health education assignment pdf

Health Education

(16 reviews)

College of the Canyons

Publisher: College of the Canyons

Language: English

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Reviewed by April Parrott, Instructor, Lane Community College on 8/15/24

Comprehensiveness rating: 5 see less

Covers all major topics well. I believe the section on cardiovascular disease should contain information on early heart attack detection and what to do, and BEFAST for stroke. The psychological health section covers a HUGE array of topics but lacks information about treatment for most disorders. In general, great information on topics but less information on how to manage issues.

Content Accuracy rating: 4

Information feels accurate.

Relevance/Longevity rating: 4

Updates should be easy edits for this textbook but some of the information may not be relevant for long periods of time, specifically the information on marriage and relationships.

Clarity rating: 5

Easy to read. Limited use of hard to understand terminology.

Consistency rating: 5

Very consistent in terms of terminology and framework. Each chapter is laid out similarly to the previous chapter. However, this also means that each chapter is lacking in things like images, charts and graphs.

Modularity rating: 5

This textbook has very logically modulated the chapters and subtopics within those chapters. It would be very easy to direct students to certain blocks of information. I do not recall any self-referential material.

Organization/Structure/Flow rating: 5

Organization is logical and builds upon itself. For example, the chapter on stress management begins by talking about what stress is and its effects on the body then into managing and coping. Chapter 5 introduces gender and sexuality which is immediately followed by sexual health which is followed by sexually transmitted diseases.

Interface rating: 4

There are some headings that are on one page and their text on the next or places where photos cause large gaps on previous pages. It does not have a navigable TOC.

Grammatical Errors rating: 5

Easy to read.

Cultural Relevance rating: 4

I believe the section on Relationships and Communication is slightly dated and could be offensive to some readers as it describes relationships in a this way or that way type of language where it is likely that gender and relationships between genders is more fluid. I think this will date this chapter rather quickly.

In general, the book lacked things that made it interesting to look at. There were few images and they were not all the quality in terms of the breath of information they added. There is a lot of information that would be better presented in charts or tables. There is a general lack of how to turn this knowledge into practice.

Reviewed by Uma Hingorani, Affiliate Professor, Metropolitan State University of Denver on 10/12/23

There is a Table of Contents, but an index and glossary of terms would both be helpful to find information quickly. read more

Comprehensiveness rating: 4 see less

There is a Table of Contents, but an index and glossary of terms would both be helpful to find information quickly.

The information is well organized and accurate. Some updates are needed, such as reference to latest edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM), including online tools to track menstrual cycle and Roe vs. Wade overturned stance on abortion in U.S., using more current CDC Fact sheets, including psychodelic mushrooms under drugs of abuse and impacet of legalization of marijuana on abuse potention, and including e-cigarettes, JUUL, and other modern cigarette types. Some minor typographical and spelling errors were noted ('spermacides').

Updating sections to include modern aspects would be helpful.

The language is clear and conducive to an undergraduate level college audience.

The book flows well and uses consistent terminology throughout the chapters.

The text is divided into subsections, making it manageable to read and understand.

Organization/Structure/Flow rating: 4

The book is well organized and flows well.

Use of more diagrams would be helpful. The diagrams and charts used emphasize the textbook reading.

Grammatical Errors rating: 4

Some minor typographical (bullets points not aligned in e-copy) and spelling errors were noted ('spermacides').

Culturally and racially sensitive.

This is a well-written, well-organized textbook which provides a good overview of health. Including the WHO definition of health and wellness would be beneficial as well as using more references to college-age students to engage this audience. In addition, updating sections to modern times would be helpful. Nonetheless, it is a straightforward and helpful textbook to use for a general health class elective.

Reviewed by Anna Smyth, Adjunct Faculty, Salt Lake Community College on 4/18/21

Health is a broad subject, and this book has done a nice job of categorizing and explaining some of the most important aspects. The book does not have a glossary or index but provides references at the end of each chapter for further exploration. read more

The data and information presented in the book appears to be accurate but some statistics are over 10 years old. Students would benefit from an updated edition. The information about sensitive topics such as violence in relationships, sexual health, etc. are handled skillfully without bias.

The text is written in a way that it would be relatively easy to update. Some of the topics, legal marriage for example, are changing due to legislation across the country, but the book speaks generally enough about these topics to capture this reality. The reader can pursue the references included at the end of each chapter to find more specific time-sensitive data around such topics.

Clarity rating: 4

The book is very clear in its use of language. This is a particularly appealing element if you have students whose native language isn't English. A moderate proficiency in English will make this book accessible--easy to read and understand. One missing piece of context noted: Section 5.6 seems to refer to a chart, ie "in the lower left corner" but no chart is included.

Consistency rating: 4

The text is consistent in the way the framework has been structured and the terminology is relatively consistent throughout, however there are some occasional verb tense inconsistencies, for example in Chapters 6 and 8 the voice alternates between speaking directly to the reader (you) and in third-person.

Modularity rating: 4

It would be as easy to pull a few excerpts from the book as assigned reading as it would be to review the entire text throughout a semester. There could be more of a contextual introduction to each chapter that may help provide a useful modular framework.

As the text is a presentation of a variety of interrelated topics rather than information that must be presented in a particular sequence for full and proper understanding, the organization seemed appropriate and sufficient. As Maslow's heirarchy is presented, there is an argument for using the order from that framework or the order of the six dimensions of health presented in Chapter 1, but the content therein, aside from Chapter 1, is not determined by the sequence so the current organization is sufficient.

I saw no significant interface issues, however the text could benefit from more illustrative images throughout to support learning and such images could help with minimizing any confusion as well as retention of the information presented. An example of such is Figures 14 and 15 on page 152 and Figure 4 in Chapter 9.

In my review, I noticed very few grammatical or spelling errors.

Cultural Relevance rating: 3

Some of the sections could be updated with more inclusive language, such as the section on fertility and conception. Language such as "pregnant people" rather than "pregnant women" or "birthing person" rather than "pregnant mother" is more inclusive of the transgender community. The text generally tends to reference nationwide statistics without detail or context regarding specific demographics. This could be a valuable addition as illustrated in Chapter 1 that health can be substantially influenced by things such as race and ethnicity, culturally sensitive healthcare, sexual identity and orientation, etc. which are topics included later in the text. Expounding upon some of these critical aspects of health and determinants of health would add value and represent a more comprehensive perspective of health in the US.

This book is a solid resource with lots of useful information to use in health-related course curricula.

Reviewed by Garvita Thareja, Assistant Professor, Metropolitan State University of Denver on 3/16/21, updated 4/22/21

It had covered most of the major topics in health and wellness. However, there are some foundational topics like dimensions or health (they touched these, but need more depth), theories for behavior change that should be added , being foundational in nature. Then again, some concepts are just added there and may not be needed at this level as it adds to confusion than contribution. We don't need that deeper biology part as its a health topic and not anatomy/physiology.

Content Accuracy rating: 5

Its very accurate book. I would re structure some aspects and add some examples at few places, but overall, its up the mark with accuracy.

Relevance/Longevity rating: 3

Content needs an update. For example if its a weight management, then we need to add information about various apps and calorie tracking resources. If its a drug and abuse, I would add an activity that really engages students about how taking shots can affect their cognition and possibly put them in DUI. This text has too much theoretical concepts but less of applied part or case studies.

The information is clear and use simple languages. Not big jargons or difficult terms.

Yes, its consistent with the topics and headings and sub headings. Its just too much information actually VS field work, examples and real applications.

yes, its divided into various parts and sub parts. Easy to navigate and clear layout. I would just add that piece where if we click on a sub topic from table of contents, it takes us to that page automatically instead of scrolling around.

Yes, very clear and logical flow.

Interface rating: 5

Its easy to navigate. I would add a little more images as it gets monotonous reading it. WIth a topic like health, lot more colors and contrasts and images can be added.

I did not find one.

Cultural Relevance rating: 5

Not offensive. But I would actually add more of culture and diversity when it comes to health. Why are some cultures "Healthy"? or "why is disparity between genders with access to healthcare across the globe/developing nations"?

It is an interesting book. I liked reading it and refreshing some of the topics. I would just add some case studies and activities to make it more interactive instead of passive reading. May be we can have a supplemental lab with it? Its not a perfect book as it covers upper and lower division topics. But definitely, some components can be used as they are well written.

Reviewed by Sara Pappa, Assistant Professor, Marymount University on 2/24/21

The textbook is a comprehensive compilation of personal (individual) health topics, which are clearly defined and described. It would be appropriate for a Personal Health or Introduction to Health/Health Behavior course. It has a table of contents, but not an index or glossary. It does not highlight key terms. There is a reference list at the end of each chapter--this could be expanded to include helpful links. Chapters do not have introductions or summaries.

The content is accurate and relatively unbiased. It includes current public health topics such as the leading causes of death, social determinants of health and health disparities. I might suggest changing the name of Chapter 12 to Chronic Diseases.

Each chapter is made up of many sections, or short descriptions of the topics. This helps with the organization of the content. There are not a lot of case studies, examples, graphics or anecdotal information to enhance the learning process. The material is somewhat dry the way it is presented (not very engaging).

The textbook is written in clear language and at an appropriate reading level for college students.

The chapters are organized in a consistent manner.

The textbook could easily be broken down into smaller units or sections as well as followed in a different order as indicated by a course or instructor. The short sections, as well as the chapter and section/sub-section numbering systems, make it easy to follow.

The textbook is organized in a clear manner, with chapter and section titles that make it easy to follow.

The textbook is easy to read and navigate.

The textbook is well written with few grammatical errors.

The textbook does include some references to culturally competent content. It would be improved with the addition of specific examples, including data and research, about cultural differences and how these affect health.

Reviewed by Sarah Maness, Assistant Professor, Public Health, College of Charleston on 1/27/21

Covers a wide variety of health promotion topics, primarily at the individual level. Lacks a section on social relationships and health. Only covers romantic relationships and in ways that are culturally dated (section on Married and Non-Marrieds). read more

Comprehensiveness rating: 3 see less

Content Accuracy rating: 1

I would not feel comfortable using this text in my class based on issues with accuracy. Section 1.7 about Determinants of Health mentions Healthy People 2020 however does not describe the Healthy People Social Determinants of Health Framework when talking about Social Determinants of Health and includes different factors. Citations are very dated, 2008 or earlier when this edition came out in 2018. Healthy People 2030 is now out so next version should update to that as well. Bias encountered in the chapter about relationships and communication. Only covers romantic relationships and is written with from a heteronomative perspective that also centers marriage and is stigmatizing to those who are not married. ("Marriage is very popular..because it does offer many rewards that unmarried people don't enjoy." "There are known benefits to being married an in a long-term relationship rather than being single, divorced or cohabiting). Also refers to attempts to legalize same sex marriage in this chapter, which has been legal for years now. References are not formatted in AMA or APA style which is standard for the field. Wikipedia is used as a reference in Chapter 2. Chapter 6 discusses "options" for unplanned pregnancy (including taking care of yourself, talking to a counselor, quitting smoking) and does not mention abortion as an option. HPV vaccination recommendations need to be updated.

Relevance/Longevity rating: 2

All topics are relevant but the supporting statistics are outdated by more than a decade in many places. Years are not included in many statistics, nor in the citation at the end of the chapter.

Clarity rating: 3

The sections read as rather disjointed. Chapters could be more aligned and have improved flow for the reader to understand how concepts are related. For example, going right into theoretical models of behavior change in Chapter 1 is early and advanced for an introductory text.

Consistency rating: 2

In the Introduction it states the book is about health, health education, and health promotion. Since health promotion is broader than health education, and fits the topics of the book, it is not clear why this is not the title instead. This book could be useful for an introduction to health promotion class but instructors may overlook it because of the name. Some chapters contain no in text citations despite stating facts, while others contain many. Reference lists and in text citations are formatted differently in different chapters.

Almost too modular, not clear how some sections relate and there is not a lot of detail in many subsections.

Organization/Structure/Flow rating: 3

The sections within each chapter often seem disjointed and do not include enough detail in each section.

Interface rating: 3

In many chapters, only weblinks are provided as citations. If the link is broken, there is no title, author, journal or year for reference. Figures included without citations (ex: Social Readjustment Rating Scale).

Grammatical Errors rating: 3

Did not notice overt grammatical errors.

Includes examples and text of people of multiple races and ethnicities. Is not inclusive based on sexual orientation and in terms of the way it discusses marriage and relationships.

The cover does not appropriately capture what the book includes. It could be more representative of health than just a sports field/physical activity. Health is multi-dimensional and includes in addition to physical - mental, emotional, spiritual, occupational aspects, which the book acknowledges in the text. Hair and clothing style of people on cover also look outdated.

Reviewed by Corrie Whitmore, Assistant Professor, University of Alaska Anchorage on 11/11/20, updated 1/10/21

This book was developed for a Health 100 class. It covers a wide variety of personally relevant health topics, with segments defining health, discussing "your bodies response to stress," describing threats to environmental health, and offering a guide to "understanding your health care choices," which includes both nationally relevant and California-specific information. The index is detailed and specific. There is no glossary.

This textbook would be appropriate for a lower division personal health course. Some components would be useful in an introductory public health course, such as the "Introduction to Health," "Infectious Diseases and Sexually Transmitted Infections," and "Health Care Choices" secgments.

The text is not appropriate for a "Fundamentals of Health Education" or "Health Promotion" course aimed at future Health Educators.

Book provides accurate information with clear references to unbiased sources (such as the CDC for rates of diseases).

Content is releveant and timely.

