relation to readings and other assignments. Your participation grade reflects the importance of being active in this course, which relies in great part on the reflections, discussions, and exercises in class. Active participation is essential in both the classroom, on field studies, and in group work.

Individual Conference Poster and Peer Feedback 

For this exercise, you  will select one peer-reviewed epidemiological article on a health outcome of your choice. The article must use one of the study designs covered in the course. You will create a scientific conference poster summarizing and critically appraising the study, present it during an in-class poster session, and provide structured written feedback to your peers. Further detailed guidelines (including dates of presentation) will be provided in class.

Cross-National Critical Appraisal

This take-home exercise asks you to critically compare two register-based epidemiological studies (one Danish, one Swedish) examining socioeconomic inequality in cancer. 

Individual Assignment

You will choose/receive a scientific article that you should critically assess applying one of the assessment tools introduced during the course. You are allowed to discuss with your classmates, the report (max. 3 pages, 1.5 space, font 12) has to be written individually. Further detailed guideline will be provided in class.

Group Project and Presentation

In groups of 3-4, I/you will choose a health outcome of your interest and develop a full epidemiological study proposal using Danish health registers. The project has two components: a written report and a group presentation to the class.

 

Detailed assignment descriptions will be made available on Assignments on Canvas and/or in class.

 

Good academic practice with generative artificial intelligence

In this course, we approach academic work with integrity, honesty, and respect for the learning process. Exam performances and assignments should reflect your own thinking and effort. Academic work builds on the insights and contributions of others and this applies equally to generative AI tools. When used, AI must be acknowledged transparently, and its outputs must be critically evaluated rather than accepted at face value. In this course, we encourage you to engage with AI as a thinking partner that supports your curiosity and analytical reasoning, not as a substitute for your own perspective on epidemiology and health inequalities.

Required Readings

Textbook: Leon Gordis. Epidemiology, 5th ed. 2014

Lecture notes on Danish registers (will be available on Canvas)

Article List (available through Canvas)

1. Green A et al. Incidence, morbidity, mortality, and prevalence of diabetes in Denmark, 2000–2011: results from the Diabetes Impact Study 2013. Clinical Epidemiology 2015; 7:421–430.
2. Rod NH, Bengtsson J, Budtz-Jørgensen E, Clipet-Jensen C, Taylor-Robinson D, Nybo Andersen AM, Dich N, Rieckmann A. Trajectories of childhood adversity and mortality in early adulthood: a population-based cohort study. The Lancet. 2020;396(10249):489–497.
3. Elsenburg LK, Kreshpaj B, Andersen SH, de Vries TR, Thielen K, Rod NH. Childhood adversity trajectories and not being in education, employment, or training during early adulthood: The Danish life course cohort (DANLIFE). Social Science & Medicine. 2025;371:117841.
4. Brøndum-Jacobsen et al. Skin cancer as a marker of sun exposure associates with myocardial infarction, hip fracture and death from any cause. International Journal of Epidemiology 2013;42:1486–1496
5. Lange T, Keiding N. Skin cancer as a marker of sun exposure: a case of serious immortality bias. Int J Epidemiol 2014;43:971.Download Lange T, Keiding N. Skin cancer as a marker of sun exposure: a case of serious immortality bias. Int J Epidemiol 2014;43:971.
6. Nilsson et al. Homelessness as a predictor of mortality: an 11-year register-based cohort study. Soc Psychiatry Psychiatr Epidemiol (2018) 53:63–75
7. Kreshpaj B, Elsenburg LK, Hald Andersen S, De Vries TR, Thielen K, Hulvej Rod N. Association between childhood adversity and use of the health, social, and justice systems in Denmark (DANLIFE): a nationwide cohort study. Lancet Public Health. 2025 Jan;10(1):e29-e35. doi: 10.1016/S2468-2667(24)00242-1. 
8. Byrne et al. Sleep Disorders and Risk of Incident Depression: A Population Case–Control Study. Twin Research and Human Genetics (2019), 22, 140–146
9. Lynge et al. Breast density and risk of breast cancer
10. Bunddgaard et al. Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers. A Randomized Controlled Trial
11. Brøndum-Jacobsen et al. Skin cancer as a marker of sun exposure associates with myocardial infarction, hip fracture and death from any cause.
12. Lange & Keiding. Comments to Skin cancer as a marker of sun exposure: a case of serious immortality bias