Course Web Site: http://reach

							COURSE NUMBER:                                            HEA 671
COURSE TITLE:                                             IMMIGRANT AND REFUGEE HEALTH
CREDITS:                                                  3
PREREQUISITES/COREQUISITES:                               GRADUATE STANDING;
                                                          PERMISSION OF INSTRUCTOR
FOR WHOM PLANNED:                                         ELECTIVE FOR MPH/DrPH STUDENTS;
                                                          OTHER MAJORS
CONTACT PERSON:                                           SHARON MORRISON, Ph.D.
ADDRESS:                                                  DEPT. OF PUBLIC HEALTH EDUCATION
                                                          437 HHP BUILDING

CATALOG DESCRIPTION: Overview of health status of immigrant and refugee populations. Focus
on migration, resettlement, adaptation, epidemiological, behavioral, cultural, socioeconomic, legal and
political factors impacting health, and interventions to address needs.

PURPOSE OF THE COURSE:
The purpose of the course is to familiarize students with significant health and health service issues which
currently (and will for the foreseeable future) challenge the lives and adaptation of immigrants and
refugees to US host society.

STUDENT LEARNING OUTCOMES (SLOS): At the end of this course you will be able to

1. Define and discuss the terms immigrant, refugee, legal and illegal alien, undocumented and
   documented immigrant, migrant worker, acculturation, cultural adaptation, bicultural, Americanized
   (verb), Americanized (adjective)
2. Describe US immigration and refugee resettlement patterns and trends
3. Describe cultural norms, belief systems, strengths, and assets that immigrants and refugee bring with
   them
4. Describe and compare health status and health issues impacting immigrant and refugee groups
5. Discuss the role of interpreters in clinical care and health promotion among non-English speakers
6. Identify and discuss the features of multicultural competency
7. Describe strategies designed to improve health outcomes among immigrant and refugee groups

TEACHING STRATEGIES: Class discussions and activities, guest speakers, student presentations,
reading reviews, on-line case studies, team projects and papers

GRADING: Students will be graded on 1) class participation (10%); 2) Written Reading Summaries (20%); 3)
Team Research/Presentation 40 %); 4) Blackboard Case Studies (30%)
                              A = 94-100 %
                              A- = 90-93
                              B+ = 87-89
                              B = 83-86
                              B- = 80-82
                              C+ = 77-79
                              C = 73-76
                              C- = 70-72
                              F = <69




                                                                                                          1
                                             ASSIGNMENTS

Class Discussion and Participation (10%): This course relies on your curiosity, willingness to share ideas,
and attendance. You are expected to attend ALL classes, contribute to class discussion based on your
assessment of assigned readings, and personal/professional experience, when applicable. You are expected to
actively participate in other classroom learning exercises related to better understanding the topic(s) under
discussion. Where appropriate, you will be asked to give written responses to these learning exercises. These
will serve to document both attendance and participation. You are expected to come prepared for each class
session having read the text and any additional assigned materials. A set of questions will be distributed
PRIOR to the readings to help you better understand the reading. [SLOs # 1-7]

REQUIRED TEXT AND READINGS:
The following 2 books are required for the class.

1. Fadiman, Anne (1997). The Spirit Catches You and You Fall Down. New York: Farrar, Straus and Giraux.

2. Martinez, Ruben (2002). Crossing Over: A Mexican Family on the Migrant Trail. New York: Picador.

These books were chosen as they describe current contexts of immigrants and refugee lives and provide a frame
of reference for understanding factors that influence immigrant and refugee health. You will receive additional
readings from time to time. These may include newspaper and magazine clippings of current events, scholarly
journal articles, excerpts from community agency or governmental reports. We will pace our readings according
to the pace of at which we explore the course topics. Feel free to add to our knowledge base by sharing with us
any current materials or articles you may find related to immigrant and refugee health.