The book is appropriately accessible for lower division students, with clear definitions of relevant vocabulary.

Good internal consistency.

The segmentation of the book into 14 topical sections, each with subsections, makes it easy to assign appropriate chunks of reading and/or draw pieces from this text for use in other courses, such as an introductory public health course.

Well-organized.

Easy to navigate.

Good discussion of health disparities, acknowledges cultural components in health. Is not insensitive or offensive.

Reviewed by Audrey McCrary-Quarles, Associate Professor, South Carolina State University on 8/17/20

The Health Education book covered all the components usually found in other basic health books. It can be utilized as an Open Textbook for students taking the introduction to health or the basic health course, such as HED 151 - Personal and... read more

The author could use a picture that exhibits diversity on the cover.

Some of the data is just a little outdated but can be updated very easily with an article or current chart.

Clarity is okay.

Consistency is good!

Should be an easy read for students.

Organization and flow are great!

Text can use some more pictures and charts, especially in Chapter 1.

Did not notice any grammar errors in scanning over the book.

The cover should be a picture that depicts diversity as well as showing more diversity throughout the book.

Overall, the book serves its purpose. It is good!

Reviewed by Vanessa Newman, Adjunct Faculty, Rogue Community College on 7/22/20

The textbook successfully covers a wide array of health education topics. The chapters on "Relationships & Love" and "Health Care Choices" were excellent additions to what you find in many health books. Overall, I would have liked to have seen more case studies, illustrations, examples, and quick quizzes to reinforce the content presented and to reach students with different learning styles. Many of the sub-topics could be even more robust with the addition of information on auto-immune disorders for example or a section on health education professionals like personal trainers and health coaches or information on what to do if you suspect a food-borne illness and how to access help.

The contributors have done a great job of presenting accurate information but it is now outdated in many sections and chapters which is what happens in textbooks generally. The language and presentation of material appears unbiased. The addition of more graphics and examples that cross demographics, cultures, and races would be a welcome addition. I found no factual errors but did question the notion that gluten-free diets can assist with anemia and wondered if research about the resilience gene in children might be referenced.

The research presented is all 2015 or before with an emphasis on 2008 information. Sections about marijuana and cannabis, infertility, social disorder, and smoking need refreshing. It would be helpful to have information about genetic testing (23 and me and Live Wello) added, functional fitness addressed, and infectious disease content brought up to date. So much has happened affecting people's health has transpired since 2015 that it is time for updating. Also, more information in sections like how baby birth weight can predict chronic disease development and mindfulness as a practice for improved quality of life.

Content is presented in clear, concise and appropriate language. Every once in a while there is a sentence structure issue or a word ordering that is clarified by a re-read. There is not an emphasis on jargon or overuse of idioms in my opinion. All terminology was defined or given reference as to where to locate additional information. Again the use of diagrams, illustrations, more examples would also improve clarity and accessibility for some. I did not recall seeing information on how many calories are in a gram of protein, carbohydrate and fat presented. And relevance affects clarity. For example, including language about portal of entry and exit in the infectious disease section.

Having a quick quiz at the end of every chapter would have added consistency. Also standardized formatting for charts and graphics would improve the textbook overall as well. The chapters, sections and headings all appear consistently presented. There was nothing presented that was jarring or appeared out of context. References looked similar and were all summarized at the end of each chapter.

Modularity was this textbook's strength. Large chunks of information were broken down into manageable sections and sub-sections and the white space was appreciated. Because of this, the information did not seem overwhelming or "too much too fast." Students can take breaks and not lose track of where they were or forget critical information. Again, more examples, quizzes or case studies could also improve modularity and add an interest factor. The table of contents was thorough.

Time was taken to decide which chapters and topics should be presented in which order. The flow was organic, natural and later sections built on previous information. The structure of the textbook made sense and usually my questions about a topic or subject were answered within the same page. I had no complaints about organization and could find sections easily based on the table of contents.

No interface issues for me, but I was reading on a personal computer and perhaps on a tablet or phone there would be.

The paragraph spacing was not what I would have chosen. There were some inconsistencies. There are contractions like isn't which I prefer not to see in textbooks because it is too casual a style for me. Many instances of punctuation coming after quotations, but this may have been a style choice. The font seemed appropriate but more bolding or color would keep the reader's attention. There are spelling errors on the food chart on p. 236. Some issues with singular vs. plural. For example on P. 64 "nightmares" needs to be plural. A few places where punctuation is missing.

The text is not culturally insensitive, but without additional examples, graphics, and diverse charts it becomes a bit bland. The reference to a handgun on p. 56 was uncomfortable for me. Under weight management, there could be more information presented on how different cultures appreciate varying body types and have different food rituals and discussion on how not to "fat shame" others. Some examples of cultural influences could be presented in the infectious disease section like how practices for burying the dead can lead to disease and how food preparation affects disease management.

I thought it was comprehensive and well organized. If it were not for relevance issues, I would choose to use this book in our general health class.

Reviewed by Robert West, EMS Program Director, North Shore Community College on 6/7/20

Health education is an enormous subject area but this text does an excellent job covering the most important topics. The comprehensive nature of it topic coverage does come at the cost of not being comprehensive within any single topic- this book... read more

Topics within Health Education are inherently subject to bias- religious, cultural and generational perspectives often influence the scientific and open-minded exploration of issues in topics like sexuality, nutrition, and relationships. This book clearly strives to support perspectives with research and did not shy away from topics like abortion and gender roles.

The greatest weakness of this text is that it often feels outdated. Health information is dynamic and no text can always be current, but there are sections that are clearly too old to be considered useful unto themselves. Examples: The narcotic abuse epidemic is absent. This is a major issue in substance abuse and the text primarily looks at heroin abuse without examining the larger issue of prescription narcotic gateways to abuse, or even other narcotics of abuse. The use of PrEP for reducing HIV transmission has been available since 2012 but is not mentioned. The section covering sexual orientation and gender identity cites the 1993 Janus Report for its source of statistics. There is no publication date listed in the text- the latest citation that I noticed was 2015 but most come well before 2010, making the text a decade old in a field that changes rapidly.

The text is well-written and easy to comprehend.

Consistency rating: 3

The Acknowledgements page at the front of the book states that it was "compiled by..." and this speaks to the way the text appears. There is no consistency is the writing of the book. Some chapters are broken down into Sections, brief (often only a paragraph long) collections of sentences that seem to address a behavioral objective that we do not see. Other chapters are written like a standard text and then some appear in a question-and-answer format. None of these are inherently problematic, but the changing style may trouble some readers.

Chapters and chapter sections are clearly delineated.

Chapters are well organized- there is no logical order into which one must teach the various issues of health. The readings of this text could easily be sequenced as desired by the instructor.

The interface is clean and simple. There are few images/illustrations- they would be a welcome addition.

The text is well-written and contains no grammatical/spelling errors that I noticed.

Overall the text seems fair and cites studies to provide evidence of its claims, though some sections simply feel less than open-minded. In the discussion of marriage vs. cohabitation (does anyone use that word anymore?), the text lists advantages of being married that include less likely to commit crimes and less addiction. Statistically, perhaps, but is there a causal relationship? A single paragraph addressing "spiritual health" states: The spiritual dimension plays a great role in motivating people’s achievement in all aspects of life. Some people, yes, but it's not a global truth. Race is never addressed as a topic within the text, though it is commonly listed when a risk factor of disease, health care disparity, etc.

If updated, this would be a superb book. As it stands, it provides an excellent framework for a college course in General Health from which the instructor, or students, could be directed to contemporary writings on these issues. An instructor could readily assign chapter readings and then short research projects that would that could be shared with the class as a whole to assure present day relevance.

Reviewed by Kathy Garganta, Adjunct Professor, Bristol Community College on 5/26/20

The textbook covers a variety of topics in a choppy sequence jumping from three chapters on sexuality and sexual health to substance abuse then onto nutrition. The book was limited in depth and many areas needed additional explanation. There are many lists that did not have the background explanations to support the lists. Several areas were lacking details and were not at college level.

Content Accuracy rating: 3

The text was generally accurate, but lacked backup documentations. Several phrases or statements appeared subjective without the supportive documentation that could lead to misinterpretation. For example, page 107, Section 6.6, Sexual Frequency is covered in one paragraph. In it a statement, “although satisfaction is lower in women,” is delivered with no backup explanation. On page 149, section 7.11, Sexually Transmitted Infections begins with a list of twenty different infections without clarity of an opening explanation.

Relevance/Longevity rating: 5

The textbook was written in 2018 and is still current today. Because of the changing nature of health, it will need updating.

The text was basic and often used lists without additional explanations. Many sections were too brief leaving the reader confused. Page 210 contained an example of a diet list. The list for 4 healthy diet approaches was followed by confusing numbering.

The structural set up of headings and subheadings were consistent, but occasionally spacing was off.

The use of headings and subheadings were helpful. The table of contents clear and easy to follow. Often the sub headings were very short and needed additional information to validate their statements. As an OER text, sections could be assigned as resources to courses outside of health.

The topics were arranged with an unusual flow. Having three chapters on sexuality before nutrition changed the flow and weight of importance.

The text is free of significant interface issues. The chapter headings in the table of contents allows for easy navigation. The use of charts, color displays, photos would have assisted in explaining the topics. The chapter’s would benefit with a more engaging approach. Introspective questions or activities would help to relate material to students lives.

The text contains no significant grammatical errors. However, spacing and formatting needed consistency. For example, on page 86, five definitions all begin with the same exact phrase, throwing off the reader’s flow. On pages 285-86 the formatting/spacing is off.

The text should make greater use of photos/drawings that are reflective of a variety of gender, races, and backgrounds.

Grateful to the author for contributing to OER resources.

Reviewed by Sonia Tinsley, Assistant Professor/Division Chair, Allied Health, Louisiana College on 4/28/20

Covers a variety of health topics that are typical to a personal and community health course. However, the information is very brief. read more

Covers a variety of health topics that are typical to a personal and community health course. However, the information is very brief.

Content is accurate. However, some chapters tend to be limited with reference information.

Some chapters include a limited number of statistics and references but could be updated.

Information is basic and easy to follow.

Terminology used is consistent throughout the text.

The information can be divided into modules to use throughout the course.

Topics are organized and easy to follow.

There were not any features in the text that seemed to be distracting or confusing.

There were no glaring grammatical errors.

The text was very basic and seemed to be written for a variety of races, ethnicities, and backgrounds.

Would have been helpful to have more self-appraisals for readers to complete and make information personable.

Reviewed by Jeannie Mayjor, Part-time faculty in the Health and Human Performance Dept., Linn-Benton Community College on 1/15/20

I think this book does a great job of making the material presented easy to understand. Many similar textbooks are more advanced due to more challenging word/term choices, but this book would work well for anyone taking an intro level class in... read more

The book doesn't cover any of the topics in an in-depth manner. Since it's an intro-level textbook, there aren't many complicated ideas to present where accuracy could be a problem. I think some areas, like nutrition, are missing more up to date info, but that could be remedied by incorporating more recent articles and info from various health journals.

Since this text provides an easy to understand overview of health, it would be easy to update. There are no cutting edge or controversial views expressed in the book, so it does have longevity, but again, there will be a need to present more up to date info to supplement the general understanding that the students will have after reading this text. I like the section on sexual health/identity/orientation in the Sexuality chapter. One more chapter that I appreciate is the chapter on psychology: the most common mental health disorders that college-aged students encounter is important and the section on resilience in both the psychology chapter and the stress management chapter are greatly needed.

The book is very clear and understandable. After having taught a health class every term for the past twenty years, I think the way this book is written would appeal to most students.

I did not catch any inconsistencies in this text. Topics discussed in early chapters might come up in later chapters at times, but the info presented the second time around is consistent with earlier explanations of ideas and terms.

Larger type on chapter headings would help improve the ability to divide the book into smaller reading sections, it's easy to miss the start of a new chapter when scrolling through the text. Once you are in a chapter, the subheadings are helpful in dividing the chapter into smaller reading sections. I wish the chapter on cardiovascular diseases (coronary heart disease and stroke) was limited to those two diseases, without including a section on cancer. I think the topic of cancer deserves its own chapter.

The text is well organized and chapters flow into each other in logical ways. There are enough chapters to spread this out over a ten or 15 week term/semester. The chapters are short enough that you could easily assign one and a half chapters or two chapters for one week's worth of classes.

I would have liked to see more photos, although there are plenty of graphs, and I enjoyed the interactive quiz called The Big 5 Personality Test, I would have liked to see more. Some of the links listed in resources are no longer working, and one link in the Fitness chapter is not working, (Adding Physical Activity to Your Life) and I had been looking forward to exploring the topic in more depth. The MyPlate.gov website has been significantly changed, around the time that this book was published, so some of the links to that site no longer work.

I usually notice grammatical and spelling errors, as well as missing words, but I did not encounter anything obviously wrong in my reading.

The text could use more cultural references. I would have liked to see more acknowledgement of cultural differences and references to the health of people from other cultures, especially as it relates to changes they may encounter once a person from another country moves here.

Great overview of the various topics covered in a 100 or 200 level college health class. I will use sections of this book to help simplify some of the topics that my students find challenging, for instance, the fitness and heart health chapters/sections. Due to the inclusion of many of the mental health disorders that our students encounter, I will fit in some of the sections in the psychology chapter. I look forward to implementing some of the material in this text into my health classes.

Reviewed by Jessica Coughlin, Assistant Professor , Eastern Oregon University on 1/6/20

This textbook includes very similar topics to most of the college level health education books that are available today. While the book includes many of the main points related to each topic, it does not go into too much depth. However, this limitation can be solved by supplementing the book with scholarly articles. Based on the number of chapters and the amount of information, I think this book would be beneficial for a 10 week or 16 week term.

