Epidemiology and Public Health

60 College Street, 785.3862
M.S., M.Phil., Ph.D.

Chair
Michael Merson

Director of Graduate Studies
Nancy Ruddle (785.2915)

Director of Medical Studies
David Katz

Professors
Michael Bracken, Kelly Brownell, Arthur DuBois, Theodore Holford, Ralph Horwitz, Keith Joiner, Edward Kaplan, Stanislav Kasl, Ilona Kickbusch, Brian Leaderer, Robert Makuch, Lawrence Marks, Diane McMahon-Pratt, Kathleen Merikangas, Michael Merson, I. George Miller, Alvin Novick, Curtis Patton, Nancy Ruddle, Peter Salovey, Eugene Shapiro, John Stitt, Mary Tinetti, Daniel Zelterman

Associate Professors
Serap Aksoy, Michael Cappello, Elizabeth Claus, Loretta DiPietro, Durland Fish, Nora Groce, Robert Heimer, Sarah Horwitz, Jeannette Ickovics, Harlan Krumholz, Susan Mayne, Mary Olson, A. David Paltiel, Harvey Risch, Mark Schlesinger, Jody Sindelar, William White, Heping Zhang, Hongyu Zhao, Tongzhang Zheng

Assistant Professors
Elizabeth Bradley, Susan Busch, Kent Buse, Joel Dubin, Akiko Iwasaki, Beth Jones, Kaveh Khoshnood, Becca Levy, Haiqun Lin, Linda Niccoli, Alexander Ortega, Melinda Pettigrew, Nina Stachenfeld, Liangbiao Zheng

Fields of Study
Programs of study are offered in the areas of biostatistics, chronic disease epidemiology, environmental health sciences, genetic epidemiology, health policy and administration, and epidemiology of microbial diseases (infectious disease epidemiology, medical entomology, microbiology, parasitology, and virology). All programs are under the faculty of the Department of Epidemiology and Public Health.

Special Admissions Requirements
Applicants should have a strong background in the biological and/or social sciences and, in the case of biostatistics, mathematics. The GRE General Test is required.

Special Requirements for the Ph.D. Degree
To be admitted to candidacy, a student must: (1) satisfactorily complete the course requirements listed below, achieving grades of Honors in at least two; (2) obtain satisfactory grades in the comprehensive examination; and (3) submit an acceptable dissertation prospectus. The comprehensive examination usually is taken at the end of the second full academic year. With the assistance of his/her faculty adviser, each student requests appropriate faculty members to join a dissertation advisory committee. The dissertation prospectus must be approved within a year of passing the comprehensive examination. Teaching experience is regarded as an integral part of the graduate training program. Ten hours per week of teaching (TF 2) or the equivalent per term are required in years two and three. In the fourth and subsequent years, students are required to be research associates, or the equivalent.

The special course requirements of each division are:

Biostatistics—twelve courses not including seminars and colloquia;

Chronic Disease Epidemiology—twelve courses not including seminars and colloquia;

Environmental Health Sciences—twelve courses not including seminars and colloquia;

Epidemiology of Microbial Diseases—two years of course work developed with a
faculty committee;

Health Policy Administration—twelve courses not including seminars and colloquia.

Master's Degrees
M.Phil. Students who have completed all requirements for the Ph.D. except the dissertation may petition the graduate school for the Master of Philosophy degree.

M.S. Upon application, the faculty may recommend students in divisions other than Biostatistics for the M.S. degree if they have satisfactorily completed the first year of a program leading to the Ph.D. degree and they intend to withdraw from the Ph.D. program. The department also offers a two-year, terminal master's degree program leading to an M.S. in Biostatistics (for the requirements see Biostatistics). A Biostatistics student who is withdrawing from the Ph.D. program may apply and be recommended for the M.S. provided he or she meets the requirements of the M.S. program in Biostatistics.

Program materials are available upon request from the EPH Admissions Office, Epidemiology and Public Health, Yale University, PO Box 208034, New Haven CT 06520-8034; e-mail, eph.doctoral@yale.edu.

Courses
BIS 505a, Introduction to Statistical Thinking. Elizabeth Claus.
An introduction to the use of statistics in the fields of epidemiology and public health. Topics include descriptive statistics, probability distributions, parameter estimation, and hypothesis testing as well as an introduction to sampling and linear regression. Statistical analysis using the Statistical Analysis Systems (SAS) software on the IBM PC is introduced. Prerequisite: algebra.

BIS 505b, Introduction to Statistical Thinking. Daniel Zelterman.
Continuation of BIS 505a, covering multiple regression, analysis of variance, nonparametric tests, survival analysis, and an introduction to logistic regression. Concludes with a review of variable classification and choice of statistical analysis. As in the first term the Statistical Analysis Systems (SAS) software package is used for statistical analysis. Prerequisite: BIS 505a.

[BIS 511a, GIS Applications in Epidemiology and Public Health.]

BIS 525a and b, Seminar in Biostatistics. Joel Dubin.
Faculty and invited speakers present and discuss current research.

