Class and Health: You Are What You Eat
By Lynn Wiegand

Suggested Grade Levels: 6th - 8th grades (9th - 11th with the adaptation)

Suggested Subject Area: Health Education

Learning Objectives:

1. Students will formulate a working definition of "class" and explore how social class might affect personal health.
2. Students will gain a basic understanding of their nutritional needs.
3. Students will work as a team to research, create & present information and to further change in their communities.

Standards List:

Standard 5: Students will demonstrate the ability to use interpersonal communication skills to enhance health. Performance indicators relate to interpersonal communication, refusal and negotiation skills, and conflict resolution.

Standard 7: Students will demonstrate the ability to advocate for personal, family, and community health. Performance indicators relate to identifying community resources, accurately communicating health information and ideas, and working cooperatively to promote health.

Tools and Materials:

1. Computers with internet access
2. Chalkboard/overhead or newsprint & markers
3. Graph paper & pencils or pens

Time Needed:
The Foundation section through Task 2 is designed to take one 90 minute block (two 45 minute class periods). Task 3 and 4 should take no more than one 90 minute block or could be assigned as homework.

Task 1: Get students thinking about the term "class" & its relationship to health issues.
1. Briefly discuss the term "class." It might be helpful to begin by exploring the many meanings of the word "class" and then narrow the conversation to focus on social class. The teacher might use examples like, "That guy has class," "My class was cancelled," and "He's in a different social class," etc. Other questions to stimulate discussion might include: Is class only defined by income? Does education affect class? How/Why? Who defines class? How might social class affect health?
2. Explain the terms "white collar" and "blue collar" and their social class implications. Have students name some jobs that fit into each category. The teacher might ask students the following questions: How would someone use his body in these jobs? How would a lawyer use his body during the day? An auto mechanic? Would these jobs require different levels of physical exertion? How might different levels of physical exertion affect health? How might personal safety be different in each job?
3. To further stimulate students' thoughts on this topic, the teacher should have students log onto the Class in America web site at http://www.pbs.org/peoplelikeus/index.html. Students should click on "STORIES" and read each story. The teacher should encourage them to think about different health-related issues that the people in the stories might encounter. (It might be good to remind students about health content areas such as stress management, disease prevention, dental hygiene and nutrition before they begin.)
4. Go back to the word "CLASS" on the board, and generate a "web" of class-related health issues, such as nutrition, access to medical care, amount of leisure time, stress levels, physical exertion and personal safety at work, etc. It might help to ask some of the following questions: Who would have more leisure time — a wealthy person or a poor person? Why? Whichever their response, ask them if the opposite might be true too. How could leisure time affect stress levels? How do stress levels affect health? What are some other differences in lifestyles between the upper, middle and lower classes? Encourage them to think about differences in education, disposable income, access to medical care, etc. How might these differences lead to different health problems? How might they change a person's approach to preventative health care?

Task 2: Students will create a chart to depict how specific health issues might be affected by social class.
1. The teacher should divide the class into groups of 4 (or so) and give each group a piece of graph paper. Have the students write the following headings across the top: amount of leisure time, stress creators, eating habits, exercise habits, personal safety on the job, access to medical care. Have the students write the following in a column down the left-hand side of the sheet: migrant farm worker, electrician, lawyer, company president. Ask the students to note what class a person in each of the professions might belong to and why.
2. The students should fill out the chart in groups, writing sentences to describe their thoughts. For example, they might write: "The migrant farm worker probably doesn't have a lot of leisure time because he works in the field all day. After he finishes one job, he must soon start the next one." They may wish to use a separate piece of graph paper for the migrant farm worker, the electrician, the lawyer and the company president, so they have more space to write.
3. Groups should share their lists, and classmates should add/comment.

Task 3:Zero in on nutrition as a class issue.
1. Discuss the importance of proper nutrition. Tell the students that they are going to investigate nutritional needs and record data to use in their final project. It might be helpful to discuss the potential difficulties of maintaining a balanced diet without proper resources ($$), without time (workaholics), without the knowledge (education) etc...
2. Students, individually or in groups, should log on to the web site at www.familyfoodzone.com. This is a site aimed at educating young people about nutrition. Have them click on the "family food guide" link and then explore the nutrition pyramid they find there. They can also click on the handle of the refrigerator, which pops up on the home page. The refrigerator door will open, and they can click on the foods inside to learn about the nutritional value of each. Have the students take notes on what they learn. These notes should cover the different vitamins and minerals they read about. They could also create a chart, listing the pyramid's different food categories down the right hand side (milk, meat, vegetables, fruits, grains and other) and creating three columns. In the first column they could give examples of each category (such as milk, butter and cheese for the milk category). In the second column, they could list which nutrients each of the categories provides. In the last column they could note why those nutrients are good for you.