The book cites quality sources, however it would be helpful to include in-text citations since the references are only at the end of the chapters and it is difficult to know where the information is coming from. This is especially important for time sensitive information such as statistics. Also, some information seems to be directly from the sources, but it is not cited.

The information is mostly up to date, however as stated before, including in-text citations would help readers have a better idea of the relevance of the material. Also, there are limited references for each chapter.

The material is delivered in a clear and concise way. Adequate context is provided for terms and concepts.

The format of the text-book is consistent as is the type of delivery for the information.

The text includes a good amount of headings and sub-headings, which makes it easy to break the information down into smaller reading sections.

The book has a good flow to it. Each section within the chapters is well-organized and provides a logical progression.

The book is free of any significant interface issues, however there are some small issues such as spacing and formatting errors. Additionally, some small changes such as larger title pages for each chapter would be helpful as well as more graphics and pictures.

I did not notice a significant number of grammatical errors.

The text is not culturally insensitive or offensive. Like most textbooks, it could provide more examples that navigate the relationship between health and different backgrounds.

I would use this textbook, along with other supplemental materials for my course. It reviews the main topics I currently cover in my course and has less limitations than many overly-priced books.

Reviewed by Kathleen Smyth, Professor of Kinesiology and Health, College of Marin on 4/17/19

This textbook covers the myriad of required topics for an Introductory Health Course. The table of contents includes all of the topics I cover in my classes. No textbook is perfect and this book is no different but one should not rely on textbooks... read more

One of the greatest challenges in teaching health is to be unbiased given so many factors affect our health like politics, economics, zip code etc. The textbook does a fine job of explaining the role of government. For example: generic drugs and the abortion debate. Any areas in question can be used by the instructor to create a discussion with the students for better/different alternatives or ideas.

Health is very dynamic so the textbook will need to be updated on a regular basis.

This is an easy to read text. The majority of college students will have no issues with the terminology.

For a textbook that is not professionally published I found the terminology and framework sufficient for my needs. Anything missing can easily be added by the instructor and used as a discussion or research assignment for the students.

Maybe the best feature of the text is the modularity. Each section of the table of contents is hyperlinked so one could easily pick and choose the topics assigned to the students.

The organization follows the same logical fashion as all of the top rated professionally published Health Education textbooks.

There are a couple formatting issues but nothing that affects clarity in my opinion. I think because this is free I have lower expectations vs a professionally published textbook and I am ok with this.

I did not notice any obvious grammatical errors.

The text is not culturally insensitive or offensive but it could include in-depth analysis of health status in relation to one's race, culture and zip code. As I mentioned previously this is a topic that can easily be supplemented by the professor.

This free textbook meets all the requirements for an introductory health course. It leaves room for me to do my job to engage my students in more detail by discussing controversial topics while giving them the opportunity to be critical thinkers. I appreciate all of your efforts on this project.

Reviewed by Amanda Blaisdell, Assistant Professor, Longwood University on 4/11/19

It gives a lot of information, but it isn't very "in-depth." Admittedly, it would be a challenge to be very in-depth with one book that covers so many topics. This book certainly lacks sufficient images/pictures. The amount of information varies by topic. For some reason, some topics (that don't seem as important in relation to other priority issues) have much more text and information, while other topics lack in comprehensive quality to a large extent. Types of intimate partner violence is incredibly insufficient. There are LOTS of ways that people are abusive, those 5 bullets are not enough. There are lots of incomplete sections. It seems like most sub-topics are hand-selected.

There are biases in the information. For example, mental health is described with an emphasis on college-aged students. Why? Mental health issues affect everyone. This makes it seem like a college student problem. Another example, on page. 57 a strategy to cope with stress is to "give in once in a while." What are we promoting here? I have taught health education and stress management for years. There is a better way to phrase the point they are getting to.

It seems like it is up-to-date as of right now, but health facts are only good for five years.

Sometimes more jargon is necessary. Too much relying on cultural metaphor.

Not all facts have footnotes so that the reader can find the source of the information. Why do some have a reference footnote but other facts do not? How can we dig deeper and fact-check? The reference sections are hyperlinks, which come and go. Why are the references lacking any actual APA, MLA, or other format? APA would be appropriate. Students emulate what they find in textbooks. Some seem to be in some formal form, but others are not and the formatting is not correct.

Yes, very much so.

Some topics fit in multiple categories, so there should be some in-document link to information.

Some sections have a space between paragraphs... some do not.. it is not consistent or visually appealing (Example, p. 23). Figure 1 on page 51 seems to have highlighting and blurriness on the image. Look on p. 122, what is that symbol before the "Copper IUD"? WHy does it say it twice? Is there a heading that wasn't bold? What is going on?

I don't know if you call this "grammar" per-se, but formatting is not consistent. For example, on p. 55 there is no consistency in capitalization of first words in bullet points. That just seems sloppy and unprofessional.

Don't refer to sexual arousal as being "turned on," as that is a cultural metaphor. Some language needs to be technical because this book is supposed to provide information. There is lots of evidence of attempts at cultural competence, but it doesn't provide enough of that. There are lots of lifestyles that are OK even if they don't fit our Western model.

To be honest, it seems like portions of this book are plagiarized. Is this a rough draft?

Chapter 1: Introduction to Health
Chapter 2: Psychological Health
Chapter 3: Stress Management
Chapter 4: Relationships and Communication
Chapter 5: Gender and Sexuality
Chapter 6: Sexual Health
Chapter 7: Infectious diseases and Sexually Transmitted Infections (STI's)
Chapter 8: Substance Use and Abuse
Chapter 9: Basic Nutrition and Healthy Eating
Chapter 10: Weight Management
Chapter 11: Physical Fitness
Chapter 12: Cardiovascular Disease, Diabetes, and Cancer
Chapter 13: Environmental Health
Chapter 14: Health Care Choices

Ancillary Material

About the book.

Readers will learn about the nature of health, health education, health promotion and related concepts. This will help to understand the social, psychological and physical components of health.

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Education Improves Public Health and Promotes Health Equity

Robert a. hahn.

1 Centers for Disease Control and Prevention, Atlanta, GA, USA

Benedict I. Truman

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health – an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits.

Education is a process and a product . From a societal perspective, the process of education (from the Latin, ducere, “to lead,” and e, “out from,” yield education, “a leading out”) intentionally engages the receptive capacities of children and others to imbue them with knowledge, skills of reasoning, values, socio-emotional awareness and control, and social interaction, so they can grow as engaged, productive, creative, and self-governing members of a society. 1 Of course, not all educational institutions achieve these goals for all children – far from it; educational institutions in the United States often fall short of goals, and too many students may be led into school failure, social dysfunction, and marginal living conditions with lifelong disadvantages.

Not all learning is acquired in a formal school setting. The process of education occurs at home, in school, and in the child’s community. Children in the United States spend a relatively small proportion of their waking hours in school – approximately 1,000 hours per year or about one fifth of their waking hours. 2 Thus there are many opportunities for informal education outside the school setting. 3 When researchers find evidence linking mental capacities, knowledge, feelings, and values with health outcomes, 4 not all consequences can be attributed to formal education.

As the product of the educational process, an education is the array of knowledge, skills, and capacities (ie, intellectual, socio-emotional, physical, productive, and interactive) acquired by a learner through formal and experiential learning. An education is an attribute of a person. And, although a person may be said to “have” a certain level of education at any particular moment, educational attainment is a dynamic, ever-evolving array of knowledge, skills, and capacities.

Although we conceive of education broadly, including both its formal and informal sources, the focus of our evidence review is the formal education that is measured in most research. Our recommendation also focuses on the formal education, from early childhood to college and beyond, that is, the subject of educational policy and, we argue, should also be the subject of public health policy.

In public health, researchers and practitioners have examined 3 principal relationships between education and health. First, health is a prerequisite for education : hungry children or children who cannot hear well, or who have chronic toothaches, eg, are hindered in their learning. 5 Second, education about health (ie, health education) occurs within schools and in many public health interventions; it is a central tool of public health. 6 Third, physical education in schools combines education about the importance of physical activity for health with promoting such activity. 7 Here we focus on 2 additional relationships between education and health. First, we propose that education as a personal attribute is a central conceptual component and essential element of health , similar to physical fitness. Second, we summarize the extensive literature demonstrating that formal education is a contributing cause of health .

We argue that education – the product and personal attribute acquired – is both a critical component of a person’s health and a contributing cause of other elements of the person’s concurrent and future health. Consistent with other definitions of health, a person who lacks basic elements of an education is not fully healthy. 8 , 9 For example, the 1978 Alma Ata International Conference on Primary Health Care defined “health” to include “a state of complete…mental and social well-being” – which we see as largely products of education. Attainment of a certain level of formal education by young adulthood affects lifelong health through multiple pathways. 8 , 10

We then argue that, because it is both an essential component and a major contributing cause of health, educational achievement broadly should be a legitimate arena for public health intervention. Thus, public health practitioners could legitimately promote educational programs to advance public health. Education should also be recognized as an essential requirement for the disruption of the cycle of poverty and inequities in health. The public health community should expand research to better understand the causal relationships between education and health, and thereby identify evidence-based educational policies that have great potential to improve public health.

A Broad Concept of Education

We propose a broad concept of education as a personal attribute, which includes not only subject-matter knowledge, reasoning, and problem-solving skills, but also awareness of one’s own emotions and those of others and control of one’s emotions (ie, “emotional intelligence”) 11 and associated abilities to interact effectively. “Education improves health because it increases effective agency, enhancing a sense of personal control that encourages and enables a healthy lifestyle. Education’s beneficial effects are pervasive, cumulative, and self-amplifying, growing across the life course.” 12

In 1983, the National Commission on Excellence in Education’s report, A Nation at Risk , launched a national conversation about the need for educational reform. 13 In 1990, the US Department of Labor initiated a program – the Secretary’s Commission on Achieving Necessary Skills – to determine critical capacities for a US workforce to be provided by the educational system. 14 The capacities proposed were based on “a three-part foundation” reflecting the broad notion of education that we propose: Basic Skills (reading, writing, arithmetic, mathematics, listening, speaking), Thinking Skills (creative thinking, decision making, problem solving, seeing things in the mind’s eye, knowing how to learn, reasoning), and Personal Qualities (responsibility, self-esteem, sociability, self-management, integrity/honesty). The project recommends as a central educational goal: “All American high school students must develop a new set of competencies and foundation skills if they are to enjoy a productive, full, and satisfying life.” 14 (p1) We would expand this list of outcomes to include a healthy life.

Education as an Element of Health

In our conception, basic education is an integral part of being healthy. A person is unhealthy if he or she lacks basic knowledge, the ability to reason, emotional capacities of self-awareness and emotional regulation, and skills of social interaction. These embodied personal attributes or mental capacities, the products of formal education as well as other learning experiences, are conceptually comparable to physical capacities of fitness and coordination – well-established components of health. “Education teaches a person to use his or her mind: Learning, thinking, reasoning, solving problems, and so on are mental exercises that may keep the central nervous system in shape the same way that physical exercise keeps the body in shape.” 8 (p738) A person is unhealthy who cannot conduct himself or herself effectively and achieve some level of “social well-being” – a critical element of the World Health Organization (WHO) conception of health, which recognized the contributions of social sectors beyond the health sector in promoting health. 9

The projects of several US and international health agencies reflect this concept of education as a component of health. For example, the US Centers for Disease Control and Prevention recognizes “cognitive health” in its Healthy Aging Program; although the focus of this program is prevention and control of Alzheimer’s disease, the “cognitive health” rubric suggests far broader considerations: “The public health community should embrace cognitive health as a priority, invest in its promotion, and enhance our ability to move scientific discoveries rapidly into public health practice.” 15 (p1) The National Institutes for Health similarly has a “healthy brain” program that recognizes cognitive as well as emotional capacities as elements of health. 16

Similar concepts are recognized internationally by the WHO, in accordance with its definition of health cited above. More recently, a WHO paper 17 included cognition and affect as 2 of 6 domains for the international comparison of health status .

Measures of Education as a Personal Attribute

Education is measured in a variety of ways. A common measure, years of schooling/educational attainment, is problematic insofar as time spent in school gives little indication of how the time is spent and what is learned. 2 School-level completion may be a better measure, but also varies in terms of the quality and quantity of what is learned. Standardized tests of subject-matter knowledge and reasoning skills may be still better for some purposes, but may offer challenges when compared across populations. 18

Some 19 , 20 have argued that teacher-assigned grades are an alternate, if not better, predictor of long-term outcomes than standardized tests because they reflect not only academic achievement, but also classroom social and learning skills that indicate abilities to learn and to interact successfully. The breadth of skills addressed by this measure better reflects the broad concept of education argued here. Subjectivity, personal preferences, and comparability are challenges with teacher-assigned grades as a measure of achievement.