BIS 538b, Survey Sampling: Methods and Management. Durland Fish.
This course reviews the major sampling plans: simple, stratified, systematic, and cluster random sampling. The uses of weighted data and ratio estimation are discussed. The course emphasizes application of methodology, including use use of SUDAAN. Prerequisite: BIS 505b or equivalent.

BIS 540a, Fundamentals of Clinical Trials. Robert Makuch.
An overview of issues related to the design, conduct, and analysis of clinical trials: protocol development, examination and selection of appropriate experimental design, methods of
randomization, sample size determination, appropriate methods of data analysis including time-to-event (possibly censored) data, and interim monitoring and ethical issues. Prerequisite: BIS 505a or equivalent.

BIS 560b, Database Management in Medicine and Epidemiology. Prakash Nadkarni.
This course covers the theory and practice of database management as applied to clinical trials, obvservational studies, and other prospective research projects. Emphasis is placed on the use of user-friendly database management packages that require little programming. Difficult problems in database management are described, although students are not expected to build applications of such complexity. Recent advances in the field of data management are studied. Prerequisite: working knowledge of Macintosh or Microsoft Windows.

BIS 561b, Advanced Topics and Case Studies in Multicenter Clinical Trials. Peter Peduzzi, Pamela Hartigan.
This course addresses advanced issues related to the design, conduct, monitoring, and analysis of multicenter randomized clinical trials. Topics include organizational, regulatory, and human rights issues; an overview of design strategies; advanced topics in sample size estimation and monitoring; data management and quality assurance procedures; cost-effectiveness and quality of life; and case studies of vaccine trials, factorial trials, primary and secondary prevention trials, large simple trials, strategy trials, and cost-effectiveness. The case studies include many of the classical and landmark clinical trials, such as the polio vaccine field trial, Physicians Health Study, and the trials of AZT for the treatment of AIDS. Prerequisites: BIS 505a and BIS 540b. Enrollment limited to second-year students.

BIS 623a, Applied Regression Analysis. Theodore Holford.
Linear regression, testing hypotheses in multivariate regression, regression diagnostics, analysis of variance, and adjusting for covariates. Emphasis on application of methods. Prerequisites: BIS 505a and 505b or equivalent.

BIS 625a, Categorical Data Analysis. Daniel Zelterman.
Presentation of methods for analyzing categorical data in public health, epidemiology, and medicine. Topics include measures of association, comparing distributions among groups, log-linear models, and logistic regression. Emphasis on the application of methods and the interpretation of results obtained by using these techniques. Prerequisites: BIS 505a,b.

[BIS 628b, Longitudinal Data Analysis.]

[BIS 631b, Topics in Genetic Epidemiology.]

BIS 635b, Topics in Statistical Epidemiology. Theodore Holford.
Discussion of methods of analyzing association among one or more factors with disease. Topics include the analysis of cohort studies, case control studies, and vital rates. Analysis of matched data also discussed. Emphasis on the application and interpretation of the techniques. Prerequisites: BIS 505a,b, 623a, or 625a.

BIS 637a, Stochastic Processes in Biology and Medicine. Daniel Zelterman.
This course derives deterministic and stochastic models that describe population growth, as well as the development and spread of disease. The models are used to describe events in either discrete or continuous time. Emphasis is placed on the derivation of mathematical models and their application to the study of specific health questions. Prerequisite: STAT 541a.

BIS 640a, Quantitative and Computational Methods in Bio-Informatics. Heping Zhang.
The Human Genome Project has created a great opportunity for biomedical research by providing enormous genetic information. A bottleneck in understanding the biological processes is how to make best use of the generated information. This course covers statistical techniques in clustering and classification, and artificial neural network, as well as computer algorithms for optimization and search. These techniques and algorithms are applied for and demonstrated in DNA sequencing, microarray analyses, and protein structure classifications. Prerequisites: BIS 623a or equivalent.

BIS 643a, Theory of Survival Analysis and Its Applications. Haiqun Lin.
This course presents the statistical theory underlying survival analysis. It is considered a first course in survival analysis because it covers only the standard models and asymptotic arguments; the martingale approach to the statistical analysis of failure time data is introduced. The application of this theory through some exemplary data sets is also presented. Prerequisite: STAT 610.

[BIS 645a, Statistical Methods in Human Genetics.]

BIS 646a, Nonparametric Statistical Methods and Their Applications. Joel Dubin.
Nonparametric statistical procedures including recursive partitioning techniques, splines, bootstrap, and other sample reuse methods are introduced. Some of the supporting theory for these methods is proven rigorously, but some are described heuristically. Advantages and disadvantages of these methods are illustrated by medical and epidemiological studies. Students may be required to compare these methods with parametric methods when analyzing data sets. Familiarity with basic statistical theory and computer languages is assumed. Prerequisites: STAT 541a and STAT 542b.

BIS 691b, Generalized Linear Models. Faculty.
This course considers a class of statistical models that is a natural generalization of the classical linear model. An outline of the generalized linear model is developed, and particular cases are discussed including binary response data, polytomous data, log-linear models, quasi-likelihood models, and models for survival data. Prerequisites: STAT 541a, STAT 542b, BIS 623a.

