Case Library

The Harvard Chan Case Library is a collection of teaching cases with a public health focus, written by Harvard Chan faculty, case writers, and students, or in collaboration with other institutions and initiatives.

Use the filters at right to search the case library by subject, geography, health condition, and representation of diversity and identity to find cases to fit your teaching needs. Or browse the case collections below for our newest cases, cases available for free download, or cases with a focus on diversity. 

Using our case library

Access to cases

Many of our cases are available for sale through Harvard Business Publishing in the Harvard T.H. Chan case collection. Others are free to download through this website.

Cases in this collection may be used free of charge by Harvard Chan course instructors in their teaching. Contact Allison Bodznick, Harvard Chan Case Library administrator, for access.

Access to teaching notes

Teaching notes are available as supporting material to many of the cases in the Harvard Chan Case Library. Teaching notes provide an overview of the case and suggested discussion questions, as well as a roadmap for using the case in the classroom.

Access to teaching notes is limited to course instructors only.

  • Teaching notes for cases available through Harvard Business Publishing may be downloaded after registering for an Educator account.
  • To request teaching notes for cases that are available for free through this website, look for the "Teaching note available for faculty/instructors" link accompanying the abstract for the case you are interested in; you'll be asked to complete a brief survey verifying your affiliation as an instructor.

Using the Harvard Business Publishing site

Faculty and instructors with university affiliations can register for Educator access on the Harvard Business Publishing website, where many of our cases are available. An Educator account provides access to teaching notes, full-text review copies of cases, articles, simulations, course planning tools, and discounted pricing for your students.

Looking for part “B” or “C” of a case? Click on “Related Case,” circled below:
related case

What's New

Atkinson, M.K., 2023. Organizational Resilience and Change at UMass Memorial, Harvard Business Publishing: Harvard T.H. Chan School of Public Health. Available from Harvard Business PublishingAbstract
The UMass Memorial Health Care (UMMHC or UMass) case is an examination of the impact of crisis or high uncertainty events on organizations. As a global pandemic unfolds, the case examines the ways in which UMMHC manages crisis and poses questions around organizational change and opportunity for growth after such major events. The case begins with a background of UMMHC, including problems the organization was up against before the pandemic, then transitions to the impact of crisis on UMMHC operations and its subsequent response, and concludes with challenges that the organization must grapple with in the months and years ahead. A crisis event can occur at any time for any organization. Organizational leaders must learn to manage stakeholders both inside and outside the organization throughout the duration of crisis and beyond. Additionally, organizational decision-makers must learn how to deal with existing weaknesses and problems the organization had before crisis took center stage, balancing those challenges with the need to respond to an emergency all the while not neglecting major existing problem points. This case is well-suited for courses on strategy determination and implementation, organizational behavior, and leadership.
Madden, S. & Ribeiro, K., 2023. “Lead, Follow or Get Out of the Way”: The Challenges Facing the New Chair of Ophthalmology, Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business PublishingAbstract

The case describes the challenges facing Shlomit Schaal, MD, PhD, the newly appointed Chair of UMass Memorial Health Care’s Department of Ophthalmology. Dr. Schaal had come to UMass in Worcester, Massachusetts, in the summer of 2016 from the University of Louisville (KY) where she had a thriving clinical practice and active research lab, and was Director of the Retina Service. Before applying for the Chair position at UMass she had some initial concerns about the position but became fascinated by the opportunities it offered to grow a service that had historically been among the smallest and weakest programs in the UMass system and had experienced a rapid turnover in Chairs over the past few years. She also was excited to become one of a very small number of female Chairs of ophthalmology programs in the country. 

Dr. Schaal began her new position with ambitious plans and her usual high level of energy, but immediately ran into resistance from the faculty and staff of the department.  The case explores the steps she took, including implementing a LEAN approach in the department, and the leadership approaches she used to overcome that resistance and build support for the changes needed to grow and improve ophthalmology services at the medical center. 

Kerrissey, M.J., Bolibol, A. & Rosenthal, M., 2022. C3: Pursuing Racial Justice in Healthcare Financing, Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business PublishingAbstract

This case describes efforts to promote racial equity in healthcare financing from the perspective of one public health organization, Community Care Cooperative (C3). C3 is a Medicaid Accountable Care Organization–i.e., an organization set up to manage payment from Medicaid, a public health insurance option for low-income people. The case describes C3’s approach to addressing racial equity from two vantage points: first, its programmatic efforts to channel financing into community health centers that serve large proportions of Black, Indigenous, People of Color (BIPOC), and second, its efforts to address racial equity within its own internal operations (e.g., through altering hiring and promotion processes). The case can be used to help students understand structural issues pertaining to race in healthcare delivery and financing, to introduce students to the basics of payment systems in healthcare, and/or to highlight how organizations can work internally to address racial equity.

