EC316: The Political Economy of Public Health
Colby College | Spring 2026
- Email: rcaraher@colby.edu
- Office: 365 Diamond Building
- Office Hours:
- Tue: 2:30pm - 4:00pm
- Thu: 9:30am - 10:30am; 2:30pm - 4:00pm
- Fri: 10:00am - 12:00pm
- Or by appointment
- Class Meeting Days: Tue/Thu
- Class Times: 1:00pm - 2:15pm
- Classroom: 342 Diamond Building
“Medicine is a social science, and politics is nothing more than medicine on a grand scale.”
-Rudolf Virchow
Course Description
This course examines the intersections between economics, social institutions, and population health outcomes. Students will explore how social, economic, and political structures influence—and are influenced by—patterns of health and illness. The course adopts a multidisciplinary approach, incorporating statistical methods, econometrics, formal economic modeling, historical analysis, qualitative research, and political economy frameworks.
The course is organized into three main modules.
The first module, Public Health in Historical Context, explores the foundational links between political-economic change and population health. We will examine major historical transitions, from the Black Death to the Industrial Revolution, and trace the origins of the modern healthcare system, including the rise of the medical profession and the impact of early large-scale public health investments.
The second module, Models of Health and Healthcare, shifts to economic theory. We will apply microeconomic models to understand the unique features of healthcare markets, including the demand for health, the role of risk and insurance, and problems of adverse selection. We will also compare the structure of the U.S. healthcare system with international models of provisioning care.
The final module, The Social and Political Determinants of Health, applies these historical and theoretical frameworks to critical contemporary issues. We will investigate deep-rooted health disparities along racial, class, and gender lines; and analyze the influence of corporate power on public health. We conclude by examining the health consequences of major economic crises, such as de-industrialization, austerity, and the rise in ``deaths of despair.”
Learning Objectives
- Learn from a diverse range of social science methods
- Students will be exposed to several of the wide varieties of methods that economists and other social scientists have used to study determinants of population health
- Understand scope of political economy analysis
- Students will gain proficiency in historical and political economy analysis to explore how institutions shape, and are shaped by, health and illness over time.
- Identify and evaluate social determinants of health using quantitative and qualitative methods
- Students will build skills in quantitative and qualitative analysis to study health disparities and to evaluate policy responses addressing these disparities.
- Conduct policy analysis on health systems
- Students will strengthen policy analysis skills by conducting their own study of a public health issue of concern
Required Materials
You are not required to purchase books for this course. All readings will be posted on Moodle.
Statistical Software
A key component of this course is learning to work with public health data. We will use R, a free statistical programming language, for data analysis. No prior experience with R is required—we will cover the basics in class.
You will also need reliable access to a computer (such as your personal laptop) to use the following software:
- R, an open-source software for statistical analyses and graphics
- R Studio, an integrated development environment (IDE), which provides an interface for working with R
The first week of class we will go over how to install these software.
Prerequisites
There are two required courses for this class:
- EC 225: Research Methods and Statistics (or its equivalent)
- EC 133: Principles of Microeconomics OR EC 134: Principles of Macroeconomics
If you have not taken these courses please speak with me the first week of class to discuss whether you are prepared for this course.
Course Structure
This class will be a combination of lecture and discussion. We will also do several assignments in groups, so much of this work will be done with your classmates.
Periodically throughout the semester, we will have in-class lab sessions where you will practice working with public health data in R. These labs will introduce you to key datasets—-such as CDC WONDER—-and help you build the skills needed for the empirical component of your final project.
Assessments
Reading Notes
This class will be reading-intensive. It is required that you do all your readings the week that we cover the topic. We will primarily be reading book chapters and articles from academic journals, and some of the readings will be quite dense and challenging. Starting the second week of class, you required to take reading notes which highlight what you think is important in the text. These notes should be about two pages for each individual, required reading using the format you think is best, and can be taken either electronically or handwritten. I will grade them on a three point scale (0 = no effort, 1 = poor understanding, 2 = satisfactory, 3 = good understanding). You will be required to submit these notes to Moodle at the end of every week by Friday at 11:59pm. Reading notes must be submitted on time and extensions will never be granted. However, at the end of the semester, I will drop the two lowest reading note grades.
Assignments
There will be four assignments in this class, combining analytical essays and empirical problems. All assignments must be completed individually. Assignment 1 will cover units 1–3; assignment 2 will cover units 4–5; assignment 3 will cover units 6–8; and assignment 4 will cover units 9–11. More information on each assignment will be provided when assigned.