Evidence of Causal Association

It may seem odd that, in the perspective developed here, education – the product and the personal attribute – is at once an element of health and a cause of health. The relationship is similar to that of physical fitness and health. Fitness is an element of health and an important cause of subsequent health – not only of physical fitness, but of other facets of health as well, including cardiac health and mental health. 21 – 23 In addition to providing extensive evidence that education is associated with health, we argue that the underlying causal process is conceptually similar to the causal relationships between physical activity or an infectious agent and health. We provide some evidence of causation, noting that the notion of causal proof in a traditional deterministic sense has been challenged. 24

Criteria to determine causality in public health developed by Sir Bradford-Hill in 1965 25 are still useful. They are:

Strength of association linking hypothetical cause and outcome (as assessed, eg, by the magnitude of relative risks)
Consistency of findings, eg, by different researchers in different settings
Specificity – the connection of specific, narrow causes to specific outcomes
Temporal sequence—the necessity of cause preceding consequence
Dose–response relationship
Plausibility in terms of current knowledge
Coherence – similar to plausibility, the fit with other contemporary knowledge
Experiment – offering the strongest support
Analogy – the comparability of postulated causality with causality in similar phenomena

Most of the Bradford-Hill criteria clearly apply when linking education to health. An obvious exception is specificity, because education itself is a broad concept including many elements, and the causal consequences of education are also numerous and heterogeneous. Bradford-Hill did not regard specificity as essential, as in the case of cigarette smoke with its multiple health consequences. As Susser has argued, “Specificity enhances the plausibility of causal inference, but lack of specificity does not negate it.” 26 (p153)

The associations presented below satisfy several standard criteria for causation. At least 3 approaches are used: 1) observational cohort studies with concurrent controls, 2) natural quasi-experiments in education policy, and 3) educational experiments. In the sections that follow, we provide samples of evidence of the causal association between education and health, assessed first by various health-related outcomes: health risk and protective behaviors, wages and income (resources for health), self-assessed health, morbidity, mortality, and life expectancy. We then provide evidence from experimental studies. The literature on these topics is extensive 4 , 8 and here we describe only a few examples, from early childhood and beyond. Evidence of the association between measures of education – the personal attribute – and other health-related outcomes is positive, strong, and consistent.

Health Risk and Protective Behaviors Are Associated With Academic Achievement

Evidence of an association between high school student grades and risk behaviors in the United States is remarkably consistent; higher average grade achievement is associated with lower rates of risk behavior ( Figure 1 ). 27 One plausible explanation is that there is causation in the reverse direction of what is proposed here, ie, that risk behavior interferes with academic achievement; such reverse causation seems reasonable, eg, for watching television and using alcohol. Also plausible is that other factors, such as strong values, promote both academic achievement and self-protective behaviors, or that academic achievement is associated with knowledge, which leads to risk avoidance. Another explanation is that underlying psychological or environmental conditions are associated with risk behavior and academic problems. Causation in both directions is likely. The consistency of a dose response for multiple behaviors is consistent with an effect of educational success on the avoidance of risky behavior.

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Health-risk behaviors and school grades, United States, 2009.

Source: www.cdc.gov/healthyyouth/health_and_academics/pdf/health_risk_behaviors.pdf .

There is also strong evidence of a dose response between years of education and many health-related risk and protective behaviors among US adults. Analysis of a representative survey of adults aged >25 years between 1990 and 2000 indicates that the prevalence of several risk behaviors is generally higher among those with fewer than nine years of formal education, begins to decline among those who have nine to 12 years of formal education, and continues to decline with additional years of education; this finding corresponds to the recognized importance of high school completion for subsequent health. 28 , 29

Wages and Income, Resources for Health, Are Associated With Educational Success

Wages and income are not health outcomes, but are closely linked with health outcomes because they provide access to health-related resources, such as healthy food, a safe environment, and healthcare. A recent analysis 30 of trends in US wages over more than 20 years finds higher wages consistently associated with higher educational attainment and a trend toward increasing differences in wages by educational status. In the causal chain, high educational attainment is antecedent to high wages or income. A recent study 31 linking individual kindergarten standardized achievement tests with wages at ages 25–27 years indicates a remarkable linear association accounting for 17% of the variability in the wage outcome – 20 years later ( Figure 2 ). Although high family income precedes and predicts educational success in children, controlling for such demographic characteristics of the kindergartner (including family income, household ownership, and marital status) diminishes, but by no means eliminates, the association found in this study.

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Association between kindergarten test score percentiles and mean wage earnings, ages 25–27 years, Tennessee STAR program.

Source: Chetty, 2010.

Self-Assessed Health Is Associated With Educational Attainment

Self-assessed health is a well-established index of morbidity and predictor of mortality. 32 , 33 A recent study compares the association of educational attainment with self-assessed health in US and Canadian populations. 34 , 35 Controlling for basic demographics and income, those with less than a high school education in the United States are 2.4 times as likely as high school graduates and 4.1 times as likely as those with post-secondary education to rate their health as poor. Further adjusting these ratios for risk behaviors only moderately reduces the ratios, suggesting that education is related to self-reported health due to important factors in addition to risk behaviors.

It is plausible that health status affects the likelihood of educational achievement, but it is likely that the major force of causation is in the opposite direction. Not only is educational attainment closely associated with self-rated health, but the association increases with age when measured by the number of days per week reported as free of major symptoms. With increasing age, the gap in symptom-free days increases between those with a college degree, those with a high school degree or some college, and those with less than a high school degree, suggesting that the effects of education are pervasive throughout the lifespan, and that its consequences have cumulative effects on health over time. 36

Morbidity is Associated With Educational Attainment

In the United States, although higher self-reported rates of several conditions, such as prostate cancer and sinusitis, are reported among more adults with greater levels of education, for most conditions the reverse direction of association is evident. Rates of major circulatory diseases, diabetes, liver disease, and several psychological symptoms (sadness, hopelessness, and worthlessness) show higher rates among adults with lower educational attainment. 35

Mortality and Life Expectancy Are Associated With Educational Attainment

Evidence also exists of a strong association between educational attainment and mortality from many diseases. 37 The parallel relationship for three heterogeneous groups of illness or injury again suggests an underlying connection unrelated to the specific etiologic pathways of each cause of death ( Figure 3 ). 37 In addition, the modal age for completing formal education (the mid-20 s) substantially precedes the peak age for mortality in the United States (77 years of age) by many years, consistent with another Bradford-Hill principle, ie, the precedence of cause before effect.

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Age-adjusted death rates among persons ages 25–64 years for several condition groupings, by sex and educational attainment. Selected US states, 1994–2005.

From the perspective of life expectancy, at age 25 in 2005, a man in the United States with less than a high school education could expect to live an additional 44.2 years to age 69.2 years; a man with a graduate degree could expect to live more than 15 years longer. At age 25 years, a woman in the United States with less than a high school education could expect to live to age 74.9 years; a woman with a graduate degree could expect to live more than 11 years longer. 38

Educational Experiments and Quasi-Experiments

True experiments in the field of education are uncommon. Nevertheless, several experiments have been conducted. Groups of children, often from low-income or minority families, have been exposed, sometimes with random assignment, to different forms of education and followed over time to determine long-term outcomes, including health-related outcomes, as shown in the following 3 examples of early childhood programs.

In the early 1960s, 3- and 4-year-olds with low IQs from low-income families were randomly assigned to either the High/Scope Perry Preschool Program – an educational program including home visits – or no intervention. Home visits were designed to strengthen parental engagement in the child’s education. Participants were periodically assessed until age 40. 39 Over several follow-up assessments, intervention participants had greater levels of educational attainment, income, and health insurance, lived in safer family environments, and had lower rates of tobacco and drug use and risky driving behavior than controls. At age 40 years, however, more intervention than control participants had chronic diseases, but fewer intervention participants had died.

In 1972, healthy infants at risk of academic difficulties because of their demographic circumstances (eg, poor, minority, single parents) were randomly assigned to the Carolina Abecedarian Project or a control intervention (offered social services, nutritional supplements, and healthcare services, but no educational program). 40 The Abecedarian preschool program focused on developing cognitive, social, language, and motor skills from birth through age 5 years. Before entering kindergarten, control and experimental children were again randomized into either routine schooling or a strengthened school program complemented by home visits for parental guidance to reinforce child learning. At follow-up, both the preschool and the early schooling programs were shown to be beneficial in terms of academic achievement; the preschool program had the larger effect. By age 21 years, participants in the early childhood education intervention (combining those with and without the strengthened primary school programming) had better health behaviors and better health than those who did not receive the early childhood education intervention. 41 By their mid-30 s, those exposed to the intervention, particularly males, had substantially more favorable cardiovascular risk profiles than those exposed to the control condition. 42

Finally, though not a true experiment, the Chicago Child-Parent Center program followed two groups of poor Chicago children aged 3 and 4 years: one exposed to an early childhood program and the other not exposed. Children residing in Chicago districts with federally funded kindergarten programs were eligible and selected on a “most-in-need basis”; comparison children lived in similarly poor neighborhoods with locally funded kindergarten programs. The Chicago Child-Parent Center provided educational enrichment from prekindergarten through the third grade, required parental involvement in the classroom a half-day per week, and provided nutrition and health services. At age 24 years, in comparison with control subjects, participants had lower rates of out-of-home placement (indicating child abuse), lower rates of arrests and conviction for violent behaviors, and lower rates of disability. 43

A recent review of the effects of early childhood educational programs indicates that programs with strong instructional components and those evaluated with strong study designs have large and enduring effects on the educational, social, and health outcomes of participants. 44

Several researchers have made use of natural quasi-experiments involving education policies that rapidly change years of schooling required, to evaluate the effects of the requirement on health-related and other outcomes. When state educational requirements change from 1 year to the next from 7 to 9 years, eg, cohorts of children of a certain age in that state will receive approximately 7 years of education, while their younger siblings will receive 9 years. The state where this policy is implemented may be compared by regression discontinuity analysis from before to after the change, but also with other states that have not made this change at the same time.

In one such study, Lleras-Muney 45 uses a sample of US census data to estimate the effects on mortality of changes in compulsory education requirements in 30 states, comparing birth cohorts before and after such changes between 1915 and 1939 with long-term follow-up data. Lleras-Muney concludes that each year of additional required schooling resulted in a reduction of mortality by 3.6% over 10 years, or gain of 1.7 years to life expectancy at 35 years of age. Although these data are old, it is likely that the general effects of increased educational requirements on mortality have not changed substantially. Other researchers have used regression discontinuity analysis to estimate the effects of education on rates of crime, arrest, and incarceration in the United States 46 and on teenage births in the United States and Norway. 47 Among researchers using this design, only Arendt 48 finds equivocal evidence regarding the effects of additional years of education on self-rated health, body mass index, and smoking in the United States, Canada, and Denmark. The heterogeneity of conditions affected by educational exposure again suggests a broad, nonspecific underlying “mechanism.”

The Fallacy of the Endowment Hypothesis

Gottfredson has proposed that intelligence – innate intellectual and associated ability – rather than educational attainment is the “fundamental cause” of socioeconomic inequalities in health, a proposal referred to as the “endowment hypothesis.” 49 Several basic features distinguish Gottfredson’s notion of intelligence from the concept of education as defined in this article: intelligence is regarded as “natural, not cultural,” “context-free,” and “highly heritable” – indicating a largely innate, biological foundation, little affected by environmental variability. From this vantage, education as conceived in this article may be regarded as largely determined by intelligence insofar as those with greater intelligence are both more likely to seek education and to succeed in acquiring it.

Gottfredson’s hypothesis is explicitly evaluated by others in a study of 2 US cohorts that assesses the contributions of education, income, and intelligence to 3 health outcomes: mortality, life-threatening illness, and self-rated health. 50 The researchers posit an alternative model, in which there are underlying “background influences on [socioeconomic status] and intelligence.” In this model, intelligence affects education and income, and both of these socioeconomic status characteristics in turn affect intelligence; a summary of research on this linkage 51 indicates that a year of education is associated with a gain of between 2 and 4 IQ points. In both study cohorts, intelligence during high school is measured by standardized and validated tests, the Henmon-Nelson test and the Wechsler Adult Intelligence Scale. The researchers find generally consistent evidence of pairwise dose–response associations between levels of education, income, and intelligence with each of 3 health outcomes.

The researchers then examine the questions: what is the effect of controlling the association of education and health outcomes for intelligence; of income and health outcomes controlling for intelligence; and of intelligence and health outcomes controlling for both education and income? This assessment allows answering 2 basic questions: how much does intelligence contribute to the effects of education and of income on health, ie, what are the effects of these determinants net the contribution of intelligence? And, to what extent are the effects of intelligence on health mediated by income and education? The researchers find that separately controlling the effects of education and income on health outcomes for intelligence alters the coefficients for education and income minimally and leaves all associations statistically significant at the 0.05 level or less, indicating that little of the effect of education on health is mediated by intelligence.

The effects of controlling the effects of intelligence on health for education and income are more complex. Only 1 of the 2 surveys finds a significant effect of intelligence on mortality ( P <.05); controlling for education and income eliminates the significance of this finding. Thus, the effect of intelligence on mortality is largely mediated by income and education. Both surveys find statistically significant effects of intelligence for both life-threatening illnesses and self-rated health; however, the effect magnitudes are diminished by a mean of 69.4% and statistical significance is again eliminated for all findings except for self-rated health in one of the surveys. These findings indicate that the effects of intelligence on health outcomes are largely mediated by education and income. 50 There is thus substantial evidence that education has a strong effect on health, independent of background intelligence. Innate intelligence may be a “fundamental cause” principally insofar as it leads to higher education and income.

Causal Pathways and Evidence Linking Education and Health

Building on the work of others, 10 , 52 we constructed a model indicating the three major pathways linking education and health outcomes in adulthood and including the several facets of education – knowledge, problem solving, emotional awareness and self-regulation, values, and interactional skills ( Figure 4 ). First is the psycho-social environment, including the individual’s sense of control, social standing, and social support, which reflects and bolsters capacity and agency. Second is work, through which the individual may achieve satisfaction and income, which allows access to many health-related resources. Finally, healthy behavior may protect an individual against health risks and facilitate negotiation of the healthcare system.

