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Name:           Tutor group:
Week                    Key question                              Completed?
1    How do health, morbidity and mortality vary globally?


2      What part does health play in world affairs?
3      Case study of one infectious disease

       -      global distribution
       -      impact on health, economic development &
           lifestyle

4      Case study of one disease of affluence

       -    global distribution
       -    impact on health, economic development &
         lifestyle
5      How are food and health related?

       -    malnutrition
       -    periodic famine
       -    obesity

6      Case study: Health care approaches in countries at
       different stages of development
7&8    Health matters in a globalising world economy

       - TNCs & pharmaceutical research
       - Production & distribution
       - Tobacco TNCs
9      Case study: Regional variations in health and
       morbidity in the UK
       -    How do they vary?
       -    What impact do age structures, income and
         occupation types, education, environment and
         pollution have?
10     How do age, gender and wealth influence access to
       facilities for exercise, health care and good nutrition?

11     Case study: local study of the implications of these
       issues for the provision of health care systems
12     End of unit assessment

If you miss a lesson you are expected to catch up the work missed (including
homework), preferably before the next lesson.
How do health, morbidity and mortality vary globally?
   Objectives:
      - Know what is meant by morbidity, mortality and other related terms
      - Know how to interpret maps to explore global patterns of mortality

   Lesson 1:

   Starter -
                              The number of cases of a disease diagnosed in an
                              area, divided by the total population, over the
                              period of an epidemic.

                              The death of people. It is measured by a number
                              of indices including death rate, infant mortality,
                              case mortality and attack rate.

                                      The number of deaths per 1,000 people in 1
                                      year


                                                A state of complete physical,
                                                mental and social well-being and not
                                                merely the absence of diseases and
                                                infirmity. (WHO, 1946)

                                             The number of people dying from a
                                             disease divided by the number of
                                             those diagnosed as having the disease.

                                           The number of deaths of children under
                                           the age of 1 year expressed per 1,000
                                           live births per year. It is a useful
                                           barometer of social and environmental
                                           conditions and is sensitive to changes in
                                           either.

                              Illness and the reporting of disease. In the UK
                              2001 census respondents were asked how well they
                              felt and whether they had a limiting long-term
                              illness. Some diseases are so infectious that by
                              law they must be reported e.g. plague and cholera.
Task – Patterns of mortality vary globally. Consider the following questions
as a group:

   Where do you think life expectancy is highest? Lowest? Why?




   Where do you think infant mortality rates are highest? Lowest? Why?




   Where do you think there are most doctors working? Least? Why?




   Where do you think most people die of AIDS related illnesses? Why?




   Where do you think most people die of malaria? Why?




   Where do you think most people die of cancer? Why?




   Where do you think most people die of diabetes? Why?




Mrs Owen will give you a large outline world map. Annotate this map to show
the information you have noted above.

Plenary – Have we achieved our objectives? Plan task for next lesson.
Lesson 2 –

Review your annotated map from last lesson as a group.

Use www.worldmapper.org to find out how the predicted patterns compare to
reality. Take notes about your findings below and be prepared to feedback to
Mrs Owen on Monday.

Similarities?




Differences?




Surprises?




Homework – How useful did you find the maps on this website? Note
strengths and limitations below:
   What part does health play in world
                affairs?
Objectives:
 Understand why it is important to study disease at different scales
 Evaluate the importance of cholera in Zimbabwe in world affairs

Lesson 1:

Starter – Feedback from comparison of predicted and actual patterns of
mortality carried out last lesson & discuss homework.

Task – Look at the www.worldmapper.org map for cholera deaths. What
pattern does this show?



Look at the map of Cholera deaths in London produced by John Snow in
1854. What can be learnt from this map?
In recent months the number of deaths from cholera in Zimbabwe has
increased rapidly. What do you know about the situation in Zimbabwe?




Watch the clip from http://news.bbc.co.uk/1/hi/world/africa/7749425.stm

Look at map and links at http://news.bbc.co.uk/1/hi/world/africa/7771184.stm

What does this map tell us about the spread of the disease?




