Describe the major social determinants of your group s chosen
disease/health issue (or another disease/health issue of your choice).
II. Explain how one or two of those social determinants influence the
prevalence or severity of the disease/health issue.
III. Present and defend relevant plausible policy implications.
IV. Submit your completed assignment to D2L. Label your file
Grading Rubric for Individual Assignment #3
Grading rubrics are designed to ensure consistency in grading and are provided
as a courtesy to students. They are guidelines as opposed to strict rules and are
not intended to serve as a template for your paper. A good paper is logically
organized and builds a persuasive argument.
1. Content and analysis (50%)
The assignment should clearly and correctly identify the major social
determinants of health associated with the disease/health issue.
The assignment should explain how one or two key social determinants
impact the prevalence or severity of the disease/health issue.
The assignment should make relevant policy suggestions at the national
regional or municipal level. (Tip: these must be plausible
recommendations and you must show how these recommendations are
warranted by your findings.)
2. Quality of writing (30%).
The assignment should be clearly organized and presented in a logical
Information should be organized in paragraphs. Each paragraph should
begin with a topic sentence.
The assignment should be written in academic prose using complete
sentences and should be free of grammatical errors.
The main arguments or claims stated by the writer should be supported by
relevant evidence examples and/or statistics. The writer should make
explicit connections between works cited and their own thoughts to create
a logical flow of ideas.
3. Appropriateness of paper and format (20%)
References should be presented in accepted academic format and ideas
that are not your own should be cited.
The assignment should not contain extensive or unnecessary quotations
of text from published sources.
All works cited should be from academically accepted sources.
All sources referred to in the text of the assignment should be listed in a
References section at the end of the assignment.
Syphilis HSOC NotesFor review articles that cite other studies I have once again just put down basic citations to save time if we choose to use any of this information I can go back and verify the information as well as provide a full citation Brian Social practices and social support networks (coping with social exclusion) and social networks (geographical aspect ) among MSM (Brian and Rumika)
Access to supportive and safe environments impacts rates of syphilis
Internet and social media provide sources of social support but also fosters anonymity and promotes casual sex.
Anal sex more abrasive Condomless sex
Social support affects gay men s ability to cope with stress of discrimination and impacts disclosure access and continued use of medical care.
Social practices such as anonymous sex alcohol and recreational drug use and non-verbal communication increases the practice of unsafe sex
How social exclusion 4access to healthcare (Brian and Rumika)
Discrimination stigma and lack of confidentiality are barriers
Knowledge and attitudes of healthcare providers
Ignorance about the specific health needs of gay men and MSMSexual Orientation as a possible social determinant:
Possibly consider the 1999 and 2006 American national plans for syphilis elimination
Website with lots of citations for studies on health care access among gay/bisexual/lesbian/MSM: http://www.ohtn.on.ca/Pages/Knowledge-Exchange/Rapid-Responses/Documents/RR79.pdfInfo from Infectious syphilis in high-income settings in the 21st century (Fenton et al 2008 Review)
GENERAL TRENDS (US-CENTRIC)
As the 21st century neared and affluent countries undertook preventative and treatment efforts directed at syphilis incidence rates declined but since the turn of the century there has been an observed resurgence of syphilis (credited to both homosexual/MSM and heterosexual relations). (Golden et al. 2003 Fenton 2004 Fenton and Imrie 2005)
The treatment of participants in a 1932-1972 study of African American males with syphilis in America (Tuskegee syphilis study) was widely criticized and gave rise to some of the ethical rules regarding human study (patients were misguided and not given sufficient treatment to see how disease progressed). (White 2000 Reverby 2001)
Figure 1 shows syphilis incidence US 1940s-2000s. The figure shows that after the WWII era syphilis incidence rates go down (attributed to the introduction of antibiotics penicillin specifically) markedly then fluctuating until the 1990s where the rates drop again (the 2000s part of the graph shows a recent uptick).
While comparing statistics between states is vulnerable to the diversity in each country s diagnostic standards in general the majority of syphilis cases in the world are found in the south-east asian or sub saharan african regions (heterosexual transmission mainly in these locales). (Gerbase et al. 1998)
Since the late 1990s syphilis rates have risen in some European countries (Fenton and Lowndes 2004).
In American men from 2000-2004 syphilis rates increased especially in the south. Also in 2004 African Americans were greatly overrepresented in the syphilis rates versus caucasians (9.0 vs 1.6 cases per 100 000). (CDC release 44) This is reminiscent of syphilis presence in America s south and urban cores during the 80s and 90s. (Golden et al. 2003)
In addition to risky sex behavior the syphilis rate increases in MSM (US recent years) were associated with also being infected with HIV. (CDC releases 45 46 Chen et al. 2002)
Social determinants leading to syphilis prevalence can vary among different populations
Increases in syphilis rates in the 90s and 80s especially affected minority low SES groups (US) (Louis et al. 1996 Aral 1996).
It has been suggested that locations related sexual interaction between men may be associated with the transmission of the disease (including internet sites which facilitate communication between potential partners) (Elwood and Greene 2005 Fenton and Imrie 2005 Klausner 2000)
Mathematical modelling suggests that if high risk groups are targeted for intervention syphilis can be managed but should continue following epidemic containment (outbreaks encouraged by high-risk concentration/lack of treatment) (Oxfam et al. 1996 Pourbohlol et al. 2003).
Info from Increasing Rates of Sexually Transmitted Diseases in Homosexual Men in Western Europe and the United States: Why (Fenton and Imrie 2005 REVIEW)
EXPLAINING STD TRENDS AMONG MSM In a reversal of the significant drops in bacterial STIs underwent in the 1980s and to some extent the 1990s (in affluent countries) since the late 1990s there have been increases in STIs in the MSM population (Macdonald et al. 2004 and Resurgent bacterial (10))
In the UK infectious syphilis rates grew by