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Pathways from educational attainment to health outcomes.

Ross and Wu 8 used 2 national probability samples of US adults to assess the effects of completed education on self-perceived health and reported physical functioning. They first assessed the association between education and each of three broad covariate groups – psycho-social environment; work; and health knowledge, literacy, and behaviors – that are themselves determinants of health outcomes ( Figure 4 ). 8 For each data source, they began with a model including as covariates only demographic characteristics of their samples. To the basic model, they first added employment and economic covariates, then social-psychological covariates, and finally risk behavior covariates, noting the changes in regression coefficients for educational exposures on health outcomes. This approach allowed assessment of the magnitude of each of these groups of covariates as pathways linking education to health-related outcomes. However, the relative contribution of each group of factors cannot be determined precisely, because these groups are unlikely to be causally independent, and covariate groups entered into the regression early are thus likely to show greater reductions in regression coefficients than those entered later.

In both samples, education was associated with all covariates in expected directions. The largest effect was for work-related variables, including income. Those with lower income not only had limited resources useful in maintaining health, but also may have experienced anxieties that exacerbate health problems. The effects of psycho-social resources were also statistically significant and of similar magnitude. Risk behavior and knowledge also contributed to the association between education and health by both measures. The 3 clusters of covariates together explain between 55% and 59% of the variance in self-reported health and between 46% and 71% of physical functioning in these surveys. This suggests that the smallest contribution to health outcomes is associated with health behaviors, which were entered last into the regression model. In both samples, education has a significant residual “direct” effect, independent of the three examined pathways. In summary, education’s association with improved health is attributable to greater work opportunities and rewards, a greater sense of control and social support, healthier behaviors, and a direct effect on health. Similar results are found by Cutler and Lleras-Muney, 28 who use different sources to assess associations between educational attainment, health behaviors, and mortality in the United States and Great Britain.

In a separate study, Ross and Mirowsky 53 provide evidence that the effect of higher levels of education on health is mediated principally by its contents, including values and skills imparted, and far less by means of status markers such as the diploma or the prestige of the degree-granting institution. Evidence for this conclusion derives from a regression analysis of national data including measures of years of education, receipt of diplomas, and school selectivity (based on test scores of entering freshmen). In another study, Reynolds and Ross 54 provide evidence that “the direct effect of education on well-being is greater than the direct effect of social origins, and the total effect of social origins is mediated mostly by education.” 54 (p226) Evidence derives from a regression analysis of two national data sources in which the researchers control for parental education, father’s occupation, and childhood poverty. They also find that a person’s level of education has a far greater effect on health if his or her parents were poorly educated than if they were well-educated. Unfortunately, in our society, parental and child educational levels are highly positively correlated, so that the children of parents with little education, who might benefit the most from higher levels of education, are least likely to receive that education. 55

Ross and Mirowsky 55 (pp597,598) conclude (emphasis added): “…certain policy implications follow. First, education policy is health policy. Second, health policy must address the educational opportunities of children raised by poorly-educated parents. Otherwise those children, in adulthood, will suffer the multiplicative health consequences of low parental education and low personal education…Structural amplification condemns some families to the concentration of low education with poor health across generations… Break that mediating link, and the moderating effect of higher education will suppress the health disadvantages of the socially disadvantaged origins. ”

High Societal Price in Health of Education Forgone

An estimate of the number of annual deaths attributable to lack of high school education among persons 25–64 years of age in the United States (237,410) exceeds the number of deaths attributed to cigarette smoking among persons 35–64 years of age (163,500) (Krueger et al., unpublished manuscript, 2013). 56 (The estimate of smoking-attributable mortality does not include adults younger than 35 years of age because mortality from smoking is negligible at this age.)

Several recent estimates have been made of economic costs to individuals, the government, and society of the failure of each American to achieve an optimal education. Although it may be argued that there is a moral duty to redress injustice and inequity regardless of cost, these estimates indicate the economic magnitude of this loss and the potential value of its redress.

Schoeni and colleagues 57 , 58 estimate the annual economic value of health forgone in the United States in 2006 by adults who lack a college education. For a population of 138 million aged 25 years or older with less than a college education, the economic value of the life and health forgone is US$1.02 trillion per year – 7.7% of US gross domestic product.

Levin and colleagues 59 provide an estimate of benefits to the government (in 2004 dollars) if those who did not finish high school had completed a high school education (or higher) with a diploma. Based on governmental benefits of income taxes associated with greater earnings of high school graduates and reduced costs of welfare and incarceration, Medicaid, and lifetime savings of approximately US$40,000 per capita in public health expenses, they estimated a total lifetime benefit of US$209,000 for each high school dropout if he or she had instead completed high school. They then examined the costs and benefits of 5 programs with demonstrated efficacy in improving rates of high school completion. Cost–benefit ratios range from 1.5 to 3.5, indicating substantial governmental benefit. 59

Education as a Domain of Public Health Action

Just as many areas of daily life are recognized domains of legitimate public health action – agriculture (eg, nutrition and food safety), transportation (eg, vehicle injuries, air pollution, and walking), immigration (eg, immigrant health and infection control), justice (eg, violent crime and prison health), urban design (eg, safety, walkable communities, and food deserts), and labor (eg, occupational safety and health) – so should education (beyond health education in schools) be recognized as a legitimate domain of public health action. Education is a critical component of health and, we argue, education is a major, long-term, multifaceted cause of health. In particular, education is a powerful means of breaking the cycle of poverty (which greatly affects ethnic and racial minority populations) and promoting health equity.(As this article was in press, the authors encountered an excellent paper by Cohen and Syme 60 which draws similar conclusions.)

Several federal agencies have supported “health in all policies,” 61 particularly through the National Prevention, Health Promotion and Public Health Council. 62 The US Department of Health and Human Services includes in its mission 63 to “engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge” and in its overarching goals to “Create social and physical environments that promote good health for all.”

States and the District of Columbia have also adopted a “health in all policies” perspective. California’s “CAL Health in all Policies” 64 – 66 recognizes the potential for education as a means of moving toward health equity. “Promote efforts that demonstrate positive effects in closing the achievement gap. Collaborate on advancing strategies, addressing the major factors that inhibit the learning of all students.” Counties (eg, Los Angeles, Baltimore) also have adopted a “health in all policies” perspective. 64 , 67 , 68

The effort to pursue multi-sectoral strategies for health improvement is international, practiced in the European Union, Australia, and elsewhere. The European Union has adopted a social determinants-based approach: “Health in All Policies addresses the effects on health across all policies such as agriculture, education, the environment, fiscal policies, housing, and transport. It seeks to improve health and at the same time contribute to the well-being and the wealth of the nations through structures, mechanisms, and actions planned and managed mainly by sectors other than health.” 69 (pXVIII)

In “A Framework for Public Health Action: The Health Impact Pyramid,” 71 Frieden writes, “Interventions that address social determinants of health have the greatest potential public health benefit” and contrasts social determinants – the base of the “health impact pyramid” – with higher strata in the pyramid. 70 (p594) Among social determinants, education is fundamental, because education forms the new members of society – children and youth. Effective teachers are facilitators of long-term health benefits. Beyond school health promotion, education as a means of public health intervention is more difficult to define, to administer, to measure, and to evaluate. It is cumulative, formative, and transformative, both for the individuals who experience it and for the society it recreates and modifies. Although these features make education more challenging than some other tools of public health, such challenges must not deter the public health community from working closely with the education community to investigate and understand this form of social determinant causation, evaluate the wide array of educational program types, and mobilize for action on this powerful force for public health benefits.

Acknowledgments

Many thanks to thoughtful readers and editors Randy Elder, Catherine Ross, Barbara Rimer, Kate W. Harris, Amy Brown, Heba Athar, and Kristen Folsom.

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Biographies

Robert A. Hahn received his PhD in anthropology at Harvard University (1976) and his MPH in epidemiology from the University of Washington (1986). Since 1986, he has served as an epidemiologist at the US Centers for Disease Control and Prevention (CDC) in Atlanta and is a member of the Senior Biomedical Research Service. He is the author of Sickness and Healing: An Anthropological Perspective (1995) and co-editor of Anthropology and Public Health: Bridging Differences in Culture and Society (2008), with a second edition recently published. In 1998–1999, he worked as a Capitol Hill Fellow in the US House of Representatives Committee on Veterans Affairs and in the office of Congresswoman Louise Slaughter. He is currently coordinating scientist of systematic reviews on health equity for the CDC Guide to Community Preventive Services .

Benedict I. Truman earned his BS in chemistry and MD from Howard University and his MPH from the Johns Hopkins Bloomberg School of Public Health, where he completed a residency in preventive medicine and public health and served as chief resident. He has held scientific and leadership positions in state, local, and federal public health agencies and is the associate director for science at the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the US Centers for Disease Control and Prevention (CDC). In this role, he works with other scientists and program managers to ensure that the CDC’s scientific products and research ethics meet the highest standards of quality and integrity. He has published many peer-reviewed journal articles on educational interventions for health equity; prevention and control of infectious diseases and chronic noninfectious diseases; adolescent and school health; community preventive services guidelines; minority health and health disparities; employee performance and public health workforce development; and applied epidemiologic methods. He serves as the Consulting Editor for Infectious Diseases for the Journal of Public Health Management and Practice .

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Basic Nutrition

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View printable brochures and handouts with healthy eating tips based on the Dietary Guidelines for Americans, 2020-2025 , including:

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Use this checklist to track healthy eating and exercise habits throughout your day!

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FDA’s Center for Food Safety and Applied Nutrition developed “Everyday Food Safety” resources to increase food safety awareness among young adults ages 18 – 29. Check out the materials available to use in your classroom, health expo, waiting room, or website.

The U.S. Food and Drug Administration (FDA) has updated the Nutrition Facts label on packaged foods and beverages with a new design, making it easier to make informed choices towards healthy eating habits.

This one-page handout highlights the key changes being made to the new Nutrition Facts Label.

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The Sisters Together program encourages Black women ages 18 and older to reach and maintain a healthy weight. Learn how to bring the program to your community.

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Challenge yourself to eating fruits and vegetables in new ways by following along to this 30-day calendar.

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Use this 31-day calendar to challenge yourself to one choice for a healthy weight each day.

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HIV and AIDS Education, Training Module.

The HIV and AIDS Education Training Module is a training programme for Teachers involved in the delivery of Basic and Higher Education. It consists of 22 similarly structured lessons covering an array of useful topics such as HIV and AIDS: the basics, History and Prevalence of the HIV and AIDS epidemic, HIV and the Immune System, Life Cycle of HIV, How HIV is transmitted, Symptoms of HIV, Testing for HIV, Opportunistic infections, The impact of HIV & AIDS in Africa, The driving force of HIV in Africa, Claims to cure HIV & AIDS in Africa, Myths and misconceptions about HIV & AIDS, Anti HIV therapy, Preventing the spread of HIV through Sexual activity, Preventing the spread of HIV: Blood transfusion, sharing needles and sharp objects, Preventing the spread of HIV & AIDS, general considerations, Counselling and care, The role of the school and the teacher, The role of parents, The role of the community and Eliminating violence, stigma and discrimination. Each lesson comprises a summary and review questions.

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Characteristics of an Effective Health Education Curriculum

Today’s state-of-the-art health education curricula reflect the growing body of research that emphasizes:

Teaching functional health information (essential knowledge).
Shaping personal values and beliefs that support healthy behaviors.
Shaping group norms that value a healthy lifestyle.
Developing the essential health skills necessary to adopt, practice, and maintain health-enhancing behaviors.

Less effective curricula often overemphasize teaching scientific facts and increasing student knowledge. An effective health education curriculum has the following characteristics, according to reviews of effective programs and curricula and experts in the field of health education 1-14 :

An effective curriculum has clear health-related goals and behavioral outcomes that are directly related to these goals. Instructional strategies and learning experiences are directly related to the behavioral outcomes.

An effective curriculum has instructional strategies and learning experiences built on theoretical approaches (for example, social cognitive theory and social inoculation theory) that have effectively influenced health-related behaviors among youth. The most promising curriculum goes beyond the cognitive level and addresses health determinants, social factors, attitudes, values, norms, and skills that influence specific health-related behaviors.

An effective curriculum fosters attitudes, values, and beliefs that support positive health behaviors. It provides instructional strategies and learning experiences that motivate students to critically examine personal perspectives, thoughtfully consider new arguments that support health-promoting attitudes and values, and generate positive perceptions about protective behaviors and negative perceptions about risk behaviors.

An effective curriculum provides instructional strategies and learning experiences to help students accurately assess the level of risk-taking behavior among their peers (for example, how many of their peers use illegal drugs), correct misperceptions of peer and social norms, emphasizes the value of good health, and reinforces health-enhancing attitudes and beliefs.

An effective curriculum provides opportunities for students to validate positive health-promoting beliefs, intentions, and behaviors. It provides opportunities for students to assess their vulnerability to health problems, actual risk of engaging in harmful health behaviors, and exposure to unhealthy situations.

An effective curriculum provides opportunities for students to analyze personal and social pressures to engage in risky behaviors, such as media influence, peer pressure, and social barriers.

An effective curriculum builds essential skills — including communication, refusal, assessing accuracy of information, decision-making, planning and goal-setting, self-control, and self-management — that enable students to build their personal confidence, deal with social pressures, and avoid or reduce risk behaviors.

For each skill, students are guided through a series of developmental steps:

Discussing the importance of the skill, its relevance, and relationship to other learned skills.
Presenting steps for developing the skill.
Modeling the skill.
Practicing and rehearsing the skill using real–life scenarios.
Providing feedback and reinforcement.