Plenary - So does cholera in Zimbabwe matter on a global scale? On
Thursday you will produce a concept map showing the importance of the
cholera outbreak in Zimbabwe to world affairs. A concept map shows key
factors and how they are linked (for more explanation and examples see
http://users.edte.utwente.nl/lanzing/cm_home.htm). Note how you will go
about this task in the space below:




Lesson 2 –

Working in pairs or threes, produce a concept map showing the importance of
the cholera outbreak in Zimbabwe to world affairs. This could be produced on
the computer or on A3 plain paper. www.bbc.co.uk/topics/zimbabwe is a
good starting point.

Homework – Question 1a from page 309 in textbook by _________________
 Case study of one infectious disease:
              HIV/AIDS
Objectives:
 To know where the incidence of HIV infection is highest and where
mortality due to AIDS related illness is highest
 To understand the impact HIV/AIDS has on people’s lives in different
parts of the world
 To evaluate the impact that HIV/AIDS has on health, economic
development and lifestyle

Lesson 1:

Starter - Why does the South African version of Sesame Street include
Kami, a Muppet who is HIV+?

Watch the clip of Kami talking to Bill Clinton. What is the key message that
they are trying to get across?




For more information, visit www.muppetcentral.com/news/2002/091702.shtml

Task – Use the Google Earth overlay of HIV/AIDS to find out more about the
distribution of this disease. Take notes below:




But how does this effect people on a personal level? Watch the DVD ‘Positive
Voices’ and note the impact of HIV/AIDS on the people shown on the spider
diagram below:




                                   Impact of
                                   HIV/AIDS
Plenary – Next lesson you will be researching and answering five questions
about HIV/AIDS and the impact of the disease on health, economic
development and lifestyle. It is up to
you to decide what your five questions
will be – Mrs Owen will show you some
question prompts to help you frame your
questions.

These prompts relate to Bloom’s
taxonomy, a classification of learning
shown here. You should aim to include
some questions from higher up the
taxonomy to challenge yourself!

Question 1 –




Question 2 –




Question 3 –




Question 4 –




Questions 5 –




Lesson 2:

Read pages 280-285 in your textbook as an introduction to this issue, then
carry out your own research to answer the five questions set last lesson.
Useful websites include:
http://news.bbc.co.uk/1/hi/in_depth/health/2005/aids_crisis/default.stm
 www.aidsinafrica.net/map.php
http://www.globalissues.org/health/aids/
http://www.globalissues.org/Geopolitics/Africa/AIDS.asp

Homework – Question 1c from page 309 in textbook by _______________
Case study of one disease of affluence
  – Coronary heart disease (CHD)
Objectives:
Know where deaths from coronary heart disease are most prevalent
Understand the impact of coronary heart disease on health, economic
development and lifestyle

Lesson 1:
Starter – Look at the interactive map at
www.bbc.co.uk/scotland/education/int/geog/health/health/index.shtml?chd
Describe the global distribution of death rates from CHD this shows:




Look at the other interactive maps available at this site. What evidence do
they provide that there is a health divide between MEDCs and LEDCs?




Read pages 286-289 in your textbook to find out more about this issue. Your
group will be visited by someone who has experience of CHD in their life.
They will talk to you about this and give you the opportunity to ask questions.
Note their key points below:




Plenary - Do you or any other members of your group have any experience of
the impact that CHD can have on families of sufferers? Have you learnt
anything today that will have an impact on your own lifestyle?
Lesson 2:

Research and produce an A3 poster showing the following aspects of
coronary heart disease:

   Risk factors
   Impact on lifestyle
   Economic costs
   Prevention

The poster could be hand drawn or produced on a computer. The
reprographics room has the facility to print A3 colour if you take your work in
on a memory stick – Mrs Owen will make sure you have permission to print.

Plan for poster –




Homework – Complete poster & answer question 1b from page 309 by _____
     How are food and health related?
Objectives:
 Know what is meant by malnutrition, periodic famine and obesity
 Understand how these conditions are related to health

Lesson 1:

Starter – Peer assess CHD posters using two stars and a wish. How are
obesity and CHD linked?



Watch a clip from ‘Tonight with Trevor McDonald’ showing an ex-student and
her battle with anorexia. What impact does anorexia have on health?



Task - Read pages 289-294 in your textbook to find out more about how food
and health are related. Define the key terms shown below:

Malnutrition –



Undernourishment –



Famine –



Obesity –



Overweight –



Plenary – Is malnutrition a major issue in both MEDCs & LEDCs?

