Course Syllabus

 

Healthcare Strategies for At-Risk Populations 

This is a draft syllabus!

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Semester & Location:

Fall 2021 - DIS Copenhagen

Type & Credits:

Elective Course - 3 credits

Major Disciplines:

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

Faculty Member:

Camilla Hoff-Jørgensen

Program Director:

Susana Dietrich

Time & Place:

Tuesdays and Fridays, 10:05 – 11:25, N7-B13

 

Faculty

Camilla

Camilla Hoff-Jørgensen

Cand.scient.anth. (Lund University 2013, BA, 2010), B.A. in Health and Nutrition, (Suhrs Seminarium, Copenhagen, 2006). Extensive academic work experience since 2008, as Cultural Health Adviser in Japan and Spain as well as anthropologist conducting quantitative and qualitative studies in Copenhagen. Currently engaged in the Danish national harm reduction strategy group, focused on the social nurse concept for homeless patients with drug abuse. In addition, DIS Public Health LLC coordinator since 2016. With DIS since 2015.

 

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. work place 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 in accessibility to health care services.

Some of the health care strategies we are going to work with are: Needle Exchange Programs (NEP), social nurses, shelters for homeless, 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 in 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 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 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. The final grade consist of the following sub-grades:

Component

Weight

Participation

1)  Answering and asking questions during class

2)  Involvement in class discussions

3)  Participating and asking questions at field visits

4)  Build canvas group page

15%

Test 1 (23%) and Test 2 (22%)

Lecture based exam. In addition, for the later test you will be asked to write a reflection about your visit with your informant. The duration of the early test is 50 minutes and the late is 1 hour and 15 min.

45%

Final group report

Throughout this course you will hand in three group assignments. The final assignment will be graded. Assigned group work time will give you the opportunity to discuss your research for the assignments among peers and with the instructor to provide guidance. You also have the opportunity to contact the instructor and arrange a meeting outside class to discuss specific details for your assignment.

Part of this grade is based on your engagement in giving and receiving feedback on your own and others' assignments during feedback sessions.

40%

 

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.

Assignments

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 two thirds of a grade for each day or part thereof that it is late (A- becomes B, B becomes C+ etc.).

 

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

DIS Contacts

Louise Bagger Iversen , Assistant Program Director, lbi@dis.dk 
Susana Dietrich, Science & Health Program Director
Science & Health Office: Vestergade 7-37

 

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 Journal13, 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