Topic Presentation
Each week includes optional readings in addition to the required texts. For this assessment, you will sign up for 1 week (or 2, depending on enrollment) to present one or more of the optional readings and lead a class discussion. Your presentation should:
- Summarize the key arguments of the reading(s)
- Explain the contribution of the text to the broader literature or debate
- Identify limitations, gaps, or areas where you are skeptical of the argument
- Pose discussion questions that connect the optional and required readings
Please email your discussion questions to me the day before you present.
Exam
There will one exam in this course, a midterm to take place after the 5th week of class. This midterm will be comprised of a set of long-answer questions meant to evaluate your understanding of the material so far. This midterm will take place during class. It will be open note, including laptops, but they cannot be connected to the internet during the exam.
Final Project
The final project for this class will require you to research a public health issue relevant in either i) your home town/home state/home country, or ii) Waterville/Maine. At the end of the semester, you will be required to submit a 15-20 page report on your findings. You will also be required to do a short (approximately 10-15 minute) presentation on your work in the last week of class.
Your final project must include an empirical component using public health data. This means you will need to identify a relevant dataset, produce descriptive statistics and visualizations, and incorporate this analysis into your argument. The goal is to ground your argument in evidence and to give you experience working with real public health data.
Throughout the semester, there will be check-ins to help you complete the final project. This will include:
- A proposal due the first month of class including an annotated bibliography
- A literature review due the second month of class
- A data summary due the third month of class
- A rough draft subject to peer review the third month of class
- A final draft due the last day of exams
In addition to completing your final project and presentation, you will also be a discussant on a fellow student’s project. As a discussant, you will spend 5 minutes after a presentation providing constructive feedback on your fellow student’s work. More information about the project will be shared throughout the semester.
Engaged Learning
Active and engaged learning participation in class are crucial for your success in this course, and thus count as a percentage of your overall grade. You can demonstrate engaged learning through a multitude of ways, including asking and answering questions in class, coming to office hours, coordinating group members, and helping your classmates with the course material.
Grading
The standard grading scale will be used. I reserve the right to curve the scale dependent on overall class scores at the end of the semester. Any curve will only ever make it easier to obtain a certain letter grade. The grade will count the assessments using the following proportions:
- 10% will be determined by your reading notes
- 28% of your grade will be determined by the 4 assignments (8% each)
- 7% will be determined by your topic presentation
- 15% will be determined by your midterm exam
- 35% will be determined by your final project
- 5% will be determined by your engaged learning
Course Policies
Attendance Policy
Unless otherwise noted, all classes will be in-person and attendance is required. If you have an extracurricular event which requires your missing a class, please notify me at least one week ahead of time. Additionally, do not come to class if you are feeling unwell. You are not required to produce a formal doctors note, but please let me know via email to check-in and help prevent you from falling behind. Any unexcused absences (i.e., absences not due to extracurricular events and illness) will count against your engaged learning grade.
Assignment Submission
Please submit all your assignments as either Microsoft Word files (.doc/.docx) or PDF files. All files must be submitted via Moodle (do not email them to me), generally at 11:59pm on the date they are due. You must confirm that your files can be opened and are not corrupt before you turn them in.
Late Assignments
All assignments must be completed on time. Only under the most dire circumstances will an extension be provided for an assignment. If there are extenuating circumstances that prevent you from completing a component of the final project on time, please reach out to me as soon as possible to discuss your options.
AI Policy
This course takes a cautious approach to artificial intelligence tools. The primary learning in this class comes from engaging directly with complex texts, struggling with difficult arguments, and developing your own analytical voice. AI cannot do this work for you. An AI summary will strip away the nuance and rhetorical choices that make these writings compelling. If you rely on summaries alone, you will struggle on the midterm and in class discussions, where I expect you to engage with specific details from the texts.
However, I do recognize that AI can often be a helpful tool. Therefore, I am allowing the use of AI in the following circumstances:
- You may use AI tools to help clarify concepts or terminology after you have read an article
- You may use AI to generate a summary of a reading as a study aid, but only as a complement to—-never a substitute for-—reading the original text yourself
- You may use AI to help brainstorm ideas for your final project topic
Under no circumstances should you try to pass off the use AI-generated text as your own, including on assignments or your final project.