Written reading summaries/responses to guiding questions (20%): You will be required to submit weekly
written critical summaries of the assigned readings. These are designed to assess your synthesis of the
concepts and how you tie together the various strands of the materials covered in the readings. To help you
prepare for the summaries related to the assigned books, a list of potential questions are posted in Blackboard
to guide you as you read. [SLO #1-7]

Blackboard on-line case studies (30%): You will participate in 3 NARRATED on-line case study
exercises. These discussions will be directed by key experts who will present case/topic scenarios related
to immigrant and refugee health. All students are expected to contribute to their group’s discussion. The
topics/questions to be discussed will be developed around issues dealing with cultural awareness and
multicultural competency. [SLOs # 5-7]

Team Research Project (30%) and Presentation (10%): There are several immigrant families in our
community with important and interesting insights on and experiences with illness, disease, health
promotion and quality of life in their country of origin and now their new home. We will be partnering
with the Center for New North Carolina to conduct oral history research with different ethnic immigrant
families within the TRIAD. As a team (2-3 members), you will be investigating a health/quality of life
related topic for immigrant and refugee families using ethnohistory/oral history research methodology.
You will be reviewing secondary data (published research) related to your topic and collecting and
analyzing primary data via oral history interviews to test/support or negate the issues raised in the
published literature. You are expected to share your project and findings in the form of a scholarly journal
article suitable for submission to the Journal of Immigrant and Minority Health. You will be expected
to exercise cultural sensitivity and respect when dealing with the families. Teams are also expected to
develop and deliver a presentation related to their oral history research project. Instructions and materials
related to this assignment will also be posted on Blackboard by the 2nd class meeting [SLOs # 4-7]



                                                                                                           2
TECHNOLOGY REQUIREMENTS: This course utilizes Blackboard asynchronous learning
techniques (e-mail, on-line announcements, readings, discussion forums) to enhance classroom lectures
and discussions. You can access Blackboard via an Internet browser (Netscape or Internet Explorer) and
ONLY through your valid UNCG e-mail account. You can obtain your UNCG email account online at
http://www.uncg.edu/irc/docs/general/email.htm

For more information on how to forward mail from your UNCG e-mail to another popular e-mail account,
contact the Superlab (1st Floor) of Jackson Library at 334-4687. An On-Line Student Orientation to
Blackboard is also available at the following Internet site http://www.uncg.edu/aas/itc/bborient/

ACADEMIC HONOR CODE: Students are responsible for familiarizing themselves with UNCG’s
policy on issues such as cheating, plagiarism, misuse of academic resources, falsification and facilitation
of dishonest conduct. Procedures and penalties related to these and other violations of the Academic
Honor Policy are found in the undergraduate bulletin as well as via the following web site.
http://saf.dept.uncg.edu/studiscp/Honor.html Any violation of the Honor Policy may result in failure of
the assignment and subsequently the entire course.

Students are required to sign the Academic Integrity Pledge given below on ALL major work
submitted to an instructor. Please note that “a student's work need not be graded until he/she has
signed the statement. Exceptions to the requirement of signing the statement may be specified by
appropriate persons or offices, as, for example, on theses and dissertations. In the absence of such
exceptions, students who do not sign the pledge may be assumed to have violated the Academic
Integrity Policy. In signing the pledge, the student indicates his/her knowledge that the Academic
Integrity Policy governs his/her academic activities at the University”.

         Academic Integrity Pledge:

         I HAVE ABIDED BY THE ACADEMIC INTEGRITY POLICY ON THIS
         ASSIGNMENT.

         Signature___________________________________________________
         Date__________________

ATTENDANCE AND PARTICIPATION POLICIES: According to UNCG Academic Regulations and
Policies, “regular class attendance is a responsibility and a privilege of university education”. As such, it is a
student’s responsibility to be familiar with the attendance policy.

SCHEDULE: The syllabus schedule and topics to be covered are TENTATIVE. The instructor reserves
the right to alter the syllabus as needed. Students will be notified accordingly via e-mail and Blackboard
announcements. Please be sure to check e-mail and the announcements in Blackboard at least 2
times each week.
READINGS AND ASSIGNMENTS: Students are responsible for doing the assigned readings PRIOR
to the in-class meeting. All assignments are to be completed and submitted according to THE
PROTOCOL AND DUE DATES GIVEN. Lateness will result in a letter grade deduction.

CLASSROOM CONDUCT: Students are expected to behave in a respectful manner during class.
Invited experts from the community may conduct special lectures. These individuals have taken time
from their busy schedules to share important information with you. Please be respectful and attentive to
our guests. In addition, students are responsible for obtaining lecture notes and handouts on the days they



                                                                                                              3
are absent. The instructor’s notes will not be available for copying. Lectures given in class are the
property of the instructor and may not be taped without prior permission.

