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Instructor Class Description

Time Schedule:

Bettina Shell-Duncan
BIO A 469
Seattle Campus

Special Topics in Biocultural Anthropology

Delineation and analysis of a specific problem or a more general area in biocultural anthropology. Offered occasionally by visiting or resident faculty.

Class description

BioA 469

Health Disparities in King County Washington: The Somali Immigrant and Refugee Experience

Overview: This course draws its inspiration from the Global to Local Initiative, a collaboration between four organizations with the shared goal of improving health in our local communities. Washington State and Seattle are at the forefront of global health activities around the world. Increasingly the challenges facing global health have come to be understood as linked biological and social problems requiring creative and innovative solutions that extend beyond the clinical setting. Recognizing that “health? is not determined solely by health care services, it becomes apparent that a multidisciplinary approach is urgently needed to understand the broader biological, sociopolitical and cultural context of disease, and to design and implement innovative programs to address these problems. While Seattle is rich with world-class health care and institutions dedicated to improving global health, King County has some of the worst health disparities in the United States. The cities of Seatac and Tukwila, located just 15 miles from Seattle’s biotech hub, has a disproportionate number of residents living at or below the poverty line, as well as a disproportionate level of chronic disease, lack of access to care, and lack of access to many services. The King County Department of Public Health profile shows that residents of Seatac and Tukwila differ from the whole of King County in a number of respects: they have lower life expectancy, higher rates of diabetes, hypertension, smoking, obesity, not exercising, and delayed or no prenatal healthcare. This is also the most diverse zipcode in the country. A recent survey of the Tukwila school district found more than 70 languages are spoken by their students. In the past 10 years this already diverse community has expanded as a number of immigrant communities have moved in. These are vibrant communities with a lot of energy, and community based organizations have been formed by residents committed to directing local development aimed at improving health in its broadest sense – physical health, mental health and economic health. In doing so, the goal is to overcome some of the most pressing social determinants of health: poverty, language and cultural barriers, poor transportation, limited adequate housing, reduced education opportunities, difficulty navigating complex health and human service systems, and discrimination.

In this class we will examine the social and biological determinants of health, focusing specifically on the Somali community residing in King County (largely Seatac and Tukwila). Somalis are only one of several peoples from the Horn of Africa who have immigrated or been resettled in the Pacific Northwest. Although Pacific Northwest Somalis are relatively homogenous in terms of ethnicity and language (with the exception of Somali Bantus), they vary in a number of ways: clans, educational attainment before and after migration, occupation, length of residence in the U.S. or other regions of the diaspora. Some have voluntarily migrated, pursuing educational or employment opportunities. Many, however, have arrived in this area through the process of refugee resettlement, which grew in scale following the 1991 overthrow of Major General Mohamed Siad Barre and the ensuing civil war that led to the death of an estimated 300,000 people by 1993. Between 1991 and 1992 approximately half of Somalia’s population was displaced. Today it is estimated that there are over 1 million Somali refugees scattered across the world, many in refugee camps in northern Kenya. The majority of Somalis in King County arrived as refugees resettled from these camps. Exact numbers of the number of Somali residents in King County are not available, but cited figures estimate range from 15,000 to 30,000, making this the third largest Somali community in the United States. Immigrants and refugees face a myriad of challenges upon arriving in the U.S. These include language barriers, illiteracy, cultural differences, assimilation stress, post-traumatic stress and depression, lack of previous education, discrimination, and difficulties finding living-wage employment. How do these factors, along with varied personal histories, influence health and contribute to the growing health disparities in King County? What solutions are being found to improve their health outcomes?

Somali Proverb: Aqoon la’aani waa iftiin la’aan (The absence of knowledge is the absence of light)

Student learning goals

By the end of the class, students will have an improved understanding of: • Somali culture and history; • The social challenges of refugee resettlement; • How to critically evaluate health evidence in the primary literature; • The social and biological determinants of negative health outcomes in the King County Somali community; • Theories of health promotion and behavior change; • The application of theory to specific health promotion activities in the Somali community; • How you and your skills can contribute to efforts to address health disparities, as well as combat misunderstandings and stereotypes of Somalis in the U.S.

General method of instruction

This course will meet twice weekly in the classroom. It also has a required service-learning component that entails 3-5 hours of service work per week with a local Somali community organization, connecting students to mentoring and tutoring opportunities.

A cooperative agreement has already been arranged with the Somali Community Services Coalition, who seek volunteers to work in their after school tutoring program for elementary and high school student. Other possible organizations include: • East African Community Services • Horn of Africa Services • ReWA (Refugee Women’s alliance) (requires 6 month commitment) Students will need to be able to arrange transport to one of the volunteer organizations. Service learning is a mandatory component of the course.

Recommended preparation

Class assignments and grading


The information above is intended to be helpful in choosing courses. Because the instructor may further develop his/her plans for this course, its characteristics are subject to change without notice. In most cases, the official course syllabus will be distributed on the first day of class.
Last Update by Bettina Shell-Duncan
Date: 05/17/2013