CDE 508a, Principles of Epidemiology I. Robert Dubrow.
An understanding of the research methods used in infectious and chronic disease epidemiology and in microbiology, showing the similarities and differences in their approaches to
diseases and other conditions. Emphasis is on methods and disease etiology, stressing the implications of research for the formulation of policy and for individual decision making. Also EMD 508a.

CDE 516b, Principles of Epidemiology II. Tongzhang Zheng.
An overview of the principles of epidemiology. The first part emphasizes fundamental epidemiologic principles including measures of disease frequency and association, bias, confounding, precision, and interaction. The second part emphasizes the design and conduct of various epidemiological studies. The final part of the course emphasizes causal inference and disease prevention and control. Prerequisites: CDE/EMD 508a, BIS 505a.

CDE 517a, Developing a Research Protocol. Stanislav Kasl.
The development of a research protocol from hypothesis formation to appropriate study design. Review of relevant background literature, consideration of appropriate statistical techniques, provision of adequate personnel and environment, and understanding of strengths and weaknesses of the proposed study included. Students are divided into groups with each group responsible for developing a research protocol suitable for submission as a grant proposal to NIH. Special attention is given to writing techniques and style. Prerequisites: CDE 516b, second-year M.P.H. or doctoral status.

CDE 518b, Introduction to Pharmacoepidemiology. Mary Olson.
The course provides a basic orientation to the study of safety, efficacy, and utilization of ethical pharmaceuticals. The application of epidemiologic methods to the field is emphasized. Among the subjects considered are the usefulness of databases from HMOs, governmental, international, and other sources; current pharmacoepidemiology research within the Yale School of Medicine; the role of the Food and Drug Administration; the assessment of drug safety; and assessment of quality of life and the role of pharmacoepidemiology in a managed care environment. This course is offered in odd years. Prerequisites: CDE/EMD 508a, BIS 505a and BIS 505b.

CDE 521a, The Epidemiology of Some Common Chronic Diseases. Beth Jones.
Introductory survey course covering some of the major chronic diseases, including coronary artery disease, cancer, stroke, chronic obstructive lung disease, alcoholism, HIV, and Alzheimer's disease. Two classes devoted to each disease. The first class is taught by an expert on the disease and covers its basic pathophysiology, etiology, epidemiology, risk factors, and public health importance. In the second class, an important research article about the disease is discussed. Emphasis on developing a working knowledge of chronic diseases and the capacity to read the literature critically.

CDE 523b, Measurement Issues in Chronic Disease Epidemiology. Susan Mayne.
Measurement issues in chronic disease epidemiology addressed from a practical perspective. Covers the use and limitations of currently available techniques for measuring exposure to a number of such etiologic factors as diet, alcohol, tobacco, physical activity, psychological stress, and environmental/occupational exposures. Focus on the measurement of outcome for some of the major chronic diseases. Prerequisite: CDE/EMD 508a.

CDE 532b, Epidemiology of Cancer. Brenda Cartmel.
Application of epidemiologic methods to the study of cancer etiology and prevention. Introductory sessions cover cancer biology, carcinogenesis, cancer incidence and mortality rates in the United States, and international variation in cancer rates. Focus on risk factors for cancer (including tobacco, alcohol, diet, radiation, and occupation) and on major cancer sites (including colon, breast, and prostate). Heavy emphasis on critical reading of the literature. Prerequisites: CDE/EMD 508a, CDE 516b or permission of instructor.

CDE 533b, Topics in Perinatal Epidemiology. Michael Bracken, Kathleen Belanger.
Pregnancy, delivery, and reproduction provide the course's organizing focus. The current perinatal epidemiologic literature critically reviewed from a methodological perspective. Topics include infertility, miscarriage, fetal growth retardation, preterm labor and delivery, aspects of prenatal care, perinatal risks for cancer and other chronic diseases, SIDS and infant mortality. Students develop an understanding of what evidence is needed to establish causal relations in this specialty. Implications of research findings for public health policy, individual decision making, and future studies considered.

CDE 535b, Vascular Epidemiology. Judith Lichtman.
Vascular disease is the leading cause of death and disability among industrialized nations. This course introduces students to the major categories of cerebrovascular and cardiovascular disease. Students are challenged to think about how individual diseases contribute to the epidemic of vascular disease in the United States. In this course, students learn basic principles about the rates of disease, risk factors, clinical trial results, and outcomes of vascular diseases. Through the analysis of actual studies, students apply basic epidemiology to critically evaluate current literature and topics in the field of vascular epidemiology. Sessions include a clinical overview of a specific disease or risk factor, as well as a highly interactive discussion on a specific epidemiologic topic or principle. Students are encouraged to develop their own solutions to current gaps in the epidemiologic literature.

CDE 550a, Introduction to Evidence-Based Health Care. Michael Bracken.
Evidence-based health care uses best current evidence in addressing clinical or public health questions. This course introduces principles of evidence-based health care in formulating clinical or public health questions, systematically searching for evidence, and applying it to the question. Types of questions considered include treatment/prevention of disease, etiology, diagnostic testing, and prognosis. Particular consideration is given to the methodology of synthesizing evidence in a systematic review. Also addressed is the role of evidence in informing economic analysis of health care programs, clinical decision analysis, and clinical practice guidelines. Using a problem-based approach, students contribute actively to the classes and small-group sessions. Students complete a systematic review in their own field of interest using Cochrane Collaboration methodology.

