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, Postdoctoral Associate, Hock Fellow at the Duke Global Health Institute

This seminar introduces students to emerging and re-emerging global infectious diseases through a scientific and epidemiologic lens. Students explore how infectious agents emerge, spread, and persist, using case studies and scenario modeling of contemporary epidemics to examine outbreak dynamics, surveillance, and public health responses. The course emphasizes biological mechanisms, epidemiologic reasoning, and novel interventions, while situating epidemics within their broader social and global contexts.

Charlotte S. Sussman, Professor of English

This class will explore both the stories doctors tell about themselves, and the stories that have been told about them.   We will begin by considering what “becoming a doctor” has meant to people of different genders, ethnicities and social classes.  We will go on to investigate some of the roles doctors play in modern society, and the ethical dilemmas that accompany those roles.  Issues to be discussed include:  doctors at the intersection of science and social management; the ethics of empathy between doctors and patients; and the nature of medical stories.

Miranda Welsh, Lecturing Fellow of Thompson Writing Program
 

In 2015, after outbreaks of SARS, H1N1, and Ebola, the United Nations and the World Health Organization warned that future epidemics were inevitable without stronger prevention and response strategies—a prediction that has since proven true.

This course examines why epidemics emerge, how they spread, and why responses differ across societies. Students will explore the ecological, cultural, political, and economic factors that shape disease outbreaks and public health responses around the world.

During the first part of the course, students will analyze an interdisciplinary case study of a single epidemic through guided readings, discussions, and short writing assignments.

In the second part of the course, students will work in three-person research teams to investigate a contemporary epidemic (such as cholera, Zika, or SARS). Each team will produce a collaborative research paper that examines the epidemic from three perspectives:
• Ecological: environmental conditions and human–environment interactions
• Cultural/Anthropological: beliefs, values, and social practices that affect disease spread
• Political/Economic: how governance, inequality, and policy shape outbreaks and responses

Through collaborative research, peer review, and revision, students will develop skills in interdisciplinary analysis, academic writing, and scientific communication while exploring how societies can better prepare for future epidemics.

Cary Moskovitz, Professor of the Practice in the Thompson Writing Program

Mosquitoes and ticks transmit some of the world’s most dangerous diseases, including malaria, dengue fever, and Lyme disease. As these vector-borne diseases continue to spread, scientists are developing new tools—such as spatial repellents, clip-on devices, and insect-repellent clothing—to reduce exposure. But how do we determine whether these innovations actually work?

In this section of Writing 120, students will examine recent scientific research on insect repellents while developing core skills in academic reading, writing, and research. Through careful analysis of experimental studies, students will practice summarizing scientific findings, evaluating evidence, and engaging critically with health science literature.

Building on these skills, students will write a substantive scientific essay that presents an evidence-based argument on strategies to reduce vector-borne diseases. Throughout the semester, students will participate in peer review, collaborative discussion, and revision, learning how scientists communicate and evaluate research.

Because collaboration is central to the course, students should be prepared to work closely with classmates outside of class. Prior coursework in statistics may be helpful but is not required.