An effective curriculum provides accurate, reliable, and credible information for usable purposes so students can assess risk, clarify attitudes and beliefs, correct misperceptions about social norms, identify ways to avoid or minimize risky situations, examine internal and external influences, make behaviorally relevant decisions, and build personal and social competence. A curriculum that provides information for the sole purpose of improving knowledge of factual information will not change behavior.

An effective curriculum includes instructional strategies and learning experiences that are student-centered, interactive, and experiential (for example, group discussions, cooperative learning, problem solving, role playing, and peer-led activities). Learning experiences correspond with students’ cognitive and emotional development, help them personalize information, and maintain their interest and motivation while accommodating diverse capabilities and learning styles. Instructional strategies and learning experiences include methods for

Addressing key health-related concepts.
Encouraging creative expression.
Sharing personal thoughts, feelings, and opinions.
Thoughtfully considering new arguments.
Developing critical thinking skills.

An effective curriculum addresses students’ needs, interests, concerns, developmental and emotional maturity levels, experiences, and current knowledge and skill levels. Learning is relevant and applicable to students’ daily lives. Concepts and skills are covered in a logical sequence.

An effective curriculum has materials that are free of culturally biased information but includes information, activities, and examples that are inclusive of diverse cultures and lifestyles (such as gender, race, ethnicity, religion, age, physical/mental ability, appearance, and sexual orientation). Strategies promote values, attitudes, and behaviors that acknowledge the cultural diversity of students; optimize relevance to students from multiple cultures in the school community; strengthen students’ skills necessary to engage in intercultural interactions; and build on the cultural resources of families and communities.

An effective curriculum provides enough time to promote understanding of key health concepts and practice skills. Behavior change requires an intensive and sustained effort. A short-term or “one shot” curriculum, delivered for a few hours at one grade level, is generally insufficient to support the adoption and maintenance of healthy behaviors.

An effective curriculum builds on previously learned concepts and skills and provides opportunities to reinforce health-promoting skills across health topics and grade levels. This can include incorporating more than one practice application of a skill, adding “skill booster” sessions at subsequent grade levels, or integrating skill application opportunities in other academic areas. A curriculum that addresses age-appropriate determinants of behavior across grade levels and reinforces and builds on learning is more likely to achieve longer-lasting results.

An effective curriculum links students to other influential persons who affirm and reinforce health–promoting norms, attitudes, values, beliefs, and behaviors. Instructional strategies build on protective factors that promote healthy behaviors and enable students to avoid or reduce health risk behaviors by engaging peers, parents, families, and other positive adult role models in student learning.

An effective curriculum is implemented by teachers who have a personal interest in promoting positive health behaviors, believe in what they are teaching, are knowledgeable about the curriculum content, and are comfortable and skilled in implementing expected instructional strategies. Ongoing professional development and training is critical for helping teachers implement a new curriculum or implement strategies that require new skills in teaching or assessment.

Botvin GJ, Botvin EM, Ruchlin H. School-Based Approaches to Drug Abuse Prevention: Evidence for Effectiveness and Suggestions for Determining Cost-Effectiveness [pdf 85K] -->. In: Bukoski WJ, editor. Cost-Benefit/Cost-Effectiveness Research of Drug Abuse Prevention: Implications for Programming and Policy . NIDA Research Monograph, Washington, DC: U.S. Department of Health and Human Services, 1998;176:59–82.
Contento I, Balch GI, Bronner YL. Nutrition education for school-aged children. Journal of Nutrition Education 1995;27(6):298–311.
Eisen M, Pallitto C, Bradner C, Bolshun N. Teen Risk-Taking: Promising Prevention Programs and Approaches --> . Washington, DC: Urban Institute; 2000.
Gottfredson DC. School-Based Crime Prevention. In: Sherman LW, Gottfredson D, MacKenzie D, Eck J, Reuter P, Bushway S, editors. Preventing Crime: What Works, What Doesn’t, What’s Promising [pdf 100K] -->. National Institute of Justice; 1998.
Kirby D. Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy . Washington, DC: National Campaign to Prevent Teen Pregnancy; 2001.
Kirby D, Coyle K, Alton F, Rolleri L, Robin L. Reducing Adolescent Sexual Risk: A Theoretical Guide for Developing and Adapting Curriculum-Based Programs . Scotts Valley, CA: ETR Associates; 2011.
Lohrmann DK, Wooley SF. Comprehensive School Health Education. In: Marx E, Wooley S, Northrop D, editors. Health Is Academic: A Guide to Coordinated School Health Programs . New York: Teachers College Press; 1998:43–45.
Lytle L, Achterberg C. Changing the diet of America’s children: what works and why? Journal of Nutrition Education 1995;27(5):250–60.
Nation M, Crusto C, Wandersman A, Kumpfer KL, Seybolt D, Morrissey-Kane, E, Davino K. What works: principles of effective prevention programs. American Psychologist 2003;58(6/7):449–456.
Stone EJ, McKenzie TL, Welk GJ, Booth ML. Effects of physical activity interventions in youth. Review and synthesis. American Journal of Preventive Medicine 1998;15(4):298–315.
Sussman, S. Risk factors for and prevention of tobacco use. Review. Pediatric Blood and Cancer 2005;44:614–619.
Tobler NS, Stratton HH. Effectiveness of school-based drug prevention programs: a meta-analysis of the research. Journal of Primary Prevention 1997;18(1):71–128.
U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People–An Update: A Report of the Surgeon General. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2011: 6-22–6-45.
Weed SE, Ericksen I. A Model for Influencing Adolescent Sexual Behavior . Salt Lake City, UT: Institute for Research and Evaluation; 2005. Unpublished manuscript.

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CURRICULUM, INSTRUCTION, AND PEDAGOGY article

Teaching health education through the development of student centered video assignment.

$\nHeather Wallace$

Public Health Department, Grand Valley State University, Grand Rapids, MI, United States

The purpose of this study was to explore the ways in which a student centered video assignment enhanced student learning about developing and teaching a health education plan designed to address a complex public health problem. The objectives of the assignment included (1) to explore a complex public health problem, (2) practice developing a corresponding health education plan, and (3) develop and fully execute a multimedia video to deliver high impact health education and or promotion to a diverse audience. The assignment referred to as the student centered video assignment was developed and piloted at Grand Valley State University and included students participating in a 200 level undergraduate introductory public health course. Students working in groups of 3, worked through the project in multiple phases with corresponding elements: problem identification, problem solving, plan development and the creation of the video, which included four primary elements: Dig Deeper, Think, Discuss, and Watch. Upon completion of the video, students were asked to voluntarily complete a 10-question survey about the benefits of learning through a video creation assignment. A total of 15 students completed the survey with the majority either strongly agreeing or agreeing that the video assignment enhanced learning. Survey results suggest that the assignment is beneficial and favored over other assignment types. Additionally, students reported that the project was beneficial in learning the concepts and competencies associated with public health education. Finally, students indicated that the creation of videos as a means to explore and apply course concepts was favored as an assignment format in future coursework. Instructor assessment of learning outcomes occurred through ongoing grading of and feedback on the project elements. The findings reveal that students enjoyed the opportunity to engage in real world problem solving, gained insight, perspective and scope through group discussion and collaboration, and felt that they learned new skills in created the video.

Background and Rationale: Multimedia Technology and Higher Education Pedagogy in Public Health and Health Science

Changes in technology are rapidly changing our culture ( 1 ). New teaching and learning formats that rely on digital and web-based technologies have greatly influenced how instructors teach as well as how students learn ( 2 ). Resnick ( 3 ) of Massachusetts Institute of Technology's Media Laboratory (MIT Media Lab) describes our society as rapidly transforming into a creative society, one in which the skilled and expert workers of the past century are replaced by creative workers adept at problem-solving. Such a trend suggests the importance of creativity in student learning and emphasizes that problem solving is not only a critical skill, but also one that can be facilitated through technological tools. Technology can enhance effective learning in many ways ( 4 – 6 ), such as providing greater depth of functionality, feedback, interactivity and simulation ( 2 ). A bank of empirical research demonstrates that blogging, video blogging (vlogging) and podcasting, when used as a part of classroom instruction, can enhance student performance, foster reflection, creativity, and knowledge construction ( 7 , 8 ). Likewise, students can be instructed to create their own multimedia work as part of a learning activity or assignment. The work of Fredenberg ( 9 ) and Armstrong et al. ( 10 ) provide examples of how students can create podcasts, rather than listening to them as an instructional tool. Fredenberg ( 9 ) reported that students are more engaged and felt more confident in their skills and abilities after mastering a podcast assignment. Armstrong et al. ( 10 ) required student-created podcasts (students could elect audio vs. video) as a means to learn objective driven business communication. Having students produce their own podcasts provided a novel way for students to disseminate information while also developing communication and literacy skills through teamwork, organization, time management, technical literacy, and overall planning ( 10 ).

The core competencies for public health professionals and other health care providers rest heavily on communication skills, literacy, creativity, problem solving, and the appropriate use of technology. Having students explore, create, and disseminate through video and other multi- media formats, such as podcasts and vlogging, may offer a novel and effective tool for enhancing these skills. Despite the growing body of research and popularity of multimedia in higher education, health education, and society, little scholarship has addressed the use of student created video and the pedagogical benefits specifically for health science students. This paper seeks to offer a starting point for exploring how student created videos can enhance health science and public health education.

Pedagogical Framework and Principles: Student Created Videos in Problem Based Learning

Students engaged in health profession education encounter numerous “wicked problems” that require teaching and learning strategies that allow for flexibility, trial and error, and engagement beyond text book and lecture based learning. The student centered video assignment was developed, in part, as a strategy to facilitate this type of learning in undergraduate courses with a public health focus, such as Introduction to Public Health. The course was taught by a faculty member from the Grand Valley State University, College of Health Professions, Master's of Public Health (MPH) Program (MPH). The student centered video assignment was developed jointly by the authors, each having over 10 years of teaching experience in the health professions. The course is offered each semester in multiple sections and has been taught multiple times by each of the authors. The class utilized a traditional in seat format while using inquiry based learning as the pedagogical approach. This approach challenges students to learn through directed questions, problems, and challenges that students work to address. Additionally, the courses incorporated Problem Based Learning (PBL) which is known as a teaching and learning approach that facilitates cultivation of knowledge, critical thinking, assessment and evaluation in solving complex, real world problems. Students engaged in PBL set to exploring and solving problems in small groups with the objective of promoting “constructive, self-directed, collaborative and contextual activity” ( 11 ). PBL research in nursing and clinical education showed improvement in critical thinking and critical reasoning ( 12 ), while research on the process of PBL reflects gains in collective and collaborative knowledge building ( 13 ).

Principles and Competencies in Health Education and Promotion

The Council on Education for Public Health (CEPH) is the accrediting body for all schools and programs of public health in the United States. They have identified 22 primary core competencies for public health students and professionals. Of the 22 competencies identified by CEPH, 6 were used in the organization of the two courses in which the student centered video assignment was implemented ( Table 1 ). The competencies selected align with the course objectives and public health program concepts. Execution of the student centered video assignment provides ample opportunity for students to practice and build competency in these areas. For example, competency 16, 21, and 22 is addressed through group collaboration and working with a complex public health issue. Competency 18, 19, and 20 is achieved through the creative development of the video, in which a public health message and health promotion tool are developed for a target population ( Table 1 ).

Table 1 . CEPH competencies used in course and assignment development.

Achieving competency requires meaningful student learning and mastery of skills related to analysis, assessment, planning, communication, management, and systems thinking ( 14 ). Video creation using a problem based learning approach allows for students to practice these skills through engaging with a real world problem in small groups and to explore and practice mastering a new technology.

Learning Environment

Grand Valley State University is a midsize, teaching intensive University located in the Midwest. The College of Health Professions houses 17 undergraduate and graduate health profession programs. The Department of Public Health offers a Master's Degree in Public Health (MPH) and includes several introductory undergraduate courses. The student centered video assignment was created by the authors who are faculty from the MPH program who teach undergraduate and graduate public health courses. The goal was to create a novel course learning activity that facilitated innovative and collaborative development of course work that is student centered, linked to real world public health issues, problem focused and outside of traditional course projects, such as research papers and or presentations. This assignment was developed and piloted in a 200-level undergraduate introductory public health course Students are generally traditional undergraduate college students at the sophomore or junior level interested in exploring a health related degree and or career. The undergraduate public health courses provide a valuable opportunity for undergraduate students to gain awareness and knowledge of the public health profession and the MPH degree. The students in the course that utilized the student centered video assignment are representative of the larger undergraduate student body. Further, students enrolled in the course as well as the students that completed the course evaluation and assignment evaluation reflect a general health professions student body that is disproportionately female.

Video Creation Assignment

The video creation assignment was developed and piloted in the 15 weeks fall semester of 2017. The overall purpose of the assignment was to provide students with a robust, collaborative, innovative, learning opportunity in which a complex public health problem are identified, explored, and responded to through the creation of a culturally appropriate health education video. The assignment was completed in four phases over a 12 weeks period, with each phase having an associated learning element. The phases and elements for the assignment are informed through the PBL pedagogical approach of the course as well as the CEPH competencies listed in Table 1 . The following sections describe the objectives and course work associated with each phase and for phase 4, each element of the student centered video assignment.