Lesson 2:

Working individually or in pairs, research and produce a mini movie showing
how food and health are related for one of the following:
 Malnutrition in LEDCs
 Malnutrition in MEDCs
 Famine
 Obesity and overweight
Homework – Be ready to show your mini movie on __________________
       Case study – Health care approaches in
     countries at different stages of development
Objectives:
 Understand how and why different health care approaches are used in
countries at different levels of development
 Evaluate these health care approaches in terms of the quality of care
provided

Lesson 1:

Starter – Watch your mini-movies from last week. Self assess using two
stars and a wish:




Share this assessment with the group – do they think it is fair?


Task – Look at the article http://news.bbc.co.uk/1/hi/health/799444.stm - why does the
quality of health care vary?



Read pages 294-296 to find out more about contrasting healthcare
approaches. Rank the different health care systems shown on page 295 from
1 (the one you think is the best system) to 5 (the one you think is worst). Be
prepared to justify your decisions when you feed back to the group.

1.


2.


3.


4.


5.



Plenary – Feedback your ranking of healthcare systems. Does everyone in
your group agree? What influences people’s views of the different systems?
Lesson 2:

Watch the film ‘Sicko’ by Michael Moore (the film
is two hours long, so you will only be able to watch
part of it in the lesson, but you are welcome to
borrow it to watch the rest at another time). The
synopsis of this film from Wikipedia is shown
below:

‘According to Sicko, almost fifty million Americans
are uninsured and those who are covered are often
victims of insurance company fraud and red tape.
Interviews are conducted with people who thought
they had adequate coverage but were denied care,
as well as former employees of insurance companies
who describe cost-cutting initiatives that encourage
bonuses for insurance company physicians to deny medical treatments for policy
holders.

In Canada, Moore describes the case of Tommy Douglas, who was voted the
greatest Canadian in 2004 for his contributions to the Canadian health system.
Moore also interviews a microsurgeon and people waiting in the emergency room
of a Canadian public hospital.

Against the backdrop of the history of the American health care debate,
opponents of universal health care are set in the context of 1950s-style anti-
communist propaganda. A 1960s record distributed by the American Medical
Association and narrated by Ronald Reagan warns that universal health care
could lead to communism. In response, Moore shows that socialized public
services like police, fire service, postal service, public education and community
libraries have not led to communism in America.

The origins of the Health Maintenance Organization Act of 1973 are presented using a taped
conversation between John Ehrlichman and President Richard Nixon on February 17, 1971;
Ehrlichman is heard telling Nixon that "...the less care they give them, the more money they
make", a plan that Nixon remarked "appeals to me". This led to the expansion of the modern
HMO-based health care system. Connections are highlighted between Pharmaceutical
Research and Manufacturers of America (PhRMA), the lobbying arm of the largest drug
companies in the United States, lobbying groups in Washington D.C., and the United States
Congress. Hillary Clinton, a champion of the Clinton health care plan, is shown to be the
Senate's second-highest recipient of health care industry campaign donations.

In the United Kingdom, a country whose National Health Service is a
comprehensive publicly-funded health care system, Moore interviews patients and
inquires about in-hospital expenses incurred by patients, only to be told that
there are no out-of-pocket payments. Moore visits a UK pharmacy, where
pharmaceuticals are free of charge for persons under 16 or over 60, and
subsidised in most cases for everyone else; only a fixed amount of £7.10 per item
on a prescription is charged (e.g 5 items on a single perscription would cost
£35.50), irrespective of cost to the NHS. Further, NHS hospitals employ a cashier,
part of whose job is to reimburse low-income patients for their out-of-pocket
travel costs to the hospital. Interviews include an NHS general practitioner, an
American woman residing in London, and Tony Benn, a Labour politician and
former Member of Parliament. Benn compares a hypothetical attempt to
dismantle the NHS with reversing women's suffrage and says it would result in a
revolution.

In France, Moore visits a hospital and interviews the head of obstetrics and
gynaecology and a group of American expatriates. Moore rides with the "SOS
Médecins", a 24-hour French medical service that provides house calls by
physicians.[7] Moore discovers that the French government provides social
services, such as day care for $1 an hour and neonatal support that includes
cooking, cleaning, and laundry services for new mothers.

