Part 1: Please choose two of four questions I to IV below. Write an essay for each question (2-3 pages in total, typed 1.5 spacing, and addressed the questions in full).
Movie 1: Unnatural Causes: In Sickness & in Wealth
a. What did the Whitehall study reveal about the connection between health and wealth?
b. What is the health-wealth gradient?
c. How do the lives of Jim Taylor, Tondra Young, Corey Anderson, and Mary Turner exemplify concepts like the wealth-health gradient and the importance of power, agency, and control?
d. What does comparing data maps of disease rates in the different Louisville council districts reveal? e. What might explain observed differences?
Whitehall study director Sir Michael Marmot says, if inequalities in health were a fixed property of society, then youd say, We cant do anything about it. But that is not the case, the magnitude of inequalities in health changes over time. It can get rapidly worse, and if it can get rapidly worse, it ought to be possible to make it rapidly better.
a. Pick 5 of the 6 existing policies (column A) and describe how each of the existing policies below might promote better health or lead to poor health.
b. Pick 5 of the 6 existing policies (column B) and describe how each of the potential policies might promote better health for everyone
Movie 2: Unnatural Causes: Place Matters
Seattle public health official James Krieger outlines neighborhood features that influence health. Pick 5 of the 7 neighborhood features and explain how each of the following affects health outcomes:
a. Proximity to environmental hazards (potential for toxic exposure)
b. Quality of schools
c. Quality of affordable housing
d. Frequency of violence and crime
e. Opportunities for social interaction with neighbors
f. Access to affordable, healthy food choices
g. Places to walk or do other kinds of physical activities
Although Gwai Boonkeuts neighborhood is home to several refineries and chemical plants that are potentially hazardous to residents health, the film suggests that other neighborhood conditions pose an even greater threat to his health.
a. What are those conditions and how do they get under the skin?
b. What health threats does Gwai face that are beyond his individual control?
c. How do neighborhood conditions, his job, and income situation and being an immigrant affect his ability to keep his children out of harms way?
d. How might all of this affect Gwais stress level and cardiovascular health? e. What options would make things better for Gwais family and others in similar situations?
Part 2: Please choose two of 3 prompts I to III below. Write an essay for each question (4-5 pages in total, typed 1.5 spacing, and addressed the questions in full.
Prompt I: The Allegory of the Orchard
The Allegory of the Orchard is an illustrative story that conveys the history of political actions and inactions that have resulted in the US regarding health equity. Briefly describe/tell the story of the allegory: the beginning, the middle, and the end
a. Describe the illustrative points/lesson of the story, i.e., what does each part of the allegory represent:
– Who is the farmer?
– Who are the seeds/trees?
– What is the soil?
– What is the depth of each hole?
– What does the farmers careless placement of the seeds represent?
– What do the conditions of the environment where the seed are planted represent?
– What is the fertilizer?
– What is the water?
– What is the pesticide?
– What does the farmers care or lack thereof represent?
– What does the farmers investments or lack thereof represent?
– What does the farmers lack of attention to the various soil types represent?
b. What were some of the biases, preconceived notions, assumptions and/or prejudices of the farmer? What does this represent?
c. The farmer made insufficient attempts to comprehensively assess and diagnose problems impacting each tree and authorize the necessary treatment plan so that each tree stood a fair chance of attaining its full potential. What does this represent regarding the health care system?
d. Who does the arborist represent? What does the arborists experimentation represent? What groups benefited from the work of the arborist and what does this represent?
e. What does the fungi/infection represent?
f. What is the moral of this story?
Prompt II: A Cluster-Randomized Trial of Blood Pressure in Black Barbershops and Supplementary Appendix
Answer the following questions regarding this randomized trial in black-owned barbershops in Los Angeles California:
a. What are the health and health care access disparities identified in this randomized trial?
b. Why did the authors do this trial?
c. What is the primary hypothesis?
d. Describe the baseline characteristics of the trial population.
e. What was the intervention group? What kind of care did they receive?
f. What was the control group? What kind of care did they receive?
g. What was the result of the primary outcome (mean systolic blood pressure) in the intervention and control groups at baseline and at 6 months? What happened to the mean systolic blood pressure in both groups (i.e., increase, decrease, stay the same)?
h. Based on the results of the difference in the primary outcome (mean systolic blood pressure) in the intervention group versus control group when comparing the two at the end of the 6 months; what conclusion can be drawn regarding the inclusion of a pharmacist on the chronic disease management team?
i. At what level of the community engagement continuum would you assign this health promotion program? Why
Prompt III: Pharmacists Role in Addressing Health Disparities – Part 1: Social Determinants of Health and their Intersectionality with medication use, health care utilization and health outcomes & Pharmacists Role in Addressing Health Disparities – Part 2: Strategies to move toward health equity
Answer the following questions regarding this narrative review article:
a. What are the social determinants of health?
b. What are health disparities?
c. What is intersectionality?
d. How do these 3 concepts interact with medication use, health care utilization (use) and health outcomes?
e. In your own words, what do you think is the pharmacists role in addressing health disparities and promoting health equity?