If you are unsure if a use case of an AI tool is allowed, you should ask the instructor for clarification. Any use of AI outside of these parameters or without approval from the instructor will be considered a violation of Colby’s Academic Honesty policies. If you choose to use AI in compliance with the policy above, I strongly encourage you to use Google Gemini with your Colby College account. Colby has worked with Google to help keep your data secure when interacting with this tool. Review the resources at the Davis Institute for AI for more information.
Academic Integrity and Honesty
Honesty, integrity, and personal responsibility are cornerstones of a Colby education and provide the foundation for scholarly inquiry, intellectual discourse, and an open and welcoming campus community. These values are articulated in the Colby Affirmation and are central to this course. You are expected to demonstrate academic honesty in all aspects of this course. If you understand our course expectations, give credit to those whose work you rely on, and submit your best work, you are highly unlikely to commit an act of academic dishonesty. Academic dishonesty includes, but is not limited to: violating clearly stated rules for taking an exam or completing homework; plagiarism (including material from sources without a citation and quotation marks around any borrowed words); claiming another’s work or a modification of another’s work as one’s own; buying or attempting to buy papers or projects for a course; fabricating information or citations; knowingly assisting others in acts of academic dishonesty;
misrepresentations to faculty within the context of a course; and submitting the same work, including an essay that you wrote, in more than one course without the permission of the instructors. Academic dishonesty is a serious offense against the college. Sanctions for academic dishonesty are assigned by an academic review board and may include: failure on the assignment, failure in the course, or suspension or expulsion from the College. For more on recognizing and avoiding plagiarism, see: libguides.colby.edu/avoidingplagiarism. For resources and information on academic integrity, see: https://www.colby.edu/academics/academic-integrity/.
Accommodations for Disabilities
I am committed to creating a course that is inclusive in its design. If you encounter barriers, please let me know immediately so we can determine if there is a design adjustment that can be made. I am happy to consider creative solutions as long as they do not compromise the intent of the assessment or learning activity. If you are a student with a disability, or think you may have a disability, you are also welcome to initiate this conversation with the Dean of Students Office. The Dean of Students Office works with students with disabilities and faculty members to identify reasonable accommodations. Please visit their website for contact and other information: https://www.colby.edu/studentadvising/student-access-and-disability-services/. If you have already been approved for academic accommodations, please connect within the two weeks of the start of the semester so the office can develop an implementation plan.
Mental and Emotional Health
I am invested in the mental and emotional health of my students. Even as I establish and maintain the academic standards of my course, I value each of you as individuals with complex lives, identities, and challenges. Throughout the semester, the responsibilities of your Colby education may interact with situational as well as ongoing mental and emotional challenges in foreseeable and unforeseeable ways. If you are in need of reasonable flexibility due to an emotional situation or an ongoing mental health issue, please communicate as openly as possible with your Class Dean, and/or members of the office of Access and Disability Services, preferably in advance of the need, so that we can discuss how your circumstances interface with course requirements. Together, we will consider what is needed and what is possible. If we can discuss the situation, we can manage the situation together. Please do not allow academic responsibilities to prevent you from getting help you need. Our Colby Counseling Services staff (207-859-4490) and the staff in the Dean of Studies office (207-859-4560) are available to connect with you. The safety of my students and every member of this community is paramount. If you or someone you know is struggling with thoughts of suicide or may be a danger to themselves or others, please call the on-call counselor immediately (207-859-4490, press ’0’).
Respect for Diversity
It is my intent that students from diverse backgrounds and perspectives be well-served by this course, that students’ learning needs be addressed both in and out of class, and that the diversity that students bring to this class be viewed as a resource, strength and benefit. I expect you to feel challenged and sometimes outside of your comfort zone in this course, but it is my intent to present materials and activities that are inclusive and respectful of all persons, no matter their gender, sexual orientation, disability, age, socioeconomic status, ethnicity, race, culture, perspective, and other background characteristics. Class rosters are provided to each instructor with the student’s legal name. I will gladly honor your request to address you by an alternate name and/or gender pronoun. Please advise me of this early in the semester so that I may make appropriate changes to my records.
College-Sponsored Activities and Attendance
While Colby College is supportive of college-sponsored extracurricular activities such as athletic participation by its students, academics take priority over these activities. For example, both NCAA and Colby rules prohibit missing class for practices. In the case of overlapping commitments between class and college-sponsored extracurricular activities, the student must meet with the professor as soon as possible to discuss these overlaps. The student may request permission to miss class and make up the missed work; the instructor has final authority either to grant or to withhold permission.
