Teaching Techniques ~ ~

Prevention: Key to a Healthy Lifestyle James G. McGuire

Prevention and lifestyle

Students will: 1) Define the terms, lifestyle and risk factors. 2) Identify the top 10 causes of death in the United

3) Differentiate between three types of prevention. 4) List and discuss ways to practice primary preven-

5) Explain how primary prevention and lifestyle

States with the associated risk factors.

tion.

choices influence longevity and quality of life.

1) Using open discussion and small groups, students will identify major causes of death, health risk factors, and ways to practice primary prevention.

2) Students will research relevant topics and present the information to the class.

3) A written exam is used for final evaluation.

1) At the beginning of class, the teacher writes the following numbers on the board: 116,000, 407,000,. 54,000, and 58,000. Ask students if they know what the numbers represent. After allowing a few minutes to consider, tell them the numbers relate to death. Each reflects the approximate number of Americans who died

James G . McGuire. PhD, CHES, Assistant Professor, Dept. of Physical Education and Recreation, West Georgia College, Carrollton, GA 30118. This article was submitted July 30, 1996, and revised and accepted for publication November 25, 1996.

during recent wars: 116,000 died in World War I, 407,000 died in World War 11, 54,000 died in Korea, and 58,000 died in Vietnam.

2) The teacher then writes the following numbers on the board: 720,000, 500,000, 144,000, 92,000, and 87,000. Ask the students if they know what these numbers represent. Tell them that these numbers also represent deaths. These are the numbers of Americans who die every year from each of the top five causes of death in this country. Stress that these numbers occur every year. You also can show how many deaths this number averages to each day. The teacher then writes the top five causes of death next to the matching numbers already on the board. Complete the list of the top 10 causes of death by adding the next five major causes of death and the appropriate numbers. Table 1 lists the top 10 causes of death and numbers.’

Write the number 1,770,000 on the board. Tell the students that this number represents the total number of deaths occurring each year from the top 10 causes of death. Note that the numbers have remained fairly consistent over the years, with the exception of AIDS deaths, which continues to increase at a more rapid rate than the other causes.

3) Ask students to think about differences that may exist between the people who died in wars and those who die from the top 10 causes of death today. Stimulate thought by asking students to consider the environment in which the deaths occurred, age at which they died, means of death, and brutality of the death. After allow- ing time to consider and mention differences, tell students that the men and women who died in the wars had limited control regarding their death. However, those who die from the major causes of death today have some control regarding how long they live.

Table 1 Top 10 Causes of Death in the United States’

1) Cardiovascular disease 2) Cancer 3) Cerebrovascular disease 4) Accidents 5) Chronic obstructive pulmonary disease 6) Pneumonia and influenza 7) Diabetes 8) AIDS 9) Suicide 10) Chronic liver disease

720,000 each year, 1,973 each day 533,000 each year, 1,370 each day 144,000 each year, 395 each day 92,000 each year, 252 each day 87,000 each year, 238 each day 80,000 each year, 219 each day 48,000 each year, 132 each day 42,000 in 1994, 11 5 each day during 1994’ 31,000 each year, 85 each day 26,000 each year, 71 each day

Journal of School Health January 1997, Vol. 67, No. 1 33

Tell students that most of the top 10 causes of death today are influenced primarily by lifestyle, something over which they have substantial control. Define lifestyle as the practices or behavior, both positive and negative, in which the individual participates. It refers to actions that are routine as well as those that are sponta- neous and without consideration of consequences.

The teacher should emphasize that lifestyle has a significant impact on life expectancy. Define life expectancy as how long one should be able to live when various aspects of life are considered, especially lifestyle. Other important aspects include heredity and environment. Tell students that several individual prac- tices or behaviors are related directly to a short life expectancy. These items are known as health risk factors. Emphasize that, of the 1.77 million deaths from the top 10 causes of death each year, more than 1 million are caused by 10 major health risk factors.

4) The teacher then has the students form into groups of five or six. A simple method of establishing groups involves having the students count, in turn, one through six, then each student joins a group based on the number stated. Ask each group to discuss and write down what they believe are the 10 major risk factors contributing to the top 10 causes of death in the United States. Tell them to list practices and behaviors that lead to health problems and death. Each group should select one person to do the recording. The recorder should be chosen by group members and be based on willingness to do the recording and writing legibility. After allowing time for the students to write the risk factors, have each group, in turn, name one risk factor. As the correct factors are named, the teacher writes them on the board. If students are unable to name all 10, the teacher should complete the list, using information in Table 2. After the risk factors are listed on the board, remind students that more than 1 million deaths occur from these 10 risk factors each year. The teacher finalizes the list by writ- ing the associated deaths by each risk factor. The upper grades can have each group try to determine the number of deaths associated with each risk factor. Table 2 shows the risk factors and associated number of deaths.'