Task 4: Devise and carry out a plan to improve the nutrition of different social classes in the community.
1. As homework, tell students to research which programs, organizations, and institutions in their area work to improve the nutrition of different social classes. These might include food banks, soup kitchens, free lunch programs at the schools, food stamps, etc. Students should write a paragraph about each organization or program they discover, explaining how it aims to help improve the nutrition of people in different classes.
2. Students could then choose one of the following as their final project: a) write a letter to an elected official advocating the most effective or important program, in their opinion; b) volunteer at a particular organization dedicated to improving nutrition

Assessment Recommendation:

1. Students can be evaluated on the thoroughness of their research in Task 4 and on the quality of their writing.
2. Student participation in class discussions and ability to work in a team can be assessed by the teacher.

Adaptation for older students:

This lesson can be adapted for older students (9th - 11th) by replacing Tasks 3 and 4 with the following activity involving the Healthy People 2010 web site:
1. Students could explore the Healthy People 2010 web site at http://www.health.gov/healthypeople Explain to the students that Healthy People 2010 is an initiative sponsored by the U.S. government. The U.S. Department of Health and Human Services (HHS) has developed 10-year health objectives for the nation. These are defined goals for improving the health of all Americans over the course of the next decade. Doctors and community groups around the country can look at the standards set by Healthy People 2010 and strive to reach them, just like the students might strive to get an "A" on a test.
2. Have the students click on "Measuring Progress" and then have them click on "Leading Health Indicators." A document called "Healthy People 2010: Understanding and Improving Health" will pop up. It may take a little time for all of the graphs in the document to load, depending on the speed of the modems.
3. Have the students scroll to the top and go to the section called Healthy People 2010 Goals. Tell them to look at Figure 3. Percentage of persons with fair or poor perceived health status by household income, United States, 1995. Encourage a discussion about the components of the graph. What is it measuring? What does it indicate? What does the chart say about the connection between social class and health?
4. Next, have the students look at Figure 4. Relationship between education and median household income among adults 25 years and older, by gender, United States, 1996. Ask the same questions about this graph. How is education related to social class?
5. Encourage the students to examine the other charts and graphs on the site while thinking about how each of the "Leading Health Indicators" might be affected by social class. It might be helpful to discuss the potential difficulties of maintaining health without proper resources ($$), without time (workaholics), without the knowledge (education) etc...
6. Have the students discuss what the government could do to help achieve the goals set on the Healthy People 2010 site. What should the government's role be, if any? These recommendations should be shared in the letters they write in step 7.
7. Tell the students that they are going to write a letter to a local political representative to inform him/her about the connection between social class and health. You should select a local representative ahead of time. Students should be given the following prompt: We have learned about class and class-related health issues. Using the "CLASS" web that we created, the charts, and the data gathered from the Health People 2010 web site, write a letter explaining the connection as you see it between class, health and at least two of "Leading Health Indicators" (Physical Activity Overweight and Obesity, Tobacco Use, Substance Abuse, Responsible Sexual Behavior, Mental Health, Injury and Violence, Environmental Quality, Immunization, Access to Health Care).

Extensions:

1. Students could explore the "What You Can Do" section on the Healthy People 2010 web site at http://www.health.gov/healthypeople. Have them select a local organization that works to advance community health. As a class, the students could volunteer for the organization for a day.
2. Students can explore access to health care by logging on to the National Center for Health Statistics web site at: http://www.cdc.gov/nchs/products/pubs/pubd/hus/hus.htm
   • Go to "Downloadable spreadsheet files for trend tables" and click on "1999." Note that students will need access to Excel or Lotus in order to follow the next steps.
   • Have the students click on the "Excel" or "Lotus" folder, depending on which program they're using to look at the table.
   • Next, click on table146.xls or table146.wk1 (it is the last table in the list). This is "Table 146. Persons without health care coverage by geographic division and State." Students can examine the data for their region and discuss it as a group.

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