Kerrissey, M.J. & Kuznetsova, M., 2022. Killing the Pager at ZSFG, Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business PublishingAbstract
This case is about organizational change and technology. It follows the efforts of one physician as they try to move their department past using the pager, a device that persisted in American medicine despite having long been outdated by superior communication technology. The case reveals the complex organizational factors that have made this persistence possible, such as differing interdepartmental priorities, the perceived benefits of simple technology, and the potential drawbacks of applying typical continuous improvement approaches to technology change. Ultimately the physician in the case is not able to rid their department of the pager, despite pursuing a thorough continuous improvement effort and piloting a viable alternative; the case ends with the physician having an opportunity to try again and asks students to assess whether doing so is wise. The case can be used in class to help students apply the general concepts of organizational change to the particular context of technology, discuss the forces of stasis and change in medicine, and to familiarize students with the uses and limits of continuous improvement methods. 
Yatsko, P. & Koh, H., 2021. Dr. Joan Reede and the Embedding of Diversity, Equity, and Inclusion at Harvard Medical School, Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business PublishingAbstract
For more than 30 years, Dr. Joan Reede worked to increase the diversity of voices and viewpoints heard at Harvard Medical School (HMS) and at its affiliate teaching hospitals and institutes. Reede, HMS’s inaugural dean for Diversity and Community Partnership, as well as a professor and physician, conceived and launched more than 20 programs to improve the recruitment, retention, and promotion of individuals from racial and ethnic groups historically underrepresented in medicine (UiMs). These efforts have substantially diversified physician faculty at HMS and built pipelines for UiM talent into academic medicine and biosciences. Reede helped embed the promotion of diversity, equity, and inclusion (DEI) not only into Harvard Medical School’s mission and community values, but also into the DEI agenda in academic medicine nationally. To do so, she found allies and formed enduring coalitions based on shared ownership. She bootstrapped and hustled for resources when few readily existed. And she persuaded skeptics by building programs using data-driven approaches. She also overcame discriminatory behaviors and other obstacles synonymous with being Black and female in American society. Strong core values and sense of purpose were keys to her resilience, as well as to her leadership in the ongoing effort to give historically marginalized groups greater voice in medicine and science.
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Cases Available for Free Download

Staus, R. & Hudspeth, J., 2019. Vicodin as a Treatment for Structural Violence, Harvard University: Social Medicine Consortium. Download free of chargeAbstract

Elizabeth, a middle-aged African American woman living in Minnesota, develops chest pain and eventually presents to a local emergency room, where she is diagnosed with stress-related pain and given Vicodin. Members of a non-profit wellness center where she is also seen reflect on the connection between her acute chest pain and underlying stress related to her socioeconomic status. On a larger level, how much of her health is created or controlled by the healthcare system? What non-medical policy decisions impacted Elizabeth such that she is being treated with Vicodin for stress?