CDE 562a, Nutrition and Chronic Disease. Susan Mayne.
This course provides students with a scientific basis for understanding the role of nutrition and specific nutrients in the etiology, prevention, and management of chronic diseases. Nutrition and cancer are particularly emphasized. Other topics include cardiovascular diseases, osteoporosis, obesity, diabetes mellitus, and aging. Prerequisites: biology, biochemistry, and physiology helpful. Preference given to CDE majors.

CDE 619a, Advanced Epidemiologic Research Methods. Harvey Risch.
An advanced course on quantitative issues and techniques relevant to the design and analysis of observational epidemiologic studies. Starts with formal definitions of the commonly used epidemiologic parameters, assumes working knowledge of ANOVA and linear regression, covers analyses based on various related types of regression, e.g., logistic Poisson, Cox, etc. The GLIM and PECAN computer programs are described and used throughout. Students analyze and discuss data sets of generally increasing complexity. Prerequisites: HP or better in BIS 505a,b; doctoral status or permission of instructor.

CDE 634a, Advanced Seminar in Perinatal Epidemiology. Michael Bracken.

EHS 502a, Physiology for Environmental Health Sciences. Gary Mack, Lawrence Marks.
Description of the basic physical properties associated with exposure to environmental stress, and the physiological strategies used to maintain homeostasis in the human body. Prerequisites: biology, chemistry.

EHS 503b, Introduction to Toxicology. Faculty.
Factors that affect the toxicity of foreign substances. The absorption, distribution, excretion, and metabolism of foreign compounds. Lectures in cell biology, teratology, chemical carcinogenesis, dose-response relations, and behavioral toxicology.

EHS 505a, Introduction to Industrial Hygiene. Judith Sparer.
Students are introduced to the practice of industrial hygiene: the recognition, evaluation, and control of health hazards in the workplace. A systematic approach to identifying hazards in the workplace is presented, and students are asked to exercise these techniques in at least one industrial worksite. Topics include regulation of health and safety in the workplace, air sampling and interpretation of sampling results, and approaches to reducing place exposures.

EHS 507a, Environmental Epidemiology. Tongzhang Zheng.
The potentials and the limitations of environmental epidemiology explored as they are inherent in the design of suitable studies and as they manifest themselves in actual studies that have been conducted. The analysis of interpretation of such studies as well as the consequences for the design and conduct of studies is examined. Prerequisite: CDE/EMD 508a or permission of instructor.

EHS 508a, Assessing Exposure to Environmental Stressors. Brian Leaderer.
Human exposure to environmental stressors as it applies to environmental epidemiology and risk assessment. Indirect and direct methods of assessing exposures, case studies.

EHS 509a, Environmental Toxicology. Faculty.
Survey of the basic methods and fundamental biochemical mechanisms of toxicity. Toxicity in mammalian organ systems, techniques for evaluating toxicity, mechanisms of selective toxicity, and environmental interactions. Biomonitoring of human exposure to specific environmental toxicants. Prerequisite: EHS 503b or permission of instructor.

EHS 510b, Fundamentals of Environmental Health and Risk Assessment. Loretta DiPietro.
This course is an overview of environmental health. Students are introduced to the fundamentals of environmental health from the perspective of using risk analysis to reduce environmentally induced disease. The principles used to apply to toxicologic, statistical, and pharmacokinetics factors in the assessment of health risk from chemicals are emphasized. Quantitative risk assessment, exposure assessment, and risk characterization are emphasized.

EHS 511a, Applied Risk Assessment I. Jonathan Borak.
Applied environmental risk assessment consists of the effective integration in a specific situation of what is known about pollution sources and their characteristics, about human exposures, about the entry and absorption of pollutants, and about the adverse health effects associated with dosage exposure. In any actual situation there are uncertainties in all of the elements to be integrated. This course emphasizes methodologies in use and the limitations that inevitably constrain the process. A number of applied risk assessments are analyzed.

EHS 514a, Environmental Chemistry. Meredith Stowe.
The basic chemical principles of underlying environmental pollutants in water, soil, air, and specialized media. Various categories of federally regulated compounds and elements examined with respect to group characteristics, analytical techniques of choice, sampling methods, and data interpretation. Selected chemical agents studied with regard to possible transformations/decomposition in the environment. Insight into some current problems faced in applying pollutant measurements to public health, e.g., analytical precision, uncertainty, detection limits, chemical specification, and toxicological properties.

EHS 516b, Principles of Epidemiology II. Tongzhang Zheng.
An overview of the principles of epidemiology. Emphasis on fundamental epidemiologic principles including measures of disease frequency and association, bias, confounding, precision, and interaction; the design and conduct of various epidemiological studies; causal inference and disease prevention and control. Prerequisites: CDE/EMD 508a, BIS 505a.

EHS 532b, Indoor Climate. Brian Leaderer.
The impact of environmental factors in the indoor environment on human health and well-being is examined. Emphasis is placed on assessing the nature of and exposures to indoor air contaminants and different thermal micro-environments and their influence on health and comfort.