Returning to the United States, interviews disclose that 9/11 rescue workers who
volunteered after the September 11, 2001 attacks were denied government funds
to care for physical and psychological maladies they subsequently developed,
including respiratory disease and PTSD. Unable to receive and afford medical care
in the U.S., the 9/11 rescue workers, as well as all of Moore's friends in the film
needing medical attention, sail from Miami to Cuba on three speedboats in order
to obtain free medical care provided for the enemy combatants detained at the
U.S. Guantanamo Bay detainment camp. The group arrives at the entrance
channel to "Gitmo" and Moore uses a megaphone to request access, pleading for
the 9/11 victims to receive treatment that is on par with the medical attention the
"evildoers" are receiving. The attempt ceases when a siren is blown from the
base, and the group moves on to Havana, where they purchase inexpensive
medicine and receive free medical treatment.[8] Providing only their name and
birth date, the volunteers are hospitalized and receive medical attention. Before
they leave, the 9/11 rescue workers are honored by a local Havana fire station.

Finally, Moore addresses the audience, emphasizing that people should be "taking
care of each other, no matter the differences". To demonstrate his personal
commitment to this theme, Moore decides to help one of his biggest critics, Jim
Kenefick, webmaster of MooreWatch. According to a blog posting, Kenefick was
planning to shut down his anti-Moore website because he needed US $12,000 to
cover the costs of medical treatment for his sick wife. Not wanting the U.S. health
care system to trump Kenefick's ability to express his opinion, Moore sends
Kenefick the money anonymously.’

There has been criticism of this film from some people, for example the
Wikipedia entry goes on to say…

‘MTV's Kurt Loder criticized what he perceived as the film's cherry-picked facts,
manipulative interviews, and unsubstantiated assertions, such as the assertion
that 18,000 people will die each year because of no insurance. (A 2002 USA
Today story on an Institute of Medicine report corroborates this claim.)[30] While
admitting that the U.S. health care system needs reform, Loder criticized Moore’s
advocacy of government control, arguing that many services controlled by the
government are not considered efficient by the American public. Loder points to a
2005 documentary, Dead Meat, by Stuart Browning and Blaine Greenberg, which
documents long waiting lists for care in Canada. Its subjects include people who
became addicted to pain medication they were prescribed while waiting for
surgery, who went to other countries for treatment, or who died while on the
waiting lists. Loder points to calls for reform in Britain and France due to the
same rationing, which Loder says has hurt France's economy. Loder also criticized
Moore’s depiction of Cuba, and the human rights violations by its ruling regime.
Loder cites a case reported in the Los Angeles Times of a Cuban doctor having
been imprisoned in the late 1990’s for criticizing the government for its failure to
respond to a viral epidemic, and that when Fidel Castro became ill in 2006, he
had a specialist flown in from Spain,[31] although Spain itself has single-payer
universal health care,[32] which is what Moore supports.’

What do you think? Is the film a fair reflection of the US and UK healthcare
systems?

Homework – Research healthcare in Cuba, India, Brazil or Sierra Leone,
then answer question 2a from page 309 in the textbook by ____________
  Health matters in a globalising world
               economy
Objectives:
 Know what TNCs are and how they are involved in health matters
 Apply this understanding to the case study of Pfizer
 Explore the controversies involved in the global tobacco industry

Lesson 1:

Starter - What did you think of ‘Sicko’?   Is the film a fair reflection of the US
and UK healthcare systems?

Transnational corporations (TNCs) are playing an increasingly important
role in health matters in a globalising world. Define these key terms below,
using page 297 in the textbook to help:

Transnational corporations –



Globalisation –



Do you think the following statements about globalisation and TNCs are true
or false?

  Two thirds of international trade is accounted for by just 500 corporations.
  Of the world’s 100 largest economies, 50 are TNCs.
  Global wealth doubled from $14 trillion to $28 trillion in one decade.
According to the World Bank, this wealth has reduced global poverty.
  The 10 largest TNCs have a total income greater than that of 100 of the
world's poorest countries.
  Unilever’s corporate sales were $49.7 billion in 1994. In the same year,
the GDP of Egypt was $43.9 billion.
  About forty countries today are poorer than they were twenty years ago.

‘In a single day under globalization, poor countries lose nearly $2 billion
due to international trade, 30,000 children die from preventable
diseases, and $60 million drains from poor countries to rich ones
through debt payments.’

