Overview<\/p>\n
In this activity, you’ll learn how to create a root causes diagram for one specific disease, and then writing about the “causes of the causes” for that disease (e.g., analyzing your diagram in narrative format).\u00a0 You will post posting your final diagram and text to the class and comment on one other student’s assignment through a peer review exercise.<\/p>\n
Step 1: Pick a disease<\/p>\n
Go to the Institute of Health Metrics and Evaluation (IHME) website (we will discuss this tool and the data in more depth later), and used the tool called “GBD Compare\u00a0(Links to an external site.).” Select your country from the drop-down menu and then make sure that the settings for each area match those in the image below.<\/p>\n
Under\u00a0Location, select the country you want to write about.\u00a0 Under\u00a0Measure, start with Deaths (then later switch it to DALYs to see the listing that incorporates both death and disability\u2014we will cover the DALY in more depth later).<\/p>\n
You’ll see a chart illustrating trends over time, as well as which diseases have increased\/decreased in ranking since 1990. Choose a disease that is ranked within the top 10 for either deaths or DALYs — one that interests you, and that you think would be interesting to evaluate by thinking about underlying determinants, the “causes of the causes….”<\/p>\n
Step 2:\u00a0Make a Root Causes Diagram<\/p>\n
Lecture 2.5 walks you through the research and charting process. You will need to do some research about the disease you selected before making the chart.<\/p>\n
Step 3: Write it up! Analyze the diagram in 650-800 words (2-2.5 pages)<\/p>\n
Present the research you did to make the diagram in narrative form, using academic language and citations where appropriate. Begin by justifying why you selected the disease you did (see below). Then, present a comprehensive picture of the risk factors and determinants of health that impact that health issue. Be sure to consider the \u201ccauses of the causes of the causes.\u201d\u00a0I am looking for an application of the course concepts from the first week of lectures and readings.<\/p>\n
Justifying your selection: The issue you select does not have to be the leading cause of deaths or DALYs (death\u00a0and\u00a0disability combined), but\u00a0you must justify your selection by explaining why the health issue is significant to consider\u00a0(e.g.: it has the highest impact on years lived with disability; or, while the disease is not among the top 5 causes of DALYs, its incidence has increased significantly over time; or, it is the fastest rising NCD; or, it is a \u201cdisease of extreme poverty\u201d that has stubbornly shown the same incidence rates over time even though the country is getting wealthier\u2026) I know it is still early in the course, but I think you can do it!<\/p>\n
Tips for this section:<\/p>\n
Be as specific as you can. e.g. if your disease is “accidents and injuries,” rather than saying \u201cphysical determinants impact vulnerability to earthquakes,\u201d let me know what the physical determinants actually are. Maybe it is crowded urban housing, poor roads, or a lack of primary care facilities in rural areas, all of which are different kinds of “physical infrastructure.”<\/p>\n
Once you have described a risk factor or higher-level determinant (e.g. hand washing as a behavioral determinant, or earthquakes as a physical determinant),\u00a0think past it\u00a0to consider how other issues\/factors such as vulnerability, policy making, poverty, etc. impact that determinant. Personal choice or living in an earthquake zone do not fully explain why some people are sick\/injured and others are not during an earthquake. Keep the \u201ccauses of the causes of the causes\u201d in mind.<\/p>\n
Most risk factors and higher-level determinants have multiple sub-determinants, or causes. Discussing several determinants associated with a single risk factor is a stronger argument. e.g., If you selected heart disease, you would find that risk factors for heart disease include diets high in saturated fats and smoking. In your paper, consider the multiple determinants associated with each of those risk factors. If you only discuss determinants that impact one risk factor, your argument won\u2019t be as strong.<\/p>\n
Step 4: Submit!<\/p>\n
Submit both your diagram and your research paper.<\/p>\n
Assignment Expectations and Grading<\/p>\n
Your assignment will be graded according to the following criteria:<\/p>\n
Diagram (25%)<\/p>\n
Diagram is\u00a0clear visually, easy to read. Risk factors are displayed in ways that differentiates them from determinants (ie a different color)<\/p>\n
Risk factor listing is comprehensive for the disease\u00a0— e.g. list ALL risk factors for that disease.<\/p>\n
Determinants listing is detailed and layered.\u00a0\u00a0Select 4-5 risk factors from your comprehensive list and describe 3-8 determinants for each risk factor.\u00a0There may be multiple determinants for a single risk factor, but for at least one of those determinants, you should have 3-5 “levels” that reflect your inquiry into the “causes of the causes of the causes.”<\/p>\n
Be sure that your determinants go beyond individual\/behavioral\/biological determinants to consider a wide range of causes. The determinants is where the important detail of the assignment is located, and this should reflect your understanding of the lectures in Unit 2.<\/p>\n
Since determinants themselves are layered and operate in complex ways, rather than just listing one determinant under a risk factor, list determinants which feed that determinant. You are likely to have many layers of sub-determinants for some risk factors.<\/p>\n
Determinants accurately display the\u00a0relationship between risk factors and determinants\u00a0\u00a0(ie the determinant is linked to correct risk factor, and sub-layers of determinants are appropriately associated with the next layer of determinants). The links between each level\/layer are clear (you may need to write more than a single word to make that connection clear; but sometimes the connection between 2 levels will be obvious. Use your best judgement)<\/p>\n