Gordon, R. & Moon, S., 2014. Haiti in the Time of Cholera, Harvard University: Global Health Education and Learning Incubator. Access onlineAbstract
This case examines the United Nations' reactions to the cholera epidemic in Haiti and illuminates contemporary gaps in global governance. In January, 2010, an earthquake devastated Haiti, the poorest country in the Western Hemisphere. The public health community anticipated Haiti to be at risk for many health threats, but did not consider a cholera outbreak a likely possibility. However, in October of that year, the first case of cholera in more than 100 years was reported, sparking a cholera epidemic in Haiti. Scientific evidence later linked the original source of the cholera to poor sanitation management practices at a United Nations (UN) peacekeepers camp run by Nepal. However, the UN refused to acknowledge any responsibility for causing the cholera outbreak. Readers of this case consider the role of global governance and accountability, especially in an environment with a weak nation state. 
Alidina, S., Paulus, J. & Kane, N.M., 2009. Malaria and DDT in Uganda, Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Download free of chargeAbstract
In October 2008, Dr. Richard Mgaga, Head of the Malaria Control Programme in Uganda reviewed the monthly malaria statistics report for the district of Apac, which in April of 2008 had undergone a pilot indoor residual spraying (IRS) program using DDT in a campaign to prevent mosquitoes from biting and spreading malaria. The campaign was halted by a court injunction requested by organic farmers, exporters and environmentalists in May 2008, and the injunction was upheld by the High Court in June. In early August, the Uganda Health Ministry began spraying a pyrethroid insecticide in place of DDT. Meanwhile the Ugandan Attorney General was challenging the High Court’s decision.  Dr. Mugaga was under pressure by the Presidential Malaria Initiative (PMI) to undertake a full program of IRS in 300,000 households in the northern districts of Uganda, including Apac. However, he was unsure whether to proceed, given the opposition and apparent problems that surfaced when the Apac pilot was implemented.
Vohra, S., 2014. To Vaccinate or Not to Vaccinate: The Story of Hamilton, Columbia, Harvard T.H. Chan School of Public Health: Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED). Download free of chargeAbstract
How does one learn to become an effective advocate on public health issues?  “To Vaccinate or Not to Vaccinate: The Story of Hamilton, Columbia” introduces the reader to the fictional US state of Columbia and its legislature’s dilemma over whether to mandate the HPV vaccine for the state’s young people or simply to educate them and their parents on the importance and availability of the vaccine. On the surface this appears to be a straightforward public health question: Will a vaccine mandate or a voluntary educational effort be more effective in preventing HPV infection and ultimately HPV-related cancers? But as the narrative unfolds, we come to understand that the legislative context is much more complicated and the tensions myriad, complete with financial and political deal making, power contests in anticipation of an upcoming election, and much more. Furthermore, given that the scientific evidence is still incomplete in some aspects and does not necessarily point to a single best option for the state, the ethical concerns at stake become all the more important. What should Columbia do? As the story draws to a close, the state legislature’s Health, Education, and Labor Committee is about to open a public hearing on the dilemma, inviting an array of experts, community leaders, pharmaceutical reps, and government staffers and elected officials to speak on two bills under consideration: one for a mandate and the other for education only. This is where the students will step in to bring the hearing to life, arguing for the course of action they think is most prudent and learning techniques in effective legislative advocacy on important public health issues in the process. 
Weinberger, E., 2015. Weighing the Evidence: One University Takes a Hard Look at Disordered Eating Among Athletes, Harvard T.H. Chan School of Public Health: Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED). Download free of chargeAbstract
Colburn University is the largest private university in the fictitious state of Columbia and is often recognized by people from distant parts of the country for its award-winning Division I athletic teams. That’s why when athletic director Harry Ritchie makes an offhanded comment about Colburn student-athletes with eating disorders, the press pounces. This incident coupled with a complaint from a parent draws the attention of Dean Francis Reilly, who finds himself needing to peel back some of the layers embedding college athletics on the issue of eating disorders among athletes. Throughout the narrative, different perspectives on sports and eating disorders are revealed from top-level administrators, like Dean Reilly, to the student-athletes themselves. As the story concludes, the conversation about eating disorders has begun, but questions still remain on how to make Colburn University a healthy environment for its student-athletes.
Intermediate and advanced level teaching notes available for faculty/instructors.
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Focus on Diversity, Equity, and Inclusion