Adapted from:
http://www.franciscansisters.org/english/jpic/globalization_quiz.htm and
http://www.newint.org/issue296/facts.html

Task – Pfizer is the largest pharmaceutical company in the world, according
to 2006 sales figures ($45,083 million). Visit www.pfizer.co.uk to find out
more about this organisation.
Next lesson you will carry out a de Bono six-hat analysis of the role of Pfizer
in the production and distribution of drugs. Here are some ideas for questions
to consider:

  White hat – what information can you easily find about Pfizer? What
information is more difficult to find? Why is this? (You may find it helpful to
liaise with others in your group and look at how they have been getting on
with finding useful information).
  Blue hat – who is in charge of Pfizer? What are Pfizer’s values? Who
promotes these values? What is the big picture?
  Yellow hat – what positive things do Pfizer do? Who has benefited from
the work of Pfizer? Can you give specific examples?
  Black hat – what negative things do Pfizer do? Who has suffered
because of the work of Pfizer? Can you give specific examples?
  Red hat – What are the views of different groups of people about the role
of Pfizer in the pharmaceutical industry? How do these views change
between location, gender etc?
  Green hat – What are the consequences of Pfizer’s actions for the world?
What are the subsequent issues going to be?

Decide which ‘hat’ will be tackling. If there is time, start your research in this
lesson.

Note the sources of information that you use here:




Plenary – How useful is De Bono’s six hat approach for analysing an issue in
more detail?

Lesson 2:

Carry out your research into the operations of Pfizer, remembering to look at
the operations from the view of one ‘hat’.

Homework – Prepare feedback to share next lesson.
Lesson 3:

Starter –Share findings from research into Pfizer, taking notes in the table
below:

   Hat                     Key points                     Peer-assessment




Now take off your ‘hat’. What do you think about Pfizer’s operations?




Task - Pharmaceutical TNCs carefully patent their drugs to prevent others
producing cheap copies. This allows them to cover their huge research and
development costs, but some people think that the TNC’s focus on making
money means that the poorest people are denied the treatments they
deserve. Read the article below to find out more about this issue in relation to
HIV/AIDS:
HIV drugs 'still denied to many'
Just 28% of poor people with HIV have access to the antiretroviral drugs that
could save their lives, a study shows.

The report is published by the World Health Organization, UNAids and Unicef. It warned
many obstacles remain to meeting the United Nations' target of universal access to
HIV/Aids prevention and care programmes by 2010. However, the report said
"substantial, ongoing progress" had been made towards improving treatment and
diagnosis of people with HIV. Margaret Chan, WHO director general, said: "We need
ambitious national programmes, much greater global mobilisation and increased
accountability if we are going to succeed."

Big improvement

The report found that by the end of 2006, 2,015,000 people in low and middle-income
countries were receiving antiretroviral drugs to control their HIV infection - a 54% increase
in one year. However, it is estimated that 7.1 million people in those countries could
benefit from the drugs. It also falls short of the WHO aim of getting antiretrovirals to 3
million needy people by the end of 2005.

The report found that 1.3 million HIV patients in sub-Saharan Africa are now receiving the
drugs. This represents a coverage rate in the area of 28% - compared with just 2% in
2003. The lowest access rate - just 6% - was in the North Africa and Middle East region.
Only 11% of pregnant women with HIV are getting drugs that could prevent them passing
the virus to their baby. The report calls for prevention of mother-to-child transmission to
be made a top priority.

Drug costs

Front-line drug prices in the world's poorer countries fell by up to 20% last year, meaning
some drugs are now less than half the price they were in 2003. The drop in prices has
been put down to competition from manufacturers of generic drugs, and political pressure
from the international community. However, the report warns that second-line drugs - the
next option if first-line alternatives have limited effect - are still "unaffordably high" in
these countries.

Pharmaceutical companies have previously argued that antiretroviral drugs were too
complex for poor countries which often lack a sophisticated medical infrastructure. But the
report shows that patients in these countries are responding just as well to the drugs as
their peers in the developed world.

Dr Peter Piot, executive director of UNAids, said: "The significant progress outlined in this
report in scaling up access to treatment is a positive step forward for many countries in
achieving their ambitious goals of universal access to HIV prevention, treatment, care and
support.