Tell students that each risk factor contributes signifi- cantly to at least one of the top 10 causes of death, while some contribute to several. Use information from Table 3 to report for which top 10 cause of death each risk factor is related.'.' Have each group write the cause of

Table 2 Major Risk Factors and Associated Deaths Each Year'

Risk factors Tobacco 40,000 Poor diet 150,000 Inactivity 1 50,000 Alcohol 100,ooO Infectious agents' %afJ Toxic agents' a,aQ Firearms 35.000 Sexual behavior 30,000 Motor vehicles 25,000 tllnt use of drugs m,m

Associated deaths each year

lnfechws apents refer to mrcnmrganisms that causes diseases such as pneumonia and hepat~trs, toxic agents refer to enuronmental pllution, contaminated food and water, and exposure to commercial products

death by the risk factors already written on their paper. Discuss this point with the students. Key points to mention include the many different risk factors associ- ated with cardiovascular disease, liver disease, and AIDS, the various types of cancer, and how suicide relates both to firearms and alcohol.

5) Write the words Primary Prevention on the board. Differentiate this term from lifestyle. Remind students that lifestyle includes routine and spontaneous behaviors and practices, both positive and negative. Define primary prevention as activities that prevent health prob- lems or diseases from occurring. At this point, the teacher can define, and distinguish between, secondary prevention and tertiary prevention. Secondary preven- tion is action taken to detect a health problem or disease early so a treatment can eliminate or make it less severe. Tertiary prevention is action taken after a health prob- lem or disease reaches advanced stages, thus requiring rehabilitation or other recovery program.' Emphasize that primary prevention relates exclusively to the behav- iors and practices that enhance health and keep health problems from beginning. Tell students this point is important to understand because most of the top 10 causes of death are chronic, meaning they develop over time. They possibly begin during the teen years and, therefore, are preventable. So control of life expectancy depends to an extent, on lifestyle choices while young.

The teacher should clarify that, although some risk factors relate more to chronic disease such as heart disease and cancer, which they can help prevent by modifying lifestyle choices early in life, some relate to

Table 3 Major Risk Factors and the Top 10 Causes of Death''

Tobacco a) cardiovascular diseases (coronary artery disease, stroke, and high blood pressure)

b) cancer (lung, esophagus, mouth, pancreas, kidney, and bladder) c) chronic obstructive pulmonary disease (emphysema and bronchitis)

Diet a) cardiovascular disease b) cancer (colon, breast and prostate) c) diabetes

Inactivity a) cardiovascular disease b) cancer (colon) c) diabetes

Alcohol a) accidents (motor vehicle, drowning, fire) b) liver disease (cirrhosis) c) suicide

Infectious apents a) AIDS b) liver disease (hepatitis) c) pneumonia and influenza

Toxic agents a) cancer (lungs, liver, kdney, bladder) b) cardiovascular diseases

Firearms a) suicide

Sexual behavior a) AIDS b) liver disease (hepatitis)

Motor vehicles a) accidents

lllicrt drug use a) AIDS b) liver disease (hepatitis) c) pneumonia d) cardiovascular disease (endocarditis) e) accidents (motor vehicle, falls, drowning)

34 Journal of School Health January 1997, Vol. 67, No. 1

them now. For example, AIDS was responsible for almost 8,000 deaths among people ages 25-44 during 1994.3 The major risk factors involved were sexual behavior and drug use. In addition, more than 4,000 young people ages 15-24 died in automobile accidents during 1994.4 The major risk factor involved was drug use (alcohol).

6) The teacher then leads a discussion about ways to practice primary prevention. Remind students they can influence occurrence of the top 10 causes of death by becoming active in primary prevention. Stimulate the discussion by asking students to look again at the top 10 risk factors and associated number of deaths. Tell students, as groups, to discuss then list specific behav- iors related to each risk factor in Table 2. To ensure that students remain on track, the teacher should give the following example: “Poor diet” is a risk factor, specific behaviors related to this risk factor include eating fast food, snacking on junk food, and infrequent consump- tion of fruits and vegetables. Students then are allowed time to make a list for each risk factor.

After students complete their lists, a summary discus- sion should be conducted. Allow each group to state the behaviors they cited for each risk factor. To finalize the lesson, the teacher should focus again on primary prevention. Point out to students they now are aware of behaviors closely related to health problems and prema- ture death. Therefore, to have more control of their health, they should practice healthy habits, or primary prevention. The teacher then makes reference to every risk factor and has each group, in turn, state a way to practice primary prevention. The teacher should write these items on the board. The final list should contain at least the following: not smoking, eating healthy food, being active, maintaining an appropriate body weight,

not using drugs, not drinking and driving or riding with a driver who has been drinking, wearing a seat belt, avoiding environmental pollutants, practicing abstinence or safe sex, and avoiding firearms (Table 3).

7) An additional assignment involves having groups of four to five students research each of the top 10 causes of death. Allow time at the beginning of the next few class sessions for each group to report their information.

8) To assess student knowledge from this teaching technique, the teacher can give an examination asking students to list and briefly discuss the major causes of death, risk factors, ways to practice primary prevention, and why primary prevention is important at young ages.

Grades 8-1 2/health, social studies, science

References 1. McGinnis JM, Foege WH. Actual causes of death in the United

States. JAMA. 1993;270(1):2207-2212. 2 . Mullen KD, Gold RS, Belcastro PA, McDermott RJ.

Connections f o r Hea l th , 4th ed. Madison, Wis: Brown and Benchmark; 1996.

3. CDC. Update: Mortality attributable to HIV infection among persons aged 25-44 years - United States, 1994. M M W R . 1996;45(6):121-125.

4. CDC. Update: Alcohol-related traffic crashes and fatalities among youth and young adults - United States, 1992-1994. MMWR. 1995;44(47):869-874.

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