Unit 1: Disease Has a Changing Ecology  
                Instructor's Guide to Activities
 

Goal
The activities in Unit 1 are designed to help students explore what health and disease mean. Students examine their own perceptions and stereotypes about health and disease and become familiar with the collection and mapping of disease data.

Learning Outcomes
After completing the exercises associated with this Unit, students should:

Choice of Activities
It is neither necessary nor feasible in most cases to complete all activities in each unit.  Select those that are most appropriate for your classroom setting and that cover a range of activity types, skills, genres of reading materials, writing assignments, and other activity outcomes.  This unit contains the following activities:
 
Activity 1.1:  How's Your Health? --In-class writing assignment and group discussion
Activity 1.2:  It Could Happen to You -- Bringing Health Home --Narrative analysis, team work, and group discussion
Activity 1.3:  Disease Diffusion and Mapping --Analysis, mapping, and interpretation of disease incidence rates
 

Suggested Readings
The following readings accompany the activities for this unit.  Choose those readings most appropriate for the activities you select and those most adequate for the skill level of your students.

 
 
Activity 1.1:  How's Your Health?
 
Goals
Students learn to think of health as more than being free from disease, but as a state of well-being both physically and mentally. This activity helps students understand the many possible forms in which health problems are manifest and that well-being is influenced by multiple global environmental changes.

Skills

Material Requirements Time Requirements
25-30 minutes

Tasks
This short in-class writing assignment can be used as a starter activity. Students write individually for five minutes followed by a brief class discussion of their ideas. The activity is intended to help students realize that health means different things to different people and that factors other than infectious diseases can cause a loss of well-being. Lifestyle choices, technology, and where we live all affect what health afflictions we are exposed to and in turn, expose others to. Students also begin to understand that actions of others elsewhere can have an impact on their well-being. Once students see that there are many different conceptions of health and disease, they will be more receptive to understanding the human health effects of global environmental change.

The questions below are also provided on the student worksheet.

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Activity 1.2:  It Could Happen to You -- Bringing Health Home
 

Goals
Students recognize some widespread misconceptions about the nature and distribution of disease/illness and the availability of health care resources. Students examine how ethnocentrism and socio-economic status affect the perception of heath risk in and by individuals.

Skills

Material Requirements Time Requirements
One class period (50 minutes)

Tasks
To begin, present the short narratives in Supporting Material 1.2. These illustrate that conditions and afflictions commonly associated with less developed nations or less affluent socio-economic groups are problems in the US and other developed countries. You can either read these narratives aloud or photocopy them and provide them to students. After the narrative presentations, students work together in groups of two or three people to respond to the questions for each narrative on the student worksheet. (If you read the narratives to the students, allow students time to answer the questions for each narrative immediately after you’ve finished reading it.) After students have finished, reconvene the class for a brief follow-up discussion of their responses.

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Activity 1.3:  Disease Diffusion and Mapping
 

Goals
Students use disease incidence rates to map the distribution of diseases at various geographic scales.

Skills

Material Requirements Time Requirements
Part A: One class period (50 minutes); Part A also works well as a homework assignment.
Part B: 7 to 10 days outside of class.

Tasks
Depending on your time constraints, class size, and students’ familiarity with the subject, you can ask students to complete only Part A or Part B of this activity. Divide the class into small groups for either part. If you decide to do both parts, students can use Part A as a guide for the analysis in Part B.

Part A: Tinytown

Students use the student worksheet to follow the process outlined below:

  1. Students use the incidence rates for Yukilosis in Tinytown to produce a frequency distribution, ranking the incidence rates from high to low.
  2. Students then break the data into groups. It is recommend that they break it into three or four categories according to natural breaks in the data or quantiles (if Tinytown had more than thirty districts, you could use standard deviations from the mean).
  3. Students are asked to justify in a few sentences the method of breaking down the data.
  4.  Using the map provided on the worksheet, students shade the districts using a dark color or dense pattern of lines for the highest category and a slightly less intense color or pattern for each of the next lowest categories.
When steps 1 through 4 are complete, students answer several questions on the worksheet about their findings and the distribution of Yukilosis on their maps.

 
Part B: Your County, State, Country, Continent, or World

In Part B, students collect and analyze disease data on a larger scale than Part A. You can either choose a disease for students to investigate or allow them to decide. If you want students to map disease incidence at the world, regional, and state scales, you may need to choose the disease for them in order to insure that data are available for each scale of analysis. If you allow students to choose the disease, you can give them the option of mapping the incidence rates at one or two different scales of their choice, based on the disease and the data they are able to find.

Among the diseases you can choose for this activity are cancers (for which data is usually accurate and well-reported as a cause of death), heart disease, stroke, TB, or even diabetes (a good example of a disease that crosses age categories). In addition, a disease that most students are aware of is HIV/AIDS. Using this part of the activity to research, map, and analyze domestic and global diffusion of AIDS is an excellent way for students to dispel the notion that AIDS is a "gay only" disease and to prepare students for Unit 3, which uses HIV/AIDS as an example of the policy implications of human health and global change. HIV/AIDS data, however, may not be available at all scales of analysis (i.e., some states do not report county-level HIV/AIDS data and in some cases, doctors do not report it as a cause of death).

Encourage students to use a variety of sources to find disease incidence data. If students have access to the Internet/WWW, they can check out the sites for your state health department, as well as the World Health Organization and other sites specific to the disease they select. (See Appendix C for a partial listing of Internet sites of interest.) State-level incidence rates for TB are provided in Supporting Material 1.3. You can use these data to do a shorter version of this activity in which students only look at one geographic scale. Or, you can use the data to get students started, and ask them to find data at other scales. Use the data sources suggested in Appendix B or recommend them to students to aid their search.
 
The following process is not outlined in the student worksheet. It is provided simply as a guide for introducing Part B of this activity.

  1. Based on the scale(s) of analysis you wish to consider in this activity, provide students with a map of your state with county boundaries, a map of the United States (provided in Supporting Material 1.3), a map of North America, and/or a world map with country boundaries delineated (provided in Supporting Material 1.3).
  2. Choose (or allow students to choose) a disease that has relevance to students’ lives and that can be linked to either environmental factors or to changes in mobility. Also, choose one for which data are available at the scale(s) of analysis you want students to consider. As previously noted, AIDS, cancers, heart disease, diabetes, or TB are good examples. Depending on the size of your class, you can ask each group to consider a different disease or you can ask different groups to focus on different scales for the same disease. In either case, when you bring the class together to present their findings they will get a global picture of disease(s).
  3. Locate, or have students locate, standardized incidence rates for this disease. You may have to contact your state health department, the World Health Organization and other local, regional, or international resources on the Internet/WWW or through library resources.
  4. Students use the data to construct a frequency distribution from high to low rates for their area or region.
  5. Students then break the data into quantiles, standard deviations from the mean, or natural breaks and justify their design choice in a paragraph or two.
  6. Ask students to map the data on the appropriate map.
Once these steps are completed, ask students to answer the following questions:  BACK