EHS 551a and b, Seminar in Environmental Health. Nina Stachenfeld.
Students are introduced to a wide variety of research topics, policy topics, and applications in environmental health. Faculty members, public health professionals, and students make brief oral presentations and engage in related dialogues. The course is designed to help students develop topics for their M.P.H. theses. Second-year students have the opportunity to receive feedback on their developing research. Prerequisite: permission of the instructor.

EHS 553a, Epidemiological Methods in Injury Control. Linda Degutis.
Application of epidemiological methods to injury surveillance, etiology of injuries, and the evaluation of the effects of injury-control programs. Topics include methods of scoring injury severity; distribution of injury types and severity in segments of the U.S. population; exemplar epidemiological studies of etiology; strategies to reduce incidence and severity; evaluation of attempts to change environments and behavior by standards, laws, persuasion, and economic incentives; and the use of cost-effectiveness, cost-benefit, and cost-savings analysis.

EHS 573b, Occupational Epidemiology. Mark Cullen.
Various approaches to the epidemiologic evaluation of health hazards in the workplace. Consideration of specific substances. Critical review of the literature. Intermediate to advanced techniques in study design and analysis of occupational epidemiologic studies included. Prerequisites: BIS 505a, CDE/EMD 508a.

EHS 575a and b, Introduction to Occupational and Environmental Medicine. Mark Cullen [F], Mark Russi [Sp].
An overview of the principles of occupational and environmental medicine. Fall term covers the major diseases of environmental origin. Spring covers the major hazards—chemical, physical, and biologic, and the settings in which they occur. Prerequisite: M.D. degree or permission of instructor.

EHS 579a and b, Advanced Laboratory Techniques in Environmental Health Sciences.
This course is taken for two or three terms. Laboratory technique tools in environmental health. Methods in tissue culture, exposure measurement, toxicology, and molecular biology are offered. This is a hands-on course closely supervised by technically trained personnel. Since the laboratory works with biohazards, laboratory safety and use of biosafety hoods are emphasized. Prerequisites: familiarity with biosafety procedures, prior lab experience, and permission of the instructor.

EHS 611a and b, Advanced Research Laboratories.
This course is taken for two or three terms. Offers experience in directed research and readings in selected research laboratories. The first two terms should be taken in the first year of the doctoral program; the third term is taken at a time determined after faculty consultation with the student. Prerequisite: doctoral status and permission of the instructor.

EHS 655a or b, Readings in Environmental Health. Brian Leaderer.
By arrangement. Study of environmental topics through the current literature, often to develop a research or thesis protocol. Prerequisite: EHS major.

EMD 508a, Principles of Epidemiology I. Robert Dubrow.
An introduction to epidemiologic concepts and methods. Topics include causation, measurement of disease rates, epidemic investigation, cohort studies, clinical trials, case-control studies, ecological studies, bias and confounding, effect modification, random variation and statistical significance, and screening. The course utilizes a wide variety of case studies from both chronic and infectious disease epidemiology. Also CDE 508a.

EMD 512b, Immunology for Epidemiologists. Akiko Iwasaki.
This course is designed to introduce students to the fundamentals of immunology including antigens, antibodies, methods for detecting antibodies, cells of the immune system, products of such cells, and immune mechanisms. Prerequisite: two terms of college biology.

EMD 516a, Biology of Viruses of Humans. Louis Alexander.
This course consists of a systematic review of the spectrum of viruses and their modes of replication, dissemination, pathogenesis, and immunogenicity. Special problems representative of the characteristics of individual families of viruses are discussed. Prerequisites: biology and EMD 519a.

EMD 519a, Introduction to Microbial Diseases. Liangbiao Zheng.
This course provides an introduction to the biology and epidemiology of etiologic agents associated with infectious diseases. The course introduces students to key concepts in immunology, bacteriology, virology, parasitology, and vector biology as they relate to human disease and its control. This course provides a framework for later courses that cover these individual topics in greater detail.

EMD 530b, Hospital Epidemiology. Louise-Marie Dembry.
The history, descriptive epidemiology, surveillance methods, risk analysis methods, and economics of nosocomial infections are outlined in this introductory course. In-depth explorations of host, agent, and environmental factors influencing typical nosocomial illnesses in pediatric and adult services are reviewed by clinical faculty. Descriptive and analytical epidemiological methods are emphasized.

EMD 534b, Molecular Epidemiology of Bacterial Pathogens. Kaveh Khoshnood.
This course is designed to introduce students to the fundamentals of the molecular epidemiology of bacterial pathogens. The scientific basis for molecular epidemiological tools and their application toward addressing contemporary problems in public health is evaluated through a combination of lectures and case studies. Topics include the emergence of new bacterial pathogens, antibiotic resistance, vaccine design, and bioterrorism. Prerequisite: EMD 519a or permission of the instructor.

EMD 536b, Investigation of Disease Outbreak.
This course provides students with the basic skills and perspectives necessary to investigate acute disease outbreaks. The emphasis is on the use of epidemiology to investigate outbreaks of infectious diseases, although the methods are not limited and can be applied to outbreaks of noninfectious diseases as well. Through this course, it is hoped that students will gain a better appreciation of epidemiology as the science of public health, and the use of epidemiology to guide public health interventions and the development of public health policy.

