Improving health and reducing inequities worldwide


GHS 202D - Socio-cultural and Behavioral Determinants of Health

Tuesday, 9:00 - noon

Course Co-directors

Shari Dworkin, Ph.D., M.S.
Ian Whitmarsh, Ph.D,
Teaching assistant: Mark Fleming, M.S.

This course will examine social, cultural and behavioral determents of health. Moving from social theories to behavior, the course will cover the effects of socio-economic inequality on population health. The course will draw on faculty expertise and experience in a variety of global contexts, allowing students to compare and contrast the varied influences of cultures on health. The course will combine the methodological approaches of anthropologists, sociologists, and behavioral scientists to inform health promotion strategies and health-seeking behavior. Throughout the course we will emphasize the complex, trans-disciplinary interactions between human society and health. The content of this course examines the confluence of social and cultural factors (including globalization, the impact of social, economic, and political systems, the local and global economy, transnational organizations, culture, race, class, gender, sexuality, and North/South inequality) that lead to disparities in health both domestically and globally.

Teaching format:

Lectures, seminars, independent study, assigned papers

Course credit

3 units


At the end of the course students will be able to:

  • Identify macro level political, institutional, and structural factors that impact health and health care in relation to local, cultural, and regional contexts
  • Describe the impact of cultural, social, and economic determinants on health
  • Identify the key players, institutions, political bodies, and non-governmental organizations that contribute to health promotion and policies
  • Be prepared to respond with nuance and complexity--providing recognition of the inadvertent positive and negative consequences--when intervening on some of the most important global health issues of our time

Course content:

The course content may vary depending on the availability of prominent guest lecturers who will address the class. In general, we will examine the following topics:

  • Inequality. Gradients of inequality and social/health disparities
  • Social class and locus of control as determinants of health
  • Health promotion and behavioral norms. Theory and practice of health perception and behavior change; relevance to health messages and prevention
  • Health Diplomacy as a political tool to reduce conflict, pursue equity, and promote security
  • Social marketing, innovation, and entrepreneurship. A new paradigm?
  • Microfinance and microcredit
  • Globalization and social aspects of health advocacy. Civil society, grassroots support systems, NGOs
  • Urban health. Urbanization and megacities. Slum life. The urban advantage vs the urban penalty. Health-seeking behavior in slums
  • Rural health. Workforce crisis; task shifting; technology (cell phones) for information and health promotion
  • Social networks and social capital; neighborhoods and community
  • Culture and health. Culture as obstacle and resource for health.
  • Stigma, blame, shame, discrimination, and scapegoating. Epidemics and blame. “Emotional epidemiology”
  • Development and health; social and cultural determinants of failure, success, and sustainability of health and development interventions. Case studies
  • Social justice and human right to health. Ethics. Global declarations and covenants. Research ethics
  • Global mental health. Applied psychology and behavioral science. Allostatic load and the effect of chronic stress on health
  • Witchcraft, traditional medical “systems”; local health service providers; genital cutting, circumcision, taboos. Folk illness
  • Conflict, PTSD, humanitarian emergencies, displaced persons, refuge health
  • WHO response: Commission on Social and Cultural Determinants of Health
  • Corruption: ethics, genesis, reform. Cross-disciplinary panel from social, economic and ethical perspectives
  • Gender, kinship, race, religion, culture - effects on health