"However new data in the report also shows that there is still a long way to go, particularly
in the widespread provision of treatment to prevent mother to child transmission of HIV,
which remains one of the simplest and cheapest proven prevention methods available."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/6564107.stm

Published: 2007/04/17 13:17:40 GMT


If companies can get permission to produce generic versions of drugs it can
make a big difference, as the following article shows:

African firm seals HIV drug deal
Africa's largest drug company has secured a deal to produce a generic version of
a leading HIV treatment for sufferers in developing countries.
South Africa's Aspen Pharmacare has reached agreement with US firm Bristol Myers-
Squibb to produce and distribute Atazanavir to about 70 countries. The deal will improve
anti-retroviral drug supplies in sub-Saharan Africa. Some 25.8 million Africans have been
diagnosed as HIV-positive, but only about 10% are receiving treatment.

Affordable treatments

Africa's fight against HIV/Aids has suffered from a lack of access to affordable treatments.
Aspen said the agreement would make the new drug more widely available in South Africa
and across the continent.

"Aspen has remained committed to expanding access to HIV medicines in sub-Saharan
Africa, where millions are suffering from the disease," said Stephen Saad, the firm's chief
executive. "It is indicative of Aspen's ability to align itself with one of the world's leading
companies in an attempt to solve what has largely become an African-based problem."

Atazanavir - which is taken orally - offered more effective treatment than existing HIV
therapies, Mr Saad added. Generic drug manufacturers such as Aspen produce exact
replicas of branded drugs whose patents have lapsed, making them cheaper to buy.

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/business/4719840.stm

Published: 2006/02/16 12:23:29 GMT


Read question 2c from page 310 in the textbook. What does your group think
about this question?

Plenary – Why do different people have different opinions about this issue?
What influences their viewpoint?

Homework – Complete question 2c from p 310 in the textbook by _________


Lesson 4:

Watch the documentary by Duncan Bannatyne, showing the involvement of
British American Tobacco in targeting African children with cigarettes. Some
notes about this documentary are included below:
Mauritius
           ½ a class of 11-14 year olds smoke
           Are aware of the British American Tobacco (BAT) brands Embassy and Pall Mall
           Children are not aware of the dangers of smoking
           1/3 of all children in Mauritius aged 13-15 are smokers. They are generally from the poorest sector of
            society.
           Children can buy single sticks, single cigarettes for 4 rupees (7p) each.
           The selling of single sticks makes smoking more accessible to children.
           Bat gives free pots to shopkeepers in order to keep single sticks therefore they are promoting the use of
            single sticks and therefore smoking by children.
           BAT controls 98.9% of the market in Mauritius. Advertising is banned but still goes on in disguised form.
           For example, leaflets are given to children and shops are painted by BAT in the colours of matinee
            cigarette packets. Brand recognition is vital.
           BAT offered to paint the cardiac hospital which treats smoking related diseases in the same colours and
            provide sponsorship.

Nigeria
           BAT controls 92% of the market
           Lagos state government is suing BAT for £9 billion which is the amount needed to treat people with smoke
            related illnesses.
           BAT run campaigns to target children. For example, they hold Benson and Hedges music festivals.
           BAT deny targeting children and say the music festivals are supposed to be for over 18s.
           The B&H music festival was attended by 120,000 people and also televised.
           It used to be socially unacceptable to smoke in Nigeria but there has been a 50% increase in the last 10
            years and is now seen as sophisticated.
        Advertising is banned but BAT give away free B&H umbrellas
        5 cigarettes costs the same as 1 cheap biscuit.

Malawi
        Less than 10% of people smoke in Malawi but Tobacco is the biggest commercial crop and accounts for
         60% of exports.
        A farmer can make 8x more from tobacco than from any other crop.
        The poor in Malawi don’t worry about not being able to afford food but do worry about not being able to
         afford cigarettes.
        Most children don’t smoke but know the brands well.
        The country is going through change. Single sticks are being advertise with the cost being 2p for a single
         stick.
        More than ½ the children at a project for street children smoke.
        Some of these children are selling cigarettes to make money.
        Many children can’t read so can’t read the warning labels on the packets.
        BAT have promoted Pall Mall and Embassy music events where they promote a competition where the
         entrant buys a packet of cigarettes, they write their name on the back of the packet and then enter it into a
         draw to win a prize.
        BAT are working hard to promote cigarettes in a country where smoking is not part of the culture.
        They hold a party for the winners of the competition during which they give away free cigarettes.