Chai, J., Gordon, R. & Johnson, P., 2013. Malala Yousafzai: A Young Female Activist, Harvard University: Global Health Education and Learning Incubator. Access onlineAbstract
This case traces the story of Malala Yousafzai who has advocated passionately for girls’ right to education. In October 2012, a militant group with ties to the Taliban shot 14-year-old Yousafzai in the head as she was riding the school bus home after a day of classes. Yousafzai recovered and became the youngest recipient of the Nobel Peace Prize in 2014. This case explores the social factors that made such an attack possible and why there continue to be such barriers to educational opportunities for girls. "Malala Yousafzai: A Young Female Activist" is a part of a case series on violence against women that illustrate the critical role for leadership through an examination of how factors within a society influence women’s health. Students analyze the situations described by considering the circumstances that placed each protagonist in vulnerable positions. Participants examined the commonalities and differences of these situations in an effort to understand the circumstances that affect women’s well-being. Additionally, using the cases as a framework, students analyzed the connections between collective outrage, reactive action, and leadership. 
Al Kasir, A., Coles, E. & Siegrist, R., 2019. Anchoring Health beyond Clinical Care: UMass Memorial Health Care’s Anchor Mission Project, Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business PublishingAbstract
As the Chief Administrative Officer of UMass Memorial Health Care (UMMHC) and president of UMass Memorial (UMM) Community Hospitals, Douglas Brown had just received unanimous and enthusiastic approval to pursue his "Anchor Mission" project at UMMHC in Worcester, Massachusetts. He was extremely excited by the board's support, but also quite apprehensive about how to make the Anchor Mission a reality. Doug had spearheaded the Anchor Mission from its earliest exploratory efforts. The goal of the health system's Anchor Mission-an idea developed by the Democracy Collaborative, an economic think tank-was to address the social determinants of health in its community beyond the traditional approach of providing excellent clinical care. He had argued that UMMHC had an obligation as the largest employer and economic force in Central Massachusetts to consider the broader development of the community and to address non-clinical factors, like homelessness and social inequality that made people unhealthy. To achieve this goal, UMMHC's Anchor Mission would undertake three types of interventions: local hiring, local sourcing/purchasing, and place-based community investment projects. While the board's enthusiasm was palpable and inspiring, Doug knew that sustaining it would require concrete accomplishments and a positive return on any investments the health system made in the project. The approval was just the first step. Innovation and new ways of thinking would be necessary. The bureaucracy behind a multi-billion-dollar healthcare organization would need to change. Even the doctors and nurses would need to change! He knew that the project had enormous potential but would become even more daunting from here.
Yatsko, P., 2021. Boston Health Care for the Homeless (A): Preparing for the COVID-19 Pandemic, January-March 2020, Harvard Business Publishing: Harvard T.H. Chan School of Public Health. Available from Harvard Business PublishingAbstract

On February 1, 2020, Jessie Gaeta, the chief medical officer for Boston Health Care for the Homeless Program (BHCHP), received news that a student in Boston had tested positive for the novel coronavirus virus that causes COVID-19 disease. Since mid-January, Gaeta had been following reports of the mysterious virus that had been sickening people in China. Gaeta was concerned. Having worked for BHCHP for 18 years, she understood how vulnerable people experiencing homelessness were to infectious diseases. She knew that the nonprofit program, as the primary medical provider for Boston’s homeless population, would have to lead the city’s response for that marginalized community. She also knew that BHCHP, as the homeless community’s key medical advocate, not only needed to alert local government, shelters, hospitals, and other partners in the city’s homeless support network, but do so in a way that spurred action in time to prevent illness and death. 

The case study details how BHCHP’s nine-person incident command team quickly reorganized the program and built a detailed response, including drastically reducing traditional primary care services, ramping up telehealth, and redeploying and managing staff. It describes how the team worked with partners and quickly designed, staffed, and made operational three small alternative sites for homeless patients, despite numerous challenges. The case then ends with an unwelcome discovery: BHCHP’s first universal testing event at a large city shelter revealed that one-third of nearly 400 people there had contracted COVID-19, that most of the infected individuals did not report symptoms, and that other large city shelters were likely experiencing similar outbreaks. To understand how BHCHP and its partners subsequently popped up within a few days a 500-bed field hospital, which BHCHP managed and staffed for the next two months, see Boston Health Care for the Homeless (B): Disaster Medicine and the COVID-19 Pandemic.
 

Guerra, I., et al., 2019. SALUDos: Healthcare for Migrant Seasonal Farm Workers, Harvard University: Social Medicine Consortium. Download free of chargeAbstract
The SALUDos program began in 2008 as a response to an influx of migrant seasonal farm workers (MSFWs) at a mobile medical unit serving homeless persons in Santa Clara County in Northern California. The program offered patients free and low-cost primary care services, linkage to resources, and advocacy.  As the farm workers involved in this program became more involved in their primary care, they advocated for evening hours, transportation, linkage to coverage programs, and health education resources to better understand their medical and psychological conditions. During continual modifications of the SALUDos program, the team sought to understand and address large-scale social forces affecting migrant health through interventions to mitigate health inequities.
Staus, R. & Hudspeth, J., 2019. Vicodin as a Treatment for Structural Violence, Harvard University: Social Medicine Consortium. Download free of chargeAbstract

Elizabeth, a middle-aged African American woman living in Minnesota, develops chest pain and eventually presents to a local emergency room, where she is diagnosed with stress-related pain and given Vicodin. Members of a non-profit wellness center where she is also seen reflect on the connection between her acute chest pain and underlying stress related to her socioeconomic status. On a larger level, how much of her health is created or controlled by the healthcare system? What non-medical policy decisions impacted Elizabeth such that she is being treated with Vicodin for stress?

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