| Unit 3: Equity
and Policy Issues of Human
Health and Global Change Instructor's Guide to Activities |
Goal
The activities in Unit 3 are designed to help students understand the
links between human health and the social, cultural, and political factors
in society. Students explore this point in three activities that consider
(1) the treatment of people with TB, (2) equity and fairness in the siting
of locally unwanted land uses, like pollution sources or landfills, and
(3) the provision of services for people living with HIV/AIDS.
Learning Outcomes
After completing the activities associated with this unit, students
should be able to:
| Activity 3.1 TB in a Fishbowl | - Text comprehension and classroom "fishbowl" debate |
| Activity 3.2 Streets of Hope, Streets of Despair | - Basic equity analysis including mapping noxious facilities and analyzing census data |
| Activity 3.3 The Geography of HIV/AIDS and Service Provision | - HIV/AIDS data collection, local research, Service Provision interviewing, and writing assignment |
Suggested Readings
| Activity 3.1 TB in a Fishbowl |
Goal
Students learn about issues involved in the resurgence of tuberculosis
and the treatment of patients with tuberculosis. Students are sensitized
to issues of privacy and constitutional rights in the realm of public health.
The activity also helps students relate the resurgence of tuberculosis
to global change.
Skills
Tasks
Students should read the suggested articles as a homework assignment
and be prepared to argue for and against both confinement of patients and
directly observed therapy for TB patients.
In the next class session, use the topics covered in the readings to begin a "fishbowl debate." In this activity, two students begin the debate in the center of a circle, one arguing for confinement of patients and the other arguing for directly observed therapy. Every few minutes, rotate two new students into their positions, continuing until all students have taken part. If you have a larger class, you could rotate in pairs.
After all students have rotated into the debate, bring the class together as a whole and ask the students to summarize the major arguments that were presented during the debate, writing them on the board or an overhead transparency. Finish with a discussion centered around the larger objectives of the activity noted above.
| Activity 3.2 Streets of Hope, Streets of Despair |
Goal
Students investigate the spatial and social inequities in siting hazardous
or noxious facilities and the ways in which these inequities may affect
human health. Students also become aware that different social groups have
differentially powerful voices in speaking for their own health concerns.
Skills
Tasks
Ask students to read the suggested readings and any other readings
on environmental racism and inequities you feel necessary. Find a local
street map and census tract map and display them in an accessible location
in the classroom. Present students with a list of local facilities mentioned
above. Depending on the scale you choose for analysis, there may or may
not be multiple facilities within a certain category (i.e., there may be
several electric power plants, many landfills, or only one power plant,
one landfill). If there are multiple facilities, ask each student to select
one category or type of facility to concentrate on, and have them locate
each the facilities on the street map and determine the corresponding census
tract numbers. If there is only one of each type of facility, ask students
to focus exclusively on that facility. (More than one student can focus
on the same facility while working independently. In a large class, students
can work in pairs or small groups.)
Once all of the facilities have been mapped, each student should write down the number(s) of the census tract(s) that contain the facility(ies) they mapped. They should also select one or two census tracts that do not have that facility. As a homework assignment, students will find the following census data for the areas they investigate (the census tract(s) with the facility(ies) and the ones without):
In addition to the census data, students should also investigate the types of human health impacts that may be associated with their facility or category of facilities. For example, a local landfill may release toxics into the water supply, it may increase traffic in the local neighborhood, and it may be loud and have an unpleasant odor. Each of these characteristics will have a unique impact on human health. Students will need to conduct their own library research to determine these specific health effects.
In the designated class period, students present their general findings to the class. After the groups have finished, initiate a class discussion by asking students to make some generalizations about what they’ve learned. Discuss with them some of the reasons why it might be easier to site noxious facilities in low-income and/or minority neighborhoods. How might these communities prevent inequities?
| Activity 3.3 The Geography of HIV/AIDS and Service Provision |
Goal
Students learn about the incidence of HIV and AIDS in their community
and examine the provision of health care and social services for people
with AIDS. Students also become aware of the ways in which various societal
factors influence the ways that we meet the specific needs of people with
HIV/AIDS.
Skills
Tasks
A large factor in determining an individual’s health status is access
to health care. This activity asks students to examine the provision of
HIV/AIDS services in their community, with some attention to the number
of deaths from AIDS in their community, city, or state.
For this activity students should be divided into groups of about five students. Since they will be contacting local agencies, clinics, testing facilities, and treatment programs, a group approach will prevent students from overwhelming these facilities with information requests.
The groups’ first task is to gather local HIV/AIDS statistics focusing on age and sex and geographic distribution of mortality from AIDS. HIV incidence data (meaning those who have the virus, but don’t necessarily have AIDS) may be difficult to find, so students may choose to focus on death statistics. Some states provide this data at the county level, while others may not. If necessary, students can collect state-level data and using local population numbers, derive an estimate. Students can also find data on the Web (see Appendix C for some suggested sites).
Next, students should identify and locate the services that are locally available to people with HIV/AIDS. These include testing centers, treatment and counseling facilities, shelters, support groups, research facilities, and clinics. Recommend that they start with the phone book and branch out from there, asking the first contact to refer them to others. Once students have contacts at different facilities, they should schedule in-person interviews to gain more detailed information about the specific services. What populations does this service target and serve? What does it offer to these people? What special needs do these populations have, i.e. day care needs? Do local physicians treat people with AIDS or do they refer them to state hospitals?
Finally, groups should prepare a three- to five-page report outlining the services currently available and the location of services vis à vis clients. The report should also include recommendations for improving access to and quality of services for the population as a whole and for the specific subpopulations they learned about in their interviews. For example, what special needs might women have in terms of access? In what ways do different ethnic populations need differing intervention and treatment approaches? Set aside one class period for groups to present and discuss their findings.