BATs response
        Outside the BAT AGM protesters lay out 1000 empty shoes. Each shoe represent 1000 deaths from
         tobacco.
        “It is an example of a British industry doing abroad what they would never do at home” (protester)
        A BAT spokesperson says they are disappointed with the evidence found. The posters advertising single
         sticks also advertise the pack price with the warning about smoking.
        From 2006 they have withdrawn the free pots for holding single sticks so these should be old.
        Shops which have been painted with the brand colours are not against the law, but they have repainted
         them so they are not advertising.
        Concerts are not targeted at youths and police are used to check age verification.
BAT encourages criticism as it helps them to look at the issues.


What do you think about this issue?
   Case study – Regional variations in
     health and morbidity in the UK
Objectives:
  Know that life expectancy and morbidity vary between different regions in
the UK
  Know how to use different maps and statistics to explore these patterns
  Understand factors that can lead to these differences

Lesson 1:

Starter – Watch the presentation ‘Health in the UK’. What issues does this
raise?

Task - Read pages 301-303 in your textbook to find out more about these
issues. Explore these patterns further by looking at the interactive maps at
http://www.apho.org.uk/resource/view.aspx?RID=50214

Which of these indicators do you think will be most useful to explore patterns
of health and morbidity?




What patterns have you noticed at:

Regional level?




County level?




Plenary – What are the strengths and limitations of using these statistics and
maps to explore this issue?
Lesson 2:

Working in pairs or individually, produce a report describing regional
variations in health and morbidity in the UK and attempting to explain patterns
observed.

When explaining patterns you should consider the impact of:

   Age structures
   Income and occupation types
   Education
   Environment and pollution

Homework – Complete report by __________
 How do age, gender and wealth influence
  access to facilities for exercise, health
        care and good nutrition?
Objectives:
 Understand how age, gender and wealth influence opportunities for health
 Develop primary and secondary research skills to investigate a local issue

Lesson 1:

Starter – Swap reports from last week and peer assess using two stars and a
wish.




Task – Read pages 304-305 in your textbook to find out more about factors
that influence health in different regions. Look at the 2008 Health Profile for
Sedgemoor (our local district). What are the key issues that it raises?




You are going to carry out a mini-enquiry into how age, gender and wealth
influence access to facilities for exercise, health care and good nutrition in our
local area. This will have three strands:

  A questionnaire survey (could use www.surveymonkey.com or paper)
  An investigation into the costs and availability of healthy food in local
shops, takeaways and restaurants
  An investigation into the costs and availability of opportunities to exercise
in the local area

Plan your research in this lesson and collect your data for homework. This
data must be brought to your next lesson.

Plenary – What are the pros and cons of carrying out primary research in
comparison to secondary research?

Lesson 2:

During this lesson you should decide how you are going to present the data
collected and draw out your key findings from your research.
Homework – Be ready to feed back on your mini-enquiry next lesson.
         Case study – local study of the
       implications of these issues for the
        provision of health care systems
Objectives:
  Understand the implications of variations of age, gender and wealth for
the provision of health care systems
  Apply this understanding to our local area
  Evaluate whether the needs of people in our local area are being met by
our local healthcare provision

Lesson 1:

Starter – Present findings from mini-enquiry. Mrs Owen will assess your
enquiry using two stars and a wish – note her feedback here:




Task – What are the implications of these findings for healthcare in our local
area?




Read pages 305-308 in your textbook to find out more about how healthcare
provision is organised in the UK, including primary healthcare trusts (PCTs)
and the role of private healthcare and charities. Take notes below:

Primary healthcare trusts –




Private healthcare –



Charities –



Plenary – What have your own experiences of healthcare in our local area
been like? Do you feel that your needs are met?
Lesson 2:

Look at http://www.somerset.nhs.uk/index.asp to find more about our local
PCT.

How does this provision match the needs of our area? Consider:

   Strengths




   Areas needing improvement




   How you think the PCT should move forward in the future




   Reasons why these improvements may not be possible




Homework – Revise for an exam question on ________________
               End of unit assessment
Objectives:
 Gain experience of a real exam question and mark scheme
 Make a summative judgement about your work on this unit
 Consider how exam answers can be improved

Lesson 1:

Complete the exam question that Mrs Owen will give you.

Lesson 2:

Starter – Look at marks given for the exam question and compare them to the
mark scheme. What do you need to do to improve?

Task – Choose one part of the question to improve and write a new answer in
the space below:




Plenary – Ask a friend to peer assess your new answer:




What mark would you give this answer now?

				
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