Global Health: Problems and Paradigms

Sherryl Broverman, Professor of the Practice in Biology and Global Health

Chronic stress can alter health outcomes and contribute to health inequalities between peoples and populations. Childhood adversity has long been recognized as having a life-long impact on health via epigenetic changes. Recent research on stress and trauma has identified racism and marginalization as contributors to health inequalities, similar to the health impact of childhood adversity. However, when people encounter racial differences in health outcomes, they either incorrectly attribute them to genetic differences between socially constructed racial groups or focus on the powerful role played by the social determinants of health. This dichotomy is missing an understanding that the experience of racism or marginalization itself can cause physiological and epigenetic changes that increase health inequities. There is a robust literature on how the chronic stress of racism, marginalization, and trauma is codified in biological systems in a multitude of ways including increased inflammation; changes in gene expression; alterations in immune function; functioning of the placenta; telomere shortening leading premature aging; and possible changes in life history. This course will examine the evidence demonstrating the absence of genetic race in humans, therefore excluding race-based biology as a driver of health inequalities between groups. We will then examine the data for the epigenetic impact of racism and stress on minority or marginalized groups in the US and other countries as drivers of health inequalities. We will also address chronic stress from childhood adversity, as well as examine the research on building physiological and epigenetic resiliency.

Ernesto Ortiz, Senior Manager of Programs, Hubert Yeargan Center for Global Health

This course delves into the intricate relationship between community health, environmental health, and intercultural awareness within indigenous communities in Latin America. By examining socio-historical practices and interactions with the land, students will explore how these factors shape understandings of environment, health, well-being, and illness, and how they influence healthcare access, delivery, and outcomes. The course also emphasizes the importance of developing community health initiatives in the Andes and the Amazon to address health disparities and promote well-being among indigenous populations.

Tom Carpino PhD, Postdoctoral Associate, Hock Fellow at the Duke Global Health Institute

Charlotte S. Sussman,Professor of English