EMD 541b, Infectious Diseases: Epidemiology, Prevention, and Control. Kaveh Khoshnood.
Students learn epidemiologic methods and concepts in infectious diseases, specific viral and bacterial infections, and problems illustrative of the methods and/or disease. Methods include surveillance, seroepidemiology, case/control and cohort studies, vaccine trials, epidemic investigation, principles of causation, immunization policies and their implementation, and evaluation in developed and developing countries. Specific viral and bacterial infections of the central nervous, respiratory, and intestinal tracts; the herpes viruses; slow and persistent viral infections; retroviruses, including AIDS; the exanthems; nosocomial infections; and the relation between viruses and cancer are discussed. The use of epidemiological concepts in the prevention of disease is emphasized. Prerequisite: microbiology.

EMD 542a, Infectious Diseases in Countries with Limited Resources.
The pattern, process, and impact of infectious diseases on human populations in the Third World are studied through lecture and discussion. The epidemiology and ecology of infectious agents are reviewed in the context of environmental and socioeconomic factors that influence transmission. Epidemiological analysis of the major tropical infectious diseases address problems in surveillance, risk reduction, prevention of outbreaks, and design of research. Emphasis is placed on principles of tropical diseases, vaccination, international child health, and emerging diseases.

EMD 548b, Observing the Earth from Space. Ronald Smith, Durland Fish.
Applications of satellite images to studies of the environment are explored. Topics include the spectrum of electromagnetic radiation, satellite-borne radiometers, data transmission and storage, computer image analysis, and merging satellite imagery with GIS. The uses of remotely sensed data in climatology, oceanography, surficial geology, forestry, agriculture, ecology, and epidemiology are discussed. A research project using satellite images to address a problem in one of these realms is required. Prerequisites: physics or chemistry, two courses in environmental sciences or equivalent, and permission of the instructors. Also G&G 562b^u, F&ES 506b.

EMD 557a/657a, Public Health Issues in HIV/AIDS& Kaveh Khoshnood, Kathleen Ethier.
An introductory, broad-based survey course on the epidemiology of HIV/AIDS. Topics include virology, clinical issues, natural history of infection, laboratory testing, transmission, and prevention of HIV/AIDS. Gives a general, comprehensive understanding of HIV/AIDS issues for those beginning work in public health or HIV/AIDS, or for those who wish to expand their specialized knowledge base regarding HIV/AIDS. Regular attendance at the Yale AIDS Colloquium Series (YACS) and written synopsis required.

EMD 642a, Roles of Microorganisms in the Living World. L. Nicholas Ornston, Diane McMahon-Pratt, Robert Macnab. TTh 11.30–12.45
A topical course exploring the biology of microorganisms. Emphasis on mechanisms underlying microbial adaptations and how they influence biological systems. Prerequisites: biology, chemistry, biochemistry. Also GENE 642a, MB&B 642a, MBIO 642a, MCDB 642a.

EMD 664b, Biology of Parasitic Protozoa and Helminths. Serap Aksoy, Curtis Patton. TTh 3
Focus on developmental biology, natural history, form, function, cell and molecular biology of the major eukaryotic parasites of public health importance. Host/parasite integration, co-evolution, diagnosis, pathogenesis, and control strategies emphasized. Prerequisites: one year of biology, two years of chemistry. Also MBIO 664b.

EMD 670a and b, 671a, Advanced Research Laboratories. Diane McMahon-Pratt.
Experience in directed research and reading in selected research laboratories. May be taken for three terms. The first two terms must be taken in the first year of the doctoral program and the third term is taken at a time determined after faculty consultation with the student. Prerequisite: doctoral status.

EMD 680a,b, Advanced Topics in Molecular Parasitology. Curtis Patton, Diane McMahon-Pratt, Christian Tschudi. F 12–1.30
A broadly based seminar course on current research topics in cell and molecular parasitology, with topics chosen from the current literature. For doctoral and advanced M.P.H. students only. Also MBIO 680a,b.

EMD 682a, Advanced Topics in Vector Biology. Liangbiao Zheng.
A broadly based seminar course on current research topics in the biology of medically important vectors, vector-pathogen interactions, vector ecology, disease management, and vector control strategies. Topics are chosen from the current literature. Prere7uisites: doctoral status or permission of instructor.

EMD 695a, Readings in Vector Ecology.

HPA 510a, Health Policy and Health Systems. Mark Schlesinger.
An introduction to the making and understanding of health policy. The various goals of policy making and the alternative means of achieving those goals examined. Health issues placed in the context of broader social goals and values. The current performance of the health care system assessed, with particular emphasis on shifting needs, rising costs, and changing institutional arrangements. An overview of the important actors in the health care and political systems and introduction to methods for understanding their behavior. Students apply these methods to a set of concrete policy issues.

HPA 514b, Government and Health Policy. Karl Kronebusch.
The various processes by which governmental health policy is made in the United States and the substance and background of current policy debates. Primary emphasis on Congress and executive branch agencies, with attention given to both the financing and organization of health services and to public health problems such as AIDS. Different policy actions or problems discussed weekly, selected for both their importance and their usefulness in illuminating important aspects of the policy process.