The objective of phase 1 is to introduce and facilitate student exploration of real world public health problems. In order to achieve this objective students are randomly assigned to groups of 3–4 depending on the number of students in the course. Over a 3–4 weeks period of time, students are given access to course materials through the University learning platform which include scholarly research articles, journalistic documentaries, and web resources that reflect ongoing and emergent public health problems that are salient to health promotion and or health education. For example, students review topics like vaccine preventable infections and outbreaks, drug use during pregnancy, harm reduction measures among homeless and drug addicted youth, vaping, and sleep hygiene among college students. Students explored the problems together in class and through consensus, elected a problem of interest that is explored and analyzed in Phase 2.

A second learning activity in Phase 1 is the introduction of and experimentation with video creation technology. Students viewed professionally developed TED-Ed video talks, which served as an exemplar and model for the structure of the student created video. Students were asked to watch health related Ted-Ed talks and to reflect upon the message, format, effectiveness, and efficiency of the message.

Class time during weeks 4–6 is used to discuss and describe how to explore, evaluate, and assess root causes and systems level factors related to the selected public health problem. The objective of Phase 2 is to use principles of descriptive Epidemiology, such as time, place and person, to explore the natural history, context, and scope of the selected public health problem. In this phase, the first element, “Dig Deeper,” is introduced.

The public health problem identified in Phase 1 becomes the focus of the Dig Deeper Element introduced in Phase 2. Students are asked to dig deeper into their problem by searching for and evaluating relevant and credible literature and web resources. Students were provided with a website evaluation tool, the CRAAP, to assist in reviewing web information ( 15 ). Each group member composed a single paragraph between 250 and 500 words that included a minimum of three credible references and summarized their search and evaluation. Group members then worked collaboratively to combine the paragraphs into a concise health education or health promotion message relevant to their public health problem. As an introductory undergraduate course, gaining scope and depth of resources accessed and utilized was not the intention. Rather, the dig deeper element was considered a skill building opportunity for group collaboration and health information seeking, assessing and summarizing. Basic instructions for the Dig Deeper Element are provided in Appendix A .

The development of a video health education or health promotion plan is the objective of Phase 3. The plan becomes the framework for the actual video that the students produce in Phase 4. The basic format of the plan is aligned with the TED-Ed lesson creation guide and consists of a short informative message derived from the Dig Deeper element, thinking questions related to the message, a learn more section and a discussion section ( 16 ). The first step of Phase 3 is to complete the “Think Element,” in which students were required to create a series of multiple choice and true or false questions, which addressed the content from the Dig Deeper Element. The questions check for understanding of the content presented in the Dig Deeper element. Students were encouraged to develop thought-provoking questions at a Bloom's level of Analysis or higher. Basic instructions for the Think Element are provided in Appendix B .

The second step of Phase 3 is the Discuss element. The Discuss element required each student within the group to compose a thoughtful discussion question pertaining to the information provided in the Dig Deeper element and complimentary to the Think element. The purpose of the Discuss element is to provide an opportunity for viewers of the video to discuss and further explore the topic of the video. Students were encouraged to review Guidelines for Developing Juicy Discussion Questions ( 17 ). Groups were also encouraged to create a Google Doc so that each student could peer review and edit the discussion questions. Students were limited to 750-character limit. Basic instructions for the Think Element are provided in Appendix C .

In phase 4, student groups developed and executed TED-Ed like educational videos using the Watch element. Student groups were required to create an original video incorporating the Dig Deeper, Think, and Discuss elements they had completed in phases 1–3. Groups applied their topic research, questions, and discussion content to a storyboard template provided by the instructor. The instructor provided students with access to PowToons for Education as the medium or technology used for creating the actual video. PowToons offers a free educational subscription to web-based animation software designed to create animated videos ( 18 ). The videos were ~5 min long and were presented in class on the last day Basic instructions for Phase 4 or the Watch Element are provided in Appendix D .

Setting and Participants

The setting for the student centered video assignment was an in seat undergraduate introduction to public health course with 48 students. Two of the 48 students were male and 46 were female. All students in the course completed the assignment as part of the course work.

Student feedback and learning related to the student centered video assignment was gathered through an evaluation. As the assignment was part of the course, informed consent for participating in the assignment was not needed nor obtained. Informed consent was obtained for the evaluation of the assignment that took place following the viewing of the videos in the last class meeting. The Grand Valley State University Institutional Review Board (IRB) approved the evaluation and deemed the study exempt. The evaluation of student perception of the student-centered video assignment included 10 Likert scaled questions (rating questions 1–7, 1 strongly disagree-−7 strongly agree.) Forty-eight students were emailed the survey following the last day of class. Fifteen students completed the survey for a 31% return rate.

Of the 15 students who completed the survey the majority either strongly agreed or agreed that the video assignment enhanced learning. Survey results suggest that the assignment is beneficial and favored over other assignment types, such as traditional course research papers and or oral paper or poster presentations. Likewise, students would prefer the video assignment over other types of assignments in future classes. Additionally, students reported that the project helped them to apply and develop understanding of the concepts and CEPH competencies associated with introductory public health education. A total of 86% of the students indicated that the student-created video lesson enhanced their learning of public health content. Additionally, 73% of the students thought that creating videos to address a public health issue was a useful experience. Seventy-three percent also indicated that the student-centered video assignment was an important exercise in helping them better understand critical public health issues. Table 2 and reflect the survey questions and student response regarding the student centered video assignment.

Table 2 . Student responses to the TED-Ed student-centered video assignment.

It is not clear whether the video format or the PBL learning approach associated with the assignment influenced student preferences and responses. However, this initial evaluation along with instructor evaluation of the assignment elements completed by the groups, suggests that students enjoyed the opportunity to engage in real world problem solving, gained insight, perspective and scope through group discussion and collaboration, and felt that they learned new skills in created the video.

Overall, this project received strong and positive evaluations from students that serve as a starting point for further development, use and evaluation of similar video creation assignments. A primary strength of this assignment and preliminary evaluation is that it offers credibility and feasibility of student-created videos as a learning tool in higher education. In addition to offering a fun, innovative and novel skill set in the way of video creation, the assignment may offer valuable means for students to develop skills in problem solving and collaboration. Such skills are necessary in the modern workplace where sophistication and complexity of problems is evolving and changing. Furthermore, the video assignment was perceived to be useful in addressing key competencies related to public health and health education which are also becoming more ambiguous and complex. Limitations to the study include the moderately sized sample of students as well as the limited number of students who completed the survey. Furthermore, the generalizability of these findings is limited by the fact that this research was conducted within a single university and a single course.

This assignment serves as an example of an innovative and complex assignment with implications and consequences related to learning but also to achieving high impact learning at the undergraduate level. In other words, undergraduates undertaking this assignment are forced to confront uncomfortable and often controversial public health issues that have no clear good or bad, right or wrong answers. Success is not dependent upon memorization of course concepts but on a students ability and willingness to identify and confront their own learning styles, expectations, and collegiality in working with the instructor, class mates, group members and tangentially, the population of people their video is meant to address.

Recommendations for Educators

The experience of the assignment from the perspective of the instructor offers guidance and caution for other educators willing or curious to take on such an assignment. First, explicit instructions along with a rationale should be given to students at the outset of the semester or work period. The basic components of a student groups, a real life problem related to the course topic and or discipline and a strategy for the development of video contents and video creation are all that are needed to develop a similar assignment. However, it should be noted that students in the course conveyed concern over the timeline, uncertainty in understanding assignment expectations, and in some cases, wanted to jump ahead in creating a video without utilizing the phases and elements. Providing a detailed map of the project ahead of time may ease student concern and better facilitate dedicated in class work time. In this regard, instructors should be willing and able to dedicate a significant portion of in seat class time (45–60 min per element) to group work in completing the elements of assignment. Other aspects of the assignment, such as accessing and viewing TED-Ed lessons and public health resources can be facilitated through an online course delivery platform, such as Moodle or Blackboard. A second recommendation for educators is to seek ways to extend the work of the video creation outside of the classroom. The ability to showcase and “test out” the video with a real target population was requested by the students. The ability to self-select a problem and to work on it in a deliberate way appears to raise interest and investment in the project among students. Finally, as an assignment fully entrenched in collaborative group work, care and consideration should be given to address students who are either uncomfortable or unwilling to engage fully and fairly in group work. Likewise, the instructor should acknowledge, address, and provide a model for handling disagreement within groups. A policy, for example, included in the course syllabus could provide a pathway for students to address concerns among themselves prior to contacting the instructor. The use of a self and peer evaluation that is included in the final course grade may also provide incentive or meaningful consequence for students who do not participate fully or underperform in the group work.

Instructor Reflection on Evaluation of the Assignment

The instructor reviewed and provided feedback to groups upon completion and submission of each element within each phase of the project. The video assignment work was intentionally designed to be low stakes, meaning that groups received a complete or incomplete for each element with the expectation that feedback given would be considered in the ongoing work, resulting in a strong and appropriate video. Only the final video was scored and included the self and peer evaluation. In this way, each group member receives his or her own unique score rather than a base score for the group. The evaluation matrix used for the final video displayed in class included assessment based on the 4 elements and the CEPH competencies. This included the representativeness of the information provided in the Dig Deeper element; the complexity and appropriateness of the Think element and Discussion questions; and the overall aesthetic value and quality of the video, it's length, and it's overall message. Graduate level courses could significantly increase the complexity and scope of the evaluation matrix to include elements, such as health and cultural literacy, sophistication, timeliness and appropriateness of the literature and resources used to develop the health education plan, and pre- and post-test elements to gauge viewer learning. Finally, anectodal evidence from student work, comments and discussion offer further support for this type of assignment. Students provided thoughtful, well-written, well-supported work that reflected the healthy struggle of reaching group understanding and agreement and to conceptualize difficult and complex problems.

Further studies should examine more closely the specific characteristics of the assignment that may cultivate benefit in learning and how student centered, problem based, collaborative course work around a short, audio visual rather than written assignment can be useful in attaining high level learning outcomes.

The use of a student centered video assignment may be a novel and innovative strategy to approach the development of problem solving and group work in the classroom. The assignment described here was received positively by students and offers insight into the myriad complexities of teaching about difficult, evolving, and sophisticated issues both in and outside of the health professions. The small but positive results of the student survey as well as the assessment of student learning witnessed by the instructor should encourage other educators to develop similar assignments and to undertake additional studies to evaluate the effectiveness, merits, and strengths of creating video in public health coursework.

Ethics Statement

This study was carried out in accordance with the recommendations of Grand Valley State University Institutional Review Board with written informed consent from all subjects. All subjects gave written informed consent in accordance with the Declaration of Helsinki. The Grand Valley State University Institutional Review Board approved the protocol.

Author Contributions

JV contributed to the conception and design of this study. JV managed the data collection of this study. JV organized the data. HW and JV wrote the first draft of the manuscript. JV and HW wrote the sections of the manuscript. HW wrote the second draft of the manuscript and completed all revisions.

Grand Valley State University will cover the open access publication fee.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2019.00312/full#supplementary-material

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Keywords: health education, pedagogy, undergraduate education, multimedia, public health competencies

Citation: Wallace H and VanderMolen J (2019) Teaching Health Education Through the Development of Student Centered Video Assignment. Front. Public Health 7:312. doi: 10.3389/fpubh.2019.00312

Received: 04 May 2019; Accepted: 14 October 2019; Published: 01 November 2019.

Reviewed by:

Copyright © 2019 Wallace and VanderMolen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Heather Wallace, wallaceh@gvsu.edu

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Atkinson, M.K. , 2023. Organizational Resilience and Change at UMass Memorial , Harvard Business Publishing: Harvard T.H. Chan School of Public Health. Available from Harvard Business Publishing Abstract The UMass Memorial Health Care (UMMHC or UMass) case is an examination of the impact of crisis or high uncertainty events on organizations. As a global pandemic unfolds, the case examines the ways in which UMMHC manages crisis and poses questions around organizational change and opportunity for growth after such major events. The case begins with a background of UMMHC, including problems the organization was up against before the pandemic, then transitions to the impact of crisis on UMMHC operations and its subsequent response, and concludes with challenges that the organization must grapple with in the months and years ahead. A crisis event can occur at any time for any organization. Organizational leaders must learn to manage stakeholders both inside and outside the organization throughout the duration of crisis and beyond. Additionally, organizational decision-makers must learn how to deal with existing weaknesses and problems the organization had before crisis took center stage, balancing those challenges with the need to respond to an emergency all the while not neglecting major existing problem points. This case is well-suited for courses on strategy determination and implementation, organizational behavior, and leadership.

The case describes the challenges facing Shlomit Schaal, MD, PhD, the newly appointed Chair of UMass Memorial Health Care’s Department of Ophthalmology. Dr. Schaal had come to UMass in Worcester, Massachusetts, in the summer of 2016 from the University of Louisville (KY) where she had a thriving clinical practice and active research lab, and was Director of the Retina Service. Before applying for the Chair position at UMass she had some initial concerns about the position but became fascinated by the opportunities it offered to grow a service that had historically been among the smallest and weakest programs in the UMass system and had experienced a rapid turnover in Chairs over the past few years. She also was excited to become one of a very small number of female Chairs of ophthalmology programs in the country.

Dr. Schaal began her new position with ambitious plans and her usual high level of energy, but immediately ran into resistance from the faculty and staff of the department. The case explores the steps she took, including implementing a LEAN approach in the department, and the leadership approaches she used to overcome that resistance and build support for the changes needed to grow and improve ophthalmology services at the medical center.