SPECIAL NEEDS: If you area student with special needs, contact both Disability Services (334-5440)
and the instructor within the first week of the course so that these needs may be accommodated.




                                                                                                        4
                TENTATIVE (ORGANIC) TOPICAL OUTLINE AND SCHEDULE
We will adjust the schedule and topics based on the pace of our learning in the course. Additionally,
we must take into consideration the busy schedules of our invited guest speakers who have agreed
to share their expertise with us. We will be open to accommodating their needs. This means we may
have to reschedule or reorganize our topics and readings. Any changes will be announced in class
and on Blackboard as soon as I am aware of them.

PART 1: BACKGROUND

  WEEK 1 (Aug. 16): Introductions and Course Overview; NC & Guilford County Immigration Trends
   1. Course objectives, content and requirements. General introductions.
   2. Who are immigrants and where do they come from? Why are they coming?
   3. Reading(s) for next class: Posted on Blackboard

                WEEK 2 (Aug. 23): US Immigration Legislation, Reforms and Health
   1. What is the impact of recent legislation and policy on immigrant health?
   2. Project Discussions
   3. Reading(s) for next class: Posted on Blackboard

              WEEK 3 (Aug. 30): Cross-Cultural Systems and Immigrant Family Health
   1. What belief systems and cultural norms re transported with new immigrants? What are some of
      the common folk illnesses and healing practices? How does immigration impact family structure,
      roles and health? What is the role of the immigrant family and community in the health
      service/public health setting?
   2. Reading(s) for next class: Crossing Borders, pp. Prologue, 1-19; Posted on Blackboard

                WEEK 4 (Sept. 6): Refugee Resettlement & Health (Guest speakers)
   1. What is a refugee? How is refugee health status assessed? What does the term “cultural broker”
      mean? How does it relate to the health of refugee families?
   2. Reading(s) for next class: Crossing Borders, pp.195-330

                          WEEK 5 (Sept. 13): Border Health (Guest Speaker)
   1.   What are some distinct features of US.-Mexican border health? What policies have been put in
        place to support/harm US-Mexican border health?
   2.   Reading(s) for next class: Posted on Blackboard

                                  WEEK 7 (Sept. 20): Case Study 1
   1. Reading(s) for next class: Posted on Blackboard

                          WEEK 7 (Sept. 27): Migrant Health (Guest Speaker)
   1. What is life like for migrant workers? What are some health challenges of migrant work? What
      occupational injuries are associated with migrant farm work?
   2. Reading(s) for next class: Posted on Blackboard

                           WEEKS 8 (Oct. 4): Cultural Competency Issues
   1. Stereotyping and Ethnocentrism. Provider Competencies. Medical Interpretation &
      Communication. What is the role of Title VI legislation?
   2. Reading(s) for next class: Posted on Blackboard




                                                                                                       5
                           WEEK 9 (Oct. 11): On-line Case Study 2
1. Reading(s) for next class: The Spirit Catches You… Preface, 1-92; others Posted On-line

                    WEEK 10(Oct. 18): Immigration and Women’s Health
1. What is the impact of immigration on women’s health? What are key issues impacting the health
   of immigrant women?
2. HIV/AIDS and the Immigration Challenge: Socio-cultural, health and legal implications
3. Reading(s) for next class: The Spirit Catches You, 93-180; others Posted on-line

                              Week 11 (Oct. 25): Mental Health Issues
2. Acculturation and its psychological consequences; Mental Health seeking; Spirituality and health
3. Reading(s) for next class: The Spirit Catches you, 181-end; others Posted On-line

            WEEK 12 (Nov. 1): The Immigrant Child and Adolescent Health Issues
1. What is the impact of assimilation on immigrant child health? What are the health behaviors of
   the new 2nd generation –adolescents? What role does social capital play in the health of immigrant
   youth?
2. Reading(s) for next class: Posted on-line

                          WEEK 13 (Nov. 8): On-line Case Study 3
1. Reading(s) for next class: Posted on-line

                           WEEK 14 (Nov. 15): The Health of Elder
1. Today’s Older immigrant: aging and health, long-term care, care-giver issues
2. Draft of Team Research paper due

                        WEEK 15 (Nov. 22): THANKSGIVING HOLIDAY

                           WEEK 16 (Nov. 29): (Team Presentations)
1. Study questions for exam handed out in class

                        WEEK 17 (Dec. 6): Final Team Research Paper Due




                                                                                                   6