HPA 521a, Health Services Epidemiology. Alexander Ortega.
Epidemiologic methods and data may be used to understand and improve public health practice, health services research, and health policy. This course emphasizes methodological and conceptual issues through a research-oriented approach to health promotion and disease prevention, the measurement of health status, assessment of health needs and population-based planning, health-related behaviors and beliefs, evaluation of medical practices and health programs, and public health decision making. Prerequisite: first-term core.

HPA 529a, Policy Analysis and Health Politics. Karl Kronebusch.
Provides students with policy analytic skills and teaches students to think critically and to write succinctly about health care policy. Integrates the study of policy analysis and the world of health politics as analysts must do in real life. Considers the nature of public policy and the theories of policy analysis and policy decision making, eight key components of the policy analysis process, and jointly examines the impact of major political organizations and institutions on the process of analyzing and selecting public health care policy. Prerequisite: HPA 510a.

HPA 538a, Regulation and Public Health Policy. Mary Olson.
This course provides students with an understanding of the role of government regulation in public health and health-related markets. Students learn to analyze how economic and political forces can influence both the development and the implementation of public health regulations. The course utilizes theories and empirical evidence from economics, political science, law, and public health to help students answer five questions relating to government intervention in health-related markets: Why regulate? How are regulatory rules made? How are regulations enforced? How do we determine whether regulations are successful? What alternatives exist to regulation? Students also apply insights and concepts from the course to explain policy making in public health bureaucracies.

HPA 542a, Health of Women and Infants. Mary Alice Lee.
Focus on the health of women and infants in the United States. Epidemiology of selected health conditions presented. The utilization and financing of women's and infants' health care discussed. Existing targeted governmental and private programs identified and assessed. Major sources of data identified and compared. Students investigate a program or agency (public or private) that addresses a particular health problem of women or infants. Topics include contraceptive use, abortion, sexually transmitted diseases, substance abuse, prenatal care, low birth weight, perinatal AIDS, domestic violence, midlife health, and maternal mortality (with an international perspective). Discussion of the public health implications of these health problems provides a basis for policy analysis in later study.

HPA 544a, Public Law and Public Health: The Law, the Individual, and the State. John Culhane.
A basic orientation to the law, the legal system, and legal decision making as they relate to the public's health. Emphasis on the relation between the autonomy of the individual and the power of the state in addressing issues affecting the public's health. Topics include civil commitment, right to refuse treatment, procreation, human experimentation and clinical research, domestic violence, adoption and foster care, religious practices, and seat belt and helmet laws. Discussion of issues that must be considered in assessing the state's silence, omission, intervention, or intrusion into health matters of the person, the family, or the group. Prerequisite: first-term core.

HPA 545b, Health Care Disparities. Alexander Ortega.
This course explores what constitutes and explains a disparity in health care. Emphasis is placed on understanding the history of disparities in the U.S., in order to understand the current state of disparities, and on evaluating the effectivenesss of ongoing strategies to eliminate them, such as increasing insurance coverage and the delivery of culturally competent health care. The course also examines sociological models that explain disparities in health care, and students are required to evaluate and expand on these models. Prerequisites: HPA 510a and CDE 505a.

HPA 546b, Ethical Issues in Public Health. Bruce Jennings.
Public health policy is always the product of controversy. Scientific considerations blend with political and ethical conflicts in public health, and questions of autonomy, coercion, justice, and the common good are central. This seminar discusses these issues of ethics and political theory in reference to selected public health issues like preventive medicine and behavior modification, smoking, control of infectious diseases, and contraception and teen pregnancy.

HPA 547b, Law and the Management of Health Care Organizations. W. John Thomas.
A survey course of legal topics important to the management of health care organizations designed to acquaint the future health care manager with the basic legal issues that daily impact the provision of health care services. Examination of the relations among the parties involved in the delivery of health care; the law of business organizations, including that of corporations, partnerships, and professional corporations; the legal constraints that operate upon health care organizations, including state and federal regulatory laws, labor relations, and antitrust doctrines; and doctrines particularly applicable to managed care organizations. Consideration of a variety of emerging legal issues in the health care field.

HPA 560b, Health Care Finance and Delivery. Susan Busch.
This course introduces students to the organization and operation of the American health care system. The course examines systems of health care delivery and finance and recent trends in their organization, including the growth of managed care. The course seeks to provide students with an understanding of the existing structure of the system and to provide them with conceptual frameworks to consider forces for change and the implications of recent trends for policy and management.

HPA 570a, Cost-Effectiveness Analysis and Decision Making. A. David Paltiel.
Introduction to the methods of decision analysis and cost-effectiveness analysis in health-related technology assessment, resource allocation, and clinical decision making. Aims to develop technical competence in the methods used; practical skills in applying these tools to case-based studies of medical decisions and public health choices; and an appreciation of the uses and limitations of these methods at the levels of national policy, health care organizations, and individual patient care.

HPA 583b, Methods in Health Services Research. Elizabeth Bradley.
Introduction to both quantitative and qualitative methods for research in health services. Topics include research objectives and hypotheses formulation, study design, sampling, techniques, measurement, data analysis, results presentation, and discussion. Students synthesize these skills in the final project. Prerequisite: BIS 505a.