Research paper (75%):<\/p>\n
Justification of why you selected this particular disease.<\/p>\n
Paper discusses 2-3 causal chains in the diagram, accurately using the terms and language from lectures and readings.<\/p>\n
Paper considers the “causes of the causes of the causes” and goes beyond a risk factor or first-order determinant, to think about the sub-determinants.<\/p>\n
Paper considers the complexity of the relationship between different determinants.<\/p>\n
In-text citations and a full bibliography,\u00a0with sources that are reputable and high quality, in\u00a0APA style, provided at the end of the document.<\/p>\n
Minimum of 5 sources required. (for example, the CDC, the World Health Organization, or other reputable sources).\u00a0<\/p>\n
\u00a0<\/p>\n
Another example:<\/p>\n
Below is a sample root causes diagram from The Compass, a group that focuses on Social and Behavioral Change for public health. This one is more focused on behaviors than yours will be, but it illustrates the thinking involved in causes-of-the-causes-of-the-causes, or of having multiple layers\/levels of determinants:\u00a0(Links to an external site.)<\/p>\n
Image source:\u00a0https:\/\/www.thecompassforsbc.org\/how-to-guides\/how-conduct-root-cause-analysis\u00a0(Links to an external site.)<\/p>\n
\u00a0<\/p>\n
Root Causes Diagram & Paper<\/p>\n
Criteria<\/p>\n
Ratings<\/p>\n
Pts<\/p>\n
Paper: Justification of why you selected this particular disease. This should be data-driven. It does not have to be the leading cause of death, but your reader should understand why it is important to know more about the determinants of the disease.<\/p>\n
7 pts<\/p>\n
Full Marks<\/p>\n
0 pts<\/p>\n
No Marks<\/p>\n
Comments<\/p>\n
Provide a rate (%) rather than a raw number. More data would be useful, most of the 2nd paragraph is not really a justification, but other kinds of information.<\/p>\n
3 \/ 7 pts<\/p>\n
Paper discusses 2 causal chains in the diagram in depth, accurately using the terms and language from lectures and readings 1. Paper considers the “causes of the causes of the causes” and goes beyond a risk factor or first-order determinant, to think about the sub-determinants. 2. Paper considers the complexity of the relationship between different determinants 3. Paper may acknowledge behavioral determinants, but then digs deeper to describe the political, social and structural determinants<\/p>\n
56 pts<\/p>\n
Full Marks<\/p>\n
0 pts<\/p>\n
No Marks<\/p>\n
Comments<\/p>\n
The discussion on unprotected sex has me concerned that you think “traditional culture” is to blame for unprotected sex, but I don’t see any real facts that would explain that. Wife inheritance is not a reason for the spread of HIV. What source says that it is? This paper seems to be based on your own assumptions and stereotypes rather than real research or studies. NOTHING in the paragraph on “sharing personal effects” seems true or a main cause of HIV, and there are no sources for most of it.<\/p>\n
20 \/ 56 pts<\/p>\n
Paper: In-text citations and a full bibliography w min. 5 reputable sources 1. With sources that are reputable and high quality, in APA style, provided at the end of the document. 2. Minimum of 5 sources required (for example, the CDC, the World Health Organization, academic journal articles, or other reputable sources).<\/p>\n
7 pts<\/p>\n
Full Marks<\/p>\n
0 pts<\/p>\n
No Marks<\/p>\n
7 \/ 7 pts<\/p>\n
Diagram: Risk factors comprehensive, clear visually Risk factors are displayed in ways that differentiates them from determinants (e.g., a different color or shape). Risk factor listing is comprehensive for the disease — list ALL risk factors for that disease.<\/p>\n
6 pts<\/p>\n
Full Marks<\/p>\n
0 pts<\/p>\n
No Marks<\/p>\n
Comments<\/p>\n
risk factors are not comprehensive:\u00a0https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hiv-aidsLinks to an external site.<\/p>\n
3 \/ 6 pts<\/p>\n
Diagram: Determinants are multi-layered, reflect “causes of the causes of the causes” 1. Select 3-4 risk factors from your comprehensive list and, for each one, list 3-8 sub-determinants. You should have several “sub-levels” or layers to your diagram that reflect your inquiry\/research into the “causes of the causes of the causes.” 2. Be sure that your determinants go beyond individual\/behavioral\/biological determinants to consider a wide range of underlying social, political and structural causes. This should reflect your understanding of the lectures in Units 2 and 3.<\/p>\n
18 pts<\/p>\n
Full Marks<\/p>\n
0 pts<\/p>\n
No Marks<\/p>\n
9 \/ 18 pts<\/p>\n
Diagram: Difference between risk factors and determinants is clear For example, the determinant is linked to correct risk factor, and sub-layers of determinants are appropriately associated with the next layer of determinants. The connections between each level\/layer should be clear to the reader. Sometimes the connection between different levels will be obvious, but in other cases you may need to write more than a single word to make that the connection clear; use your best judgement.<\/p>\n
3 pts<\/p>\n
Full Marks<\/p>\n
0 pts<\/p>\n
No Marks<\/p>\n
Comments<\/p>\n
connections in the diagram don’t always make sense. e.g. how does lack of circumcision lead to unprotected sex lead to ? They are completely different things. In fact, most of the things you list under “unprotected sex” do not cause unprotected sex. LIkewise, why are age and education connected to each other?<\/p>\n
0 \/ 3 pts<\/p>\n
Diagram: Sources Sources used to make the diagram are listed somewhere on the diagram or next page (hyperlinks are fine, a formal bibliography is only required for the paper)<\/p>\n
3 pts<\/p>\n
Full Marks<\/p>\n
0 pts<\/p>\n
No Marks<\/p>\n
0 \/ 3 pts<\/p>\n","protected":false},"excerpt":{"rendered":"
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