Religious Holidays
I have attempted to avoid scheduling exams during major religious holidays. If, however, I have inadvertently scheduled an exam or major deadline that creates a conflict with your religious observances, please let me know within two weeks of the start of classes so that we can make other arrangements. Colby College is supportive of the religious practices of its students, faculty, and staff. The College is committed to ensuring that all students are able to observe their religious beliefs without academic penalty.
Sexual Misconduct/Title IX Statement
Colby College prohibits and will not tolerate sexual misconduct or gender-based discrimination of any kind. Colby is legally obligated to investigate sexual misconduct (including, but not limited to, sexual assault and sexual harassment) and other specific forms of behavior that violate federal and state laws (Title IX and Title VII, and the Maine Human Rights Act). Such behavior also requires the College to fulfill certain obligations under two other federal laws, the Violence Against Women Act (VAWA) and the Jeanne Clery Disclosure of Campus Security Policy and Campus Statistics Act (Clery Act). To learn more about what constitutes sexual misconduct or to report an incident, review the Student Handbook. I am committed to all Colby students feeling safe, accepted, and included in all aspects of their college experiences, including this course. Colby prohibits and will not tolerate sexual misconduct or gender based discrimination of any kind and is obligated, by federal and state laws, to respond to reports and provide resources to students. As your professor I am considered a “responsible employee” which requires me to report incidence of sexual assault, sexual harassment, dating violence, or stalking to the Title IX Coordinator.
If you wish to access confidential support services, you may contact:
- The Counseling Center: 207-859-4490
- The Title IX Confidential Advocate: 207-509-9122
- The Office of Religious and Spiritual Life: 207-859-4272
- Maine’s 24/7 Sexual Assault Helpline: 1-800-871-7741
Course Content
Below is a list of readings relevant to each unit. Not all readings listed will be required each week. I will indicate which readings are required on Moodle the week before we cover each unit, based on time constraints and class interest.
Module 1: Public Health in Historical Context
Unit 1: What is the Political Economy of Health?
Unit 2: The Evolution of Population Health Outcomes from Pre-History to the Early Modern Era
Unit 3: Public Health Crises and Rise of Capitalism: The Black Plague
Unit 4: Health, Living Standards, and Public Health Interventions in the Industrial Revolution
Unit 5: The Formalization of American Health Care
Module 2: Models of Health and Healthcare
Unit 6: The Demand and Supply for Healthcare
- Bhattacharya, Hyde, and Tu (2014) (chapters 2, 3, 5, and 6)
Unit 7: Risk Aversion, Adverse Selection, and Insurance
- Bhattacharya, Hyde, and Tu (2014) (chapters 7, 8, 9, 10, and 11)
Unit 8: Comparative Health Insurance Systems
Module 3: The Social Determinants of Health
Unit 9: Race, Class, and Gender
Unit 10: Corporations and Public Health
Unit 11: Economic Crises, Deindustrialization, and Health
Course Schedule
This schedule is tentative and subject to change.
| Week | Dates | Topic | Assignments Due |
|---|---|---|---|
| 1 | Feb 2-5 | Unit 1 | Reading Notes (RN) 1 |
| 2 | Feb 9-13 | Unit 2 | RN 2 |
| 3 | Feb 16-20 | Unit 3 | RN 3, Assignment 1 |
| 4 | Feb 23-27 | Unit 4 | RN 4 |
| 5 | Mar 2-6 | Unit 5 | RN 5, Topic Proposal |
| 6 | Mar 9-13 | Midterm Review & Exam | Midterm |
| 7 | Mar 16-20 | Unit 6 | RN 6, Assignment 2 |
| 8 | Mar 23-27 | Spring Break | - |
| 9 | Mar 30-Apr 3 | Unit 7 | RN 7, Literature Review |
| 10 | Apr 6-10 | Unit 8 | RN 8, Data Summary |
| 11 | Apr 13-17 | Unit 9 | RN 9, Assignment 3 |
| 12 | Apr 20-24 | Unit 10 | RN 10, Rough Draft |
| 13 | Apr 27-May 1 | Unit 11 | RN 11 |
| 14 | May 4-8 | Presentations | Assignment 4 |
| 15 | May 11-15 | Final Exam Week | Final Draft |