HPA 586b, Microeconomics for Health Care Professionals. William White.
Introduction to microeconomics. Emphasis on topics of particular relevance to the health care sector. Attention paid to issues of equity and distribution, uncertainty and attitudes toward risk, and alternatives to price competition. Designed for students with minimal previous economics.

HPA 587b, Health Care Economics. Douglas Leslie.
This course applies the principles learned in Microeconomics for Health Care Professionals (HPA 586b) to the health of individuals, to health care institutions and markets, as well as to health care policy. The economic aspects of health behaviors, hospital markets, cost-benefit analysis, regulations, and the market for physician services are covered. Prerequisite: microeconomics or permission of the instructor.

HPA 588a, Economics of Alcohol, Drugs, and Crime. Jody Sindelar.
This course uses economics as a base discipline in studying the use and abuse of alcohol and illicit drugs and the various social problems produced by each—such as crime, lost productivity, misuse of health care, and impact on families and children. Other topics included are cost-effectiveness of treatment versus the criminal justice system, racial and gender differences, comorbidity with psychiatric problems, inner-city drug problems, problems of youth, and the history of drug use. Such policy alternatives as prevention, treatment, taxation of alcohol, legalization of illicit drugs, and the criminal justice system are analyzed.

HPA 596b, Critical Policy Issues in the AIDSPandemic. Michael Merson.
Seminar for students with an understanding of the epidemiology of HIV/AIDS (either through work experience or course work). Students in public health, medicine, nursing, law, management, and international studies will appreciate this in-depth interdisciplinary examination of key policy challenges that this pandemic presents, as well as the sharpened skills in policy analysis that such examination necessarily fosters. Class size limited to eighteen students. Prerequisite: first-term core.

HPA 597b, Integrative Policy Analysis Seminar. Mark Schlesinger.
Seminar designed as the capstone educational experience for students concentrating in the health policy at EPH, though it is also open to students from other schools who have had previous training or experience in policy analysis. The first theme involves exploring different strategies of policy analysis and associated models of professionalism. The second theme involves the complicated prospects for policy analysis associated with the boundaries between health care defined in a clinical sense and the broader social determinants of health. These issues are studied in a series of applied areas, including substance abuse, family policy, and the community obligations of managed care plans. Prerequisite: HPA 510a or equivalent.

HPA 600a or b, Readings in Health Services Research and Policy. Faculty.
Seminar to explore current and cutting-edge topics in the broad fields of community and
personal health services. Designed to familiarize students with a breadth of research opportunities. Students review existing research projects and critique recent research publications. Prerequisite: doctoral status or permission of instructor.

HPA 603b, The Ethical Conduct of Research. Susan Katz.
Seminar exposing students to both practical and theoretical issues in research ethics. Focus on real-world situations in public health research with the aim of equipping students to function as responsible researchers. Representative areas include informed consent; research with vulnerable populations; privacy and confidentiality; the collection, retention, and reporting of data; federal regulations and institutional policies governing research; research in developing countries; authorship and publication; scientific misconduct; and conflict of interest. Prerequisite: doctoral status or permission of instructor.

HPA 617a, Colloquium in Health Policy and Health Services Research I. Sarah Horwitz and faculty.
Seminar focusing on the analysis of current issues in health policy and on state-of-the-art methodological issues in health services research. Guest speakers and presentations by EPH and other faculty and graduate students of ongoing research projects on health services. Students participate in critical discussions of the issues that arise in both types of sessions. Prerequisite: doctoral status or permission of instructor.

HPA 617b, Colloquium in Health Policy and Health Services Research II. Rani Hoff, Sarah Horwitz.
Seminar includes in-depth discussions of major policy concerns in the health and health care of vulnerable populations like the poor, young, old, and disabled. Students present their own research. Prerequisite: doctoral status or permission of instructor.

HPA 621a, Advanced Health Services Epidemiology. Alexander Ortega.
Epidemiologic methods and data may be used to understand and improve public health practice, health services research, and health policy. Emphasis on methodological and conceptual issues through a research-oriented approach to health promotion and diseası prevention, the measurement of health status, assessment of health needs and population-based planning, health-related behaviors and beliefs, evaluation of medical practices and health programs, and public health decision making. Prerequisite: doctoral status or permission of instructor.

HPA 650a, Colloquium on Mental Health Services Research I. Sarah Horwitz and faculty.
Seminar focusing on the state-of-the-art in the evaluation and the measurement of need for treatment and organization of mental health services. Students review ongoing research projects and develop research on the use of mental health services, prepare Œnnotated bibliographies, and participate in the examination of relevant issues. Prerequisite: doctoral status or permission of instructor; SOCY 550a.

HPA 650b, Colloquium on Mental Health Services Research II. Rani Hoff, Sarah Horwitz.
Seminar focusing on social and cultural factors in the development, diagnosis, treatment, and prevention of mental illness. Attention given to the underlying theory of and research in the social epidemiology of mental illness and the relation between stress and psychiatric status. Includes presentations of student research in mental health services. Prerequisite: doctoral status or permission of instructor.

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