This case describes efforts to promote racial equity in healthcare financing from the perspective of one public health organization, Community Care Cooperative (C3). C3 is a Medicaid Accountable Care Organization–i.e., an organization set up to manage payment from Medicaid, a public health insurance option for low-income people. The case describes C3’s approach to addressing racial equity from two vantage points: first, its programmatic efforts to channel financing into community health centers that serve large proportions of Black, Indigenous, People of Color (BIPOC), and second, its efforts to address racial equity within its own internal operations (e.g., through altering hiring and promotion processes). The case can be used to help students understand structural issues pertaining to race in healthcare delivery and financing, to introduce students to the basics of payment systems in healthcare, and/or to highlight how organizations can work internally to address racial equity.

Kerrissey, M.J. & Kuznetsova, M. , 2022. Killing the Pager at ZSFG , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract This case is about organizational change and technology. It follows the efforts of one physician as they try to move their department past using the pager, a device that persisted in American medicine despite having long been outdated by superior communication technology. The case reveals the complex organizational factors that have made this persistence possible, such as differing interdepartmental priorities, the perceived benefits of simple technology, and the potential drawbacks of applying typical continuous improvement approaches to technology change. Ultimately the physician in the case is not able to rid their department of the pager, despite pursuing a thorough continuous improvement effort and piloting a viable alternative; the case ends with the physician having an opportunity to try again and asks students to assess whether doing so is wise. The case can be used in class to help students apply the general concepts of organizational change to the particular context of technology, discuss the forces of stasis and change in medicine, and to familiarize students with the uses and limits of continuous improvement methods.

Yatsko, P. & Koh, H. , 2021. Dr. Joan Reede and the Embedding of Diversity, Equity, and Inclusion at Harvard Medical School , Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract For more than 30 years, Dr. Joan Reede worked to increase the diversity of voices and viewpoints heard at Harvard Medical School (HMS) and at its affiliate teaching hospitals and institutes. Reede, HMS’s inaugural dean for Diversity and Community Partnership, as well as a professor and physician, conceived and launched more than 20 programs to improve the recruitment, retention, and promotion of individuals from racial and ethnic groups historically underrepresented in medicine (UiMs). These efforts have substantially diversified physician faculty at HMS and built pipelines for UiM talent into academic medicine and biosciences. Reede helped embed the promotion of diversity, equity, and inclusion (DEI) not only into Harvard Medical School’s mission and community values, but also into the DEI agenda in academic medicine nationally. To do so, she found allies and formed enduring coalitions based on shared ownership. She bootstrapped and hustled for resources when few readily existed. And she persuaded skeptics by building programs using data-driven approaches. She also overcame discriminatory behaviors and other obstacles synonymous with being Black and female in American society. Strong core values and sense of purpose were keys to her resilience, as well as to her leadership in the ongoing effort to give historically marginalized groups greater voice in medicine and science.

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Chai, J., Gordon, R. & Johnson, P. , 2013. Malala Yousafzai: A Young Female Activist , Harvard University: Global Health Education and Learning Incubator. Access online Abstract This case traces the story of Malala Yousafzai who has advocated passionately for girls’ right to education. In October 2012, a militant group with ties to the Taliban shot 14-year-old Yousafzai in the head as she was riding the school bus home after a day of classes. Yousafzai recovered and became the youngest recipient of the Nobel Peace Prize in 2014. This case explores the social factors that made such an attack possible and why there continue to be such barriers to educational opportunities for girls. "Malala Yousafzai: A Young Female Activist" is a part of a case series on violence against women that illustrate the critical role for leadership through an examination of how factors within a society influence women’s health. Students analyze the situations described by considering the circumstances that placed each protagonist in vulnerable positions. Participants examined the commonalities and differences of these situations in an effort to understand the circumstances that affect women’s well-being. Additionally, using the cases as a framework, students analyzed the connections between collective outrage, reactive action, and leadership.

This teaching case study examines psychological trauma in a community context and the relevance, both positive and negative, of social determinants of health. Healthy People 2020 views people residing in communities with large-scale psychological trauma as an emerging issue in mental health and mental health disorders (Healthy People, 2016). The case study, which focuses on Newark, New Jersey, addresses three of the five key determinants of health: social and community context, health and health care, and neighborhood and built environment. The three key determinants are addressed using psychological trauma as an exemplar in the context of trauma-informed systems. The social and community context is addressed using concepts of social cohesion, civic participation, and discrimination. Access to health and health care are addressed with discussion of access to mental health and primary care services, health literacy, and the medical home model. Neighborhood and built environment are viewed through the lens of available government and NGO programs and resources to improve the physical environment with a focus on quality of housing, crime and violence, and environmental conditions. Upstream interventions designed to improve mental health and well-being that support trauma-informed systems are analyzed. The use of Newark as the case study setting allows a real-life exploration of each of these three key determinants of health.

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Weinberger, E. , 2014. Some Skin in the Game: Negotiating the End of a Campus Health Menace , Harvard T.H. Chan School of Public Health: Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED). Download free of charge Abstract Fictitious Colburn University boasts many “amenities” for its students, including cafes, a gymnasium, and U.V. tanning salon Campus Tans. Meredith Tang, a law student originally from Australia, and Barbara Holly, a public health student, cannot believe that this insidious industry has infiltrated campus life and worse yet seems to be promoted by the school, or at least is allowed to advertise on campus. Soon these students turned activists begin a campaign to evict the salon; however, they quickly discover that evicting Campus Tans may not be as easy as they thought. As the story ends, the student activists sit down to a meeting with school officials and the owner of the salon to negotiate an agreement that protects the health of Colburn students while balancing the interests of diverse stakeholders. Teaching note available for faculty/instructors .

Gordon, R. & Moon, S. , 2014. Haiti in the Time of Cholera , Harvard University: Global Health Education and Learning Incubator. Access online Abstract This case examines the United Nations' reactions to the cholera epidemic in Haiti and illuminates contemporary gaps in global governance. In January, 2010, an earthquake devastated Haiti, the poorest country in the Western Hemisphere. The public health community anticipated Haiti to be at risk for many health threats, but did not consider a cholera outbreak a likely possibility. However, in October of that year, the first case of cholera in more than 100 years was reported, sparking a cholera epidemic in Haiti. Scientific evidence later linked the original source of the cholera to poor sanitation management practices at a United Nations (UN) peacekeepers camp run by Nepal. However, the UN refused to acknowledge any responsibility for causing the cholera outbreak. Readers of this case consider the role of global governance and accountability, especially in an environment with a weak nation state.

In August of 2020, after a day treating patients, John McAdams, MD, gets ready to meet with a young couple from the community. He is excited to share the latest progress on his institution’s Cancer Treatment and Control Center, which is set to open in 3 years. The $230+ million project is something that Dr. McAdams has been building in his mind for years. Its brick and mortar location will strive to be a truly different cancer center that emphasizes population health alongside acute treatment. Cutting edge technologies and innovative public health initiatives working in tandem will close the gap between rural and urban cancer patient outcomes.

After decades of diligence, vision, and advocacy from John, Midwest Regional Health (MRH) has purchased the physical location of what will be a state-of-the-art cancer treatment and control center—a rarity for rural America. The site is on the main campus and will be connected to the inpatient and pediatric hospitals by tunnels to have the cancer center be better integrated into the continuum of cancer care than an outpatient center at a separate location. According to John, “The architects have worked very hard to make the center what we wanted…very welcoming and reassuring but intertwining all the workings of the various departments.”

However, with just three years before the grand opening, questions remain about how to structure the management of the cancer center relative to the medical center and the oncology service line, how to expand the research base in oncology, and how to drum up excitement and support in the community.

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Al Kasir, A., Coles, E. & Siegrist, R. , 2019. Anchoring Health beyond Clinical Care: UMass Memorial Health Care’s Anchor Mission Project , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract As the Chief Administrative Officer of UMass Memorial Health Care (UMMHC) and president of UMass Memorial (UMM) Community Hospitals, Douglas Brown had just received unanimous and enthusiastic approval to pursue his "Anchor Mission" project at UMMHC in Worcester, Massachusetts. He was extremely excited by the board's support, but also quite apprehensive about how to make the Anchor Mission a reality. Doug had spearheaded the Anchor Mission from its earliest exploratory efforts. The goal of the health system's Anchor Mission-an idea developed by the Democracy Collaborative, an economic think tank-was to address the social determinants of health in its community beyond the traditional approach of providing excellent clinical care. He had argued that UMMHC had an obligation as the largest employer and economic force in Central Massachusetts to consider the broader development of the community and to address non-clinical factors, like homelessness and social inequality that made people unhealthy. To achieve this goal, UMMHC's Anchor Mission would undertake three types of interventions: local hiring, local sourcing/purchasing, and place-based community investment projects. While the board's enthusiasm was palpable and inspiring, Doug knew that sustaining it would require concrete accomplishments and a positive return on any investments the health system made in the project. The approval was just the first step. Innovation and new ways of thinking would be necessary. The bureaucracy behind a multi-billion-dollar healthcare organization would need to change. Even the doctors and nurses would need to change! He knew that the project had enormous potential but would become even more daunting from here.

This case describes and explores the development of the first medical transitions clinic in Louisiana by a group of community members, health professionals, and students at Tulane Medical School in 2015. The context surrounding health in metro New Orleans, the social and structural determinants of health, and mass incarceration and correctional health care are described in detail. The case elucidates why and how the Formerly Incarcerated Transitions (FIT) clinic was established, including the operationalization of the clinic and the challenges to providing healthcare to this population. The case describes the central role of medical students as case managers at the FIT clinic, and how community organizations were engaged in care provision and the development of the model. The case concludes with a discussion of the importance of advocacy amongst health care professionals.

Guerra, I., et al. , 2019. SALUDos: Healthcare for Migrant Seasonal Farm Workers , Harvard University: Social Medicine Consortium. Download free of charge Abstract The SALUDos program began in 2008 as a response to an influx of migrant seasonal farm workers (MSFWs) at a mobile medical unit serving homeless persons in Santa Clara County in Northern California. The program offered patients free and low-cost primary care services, linkage to resources, and advocacy. As the farm workers involved in this program became more involved in their primary care, they advocated for evening hours, transportation, linkage to coverage programs, and health education resources to better understand their medical and psychological conditions. During continual modifications of the SALUDos program, the team sought to understand and address large-scale social forces affecting migrant health through interventions to mitigate health inequities. Teaching note available for faculty/instructors.

Elizabeth, a middle-aged African American woman living in Minnesota, develops chest pain and eventually presents to a local emergency room, where she is diagnosed with stress-related pain and given Vicodin. Members of a non-profit wellness center where she is also seen reflect on the connection between her acute chest pain and underlying stress related to her socioeconomic status. On a larger level, how much of her health is created or controlled by the healthcare system? What non-medical policy decisions impacted Elizabeth such that she is being treated with Vicodin for stress?

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Browse our case library

Solomon, C. & Kane, N.M. , 2016. Strategic Change at Whitman-Walker Health , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract In the seven years since Don Blanchon was hired as the Chief Executive Officer of Whitman-Walker Health, it had transitioned into a primary care-based community health center and a patient-centered medical home serving a diverse population in a rapidly changing area of Washington, DC. The Affordable Care Act of 2010 would, in Blanchon’s view, increase access to providers for WWH’s patient population, thereby increasing the competition. The implications of this change left senior management with unresolved strategic questions. Should WWH pursue a “hybrid FQHC model,” a new location, new services, or a future strategic partnership with a large health system? What should the next direction be for WWH, and how should it get there?

Siegrist, R. & Kalenderian, E. , 2012. Casey Dental Associates , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract Dr. Casey had just come out of a long meeting with his business manager, Linda Baker, and he was quite concerned. She shared with him that his practice was losing $10,000 a month on monthly revenues of approximately $90,000. Just six months ago he had opened a new office and expected his profit to be growing rather than shrinking. Did he make the wrong decision? He wondered what he should be doing to at least get back to a breakeven level for his practice as a whole.

Levin-Scherz, J. , 2021. Bank4’s New CHRO Confronts Health Care Costs , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract This case explores the challenges facing a new Chief Human Resources Officer as she evaluates health insurance benefits at a financial services company with 100,000 employees. Bank4 faces increasing costs while its employees see rising out-of-pocket expenses. Students will participate in workgroups focusing on pharmacy, provider prices, benefit and plan design, or prevention and wellness to evaluate the different options to address rising health care costs.

Yatsko, P. & Koh, H. , 2017. Dr. Jonathan Woodson, Military Health System Reform, and National Digital Health Strategy , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract Dr. Jonathan Woodson faced more formidable challenges than most in his storied medical, public health, and military career, starting with multiple rotations in combat zones around the world. He subsequently took on ever more complicated assignments, including reforming the country’s bloated Military Health System (MHS) in his role as assistant secretary of defense for health affairs at the U.S. Department of Defense from 2010 to 2016. As the director of Boston University’s Institute for Health System Innovation and Policy starting in 2016, he devised a National Digital Health Strategy (NDHS) to harness the myriad disparate health care innovations taking place around the country, with the goal of making the U.S. health care system more efficient, patient-centered, safe, and equitable for all Americans. How did Woodson—who was also a major general in the U.S. Army Reserves and a skilled vascular surgeon—approach such complicated problems? In-depth research and analysis, careful stakeholder review, strategic coalition building, and clear, insightful communication were some of the critical leadership skills Woodson employed to achieve his missions.

Kane, N.M. & Alidina, S. , 2008. Attacking Heart Disease in Suffolk County , Harvard T.H. Chan School of Public Health case collection. Download free of charge Abstract “Suffolk County is experiencing elevated cardiovascular disease mortality relative to New York State,” explained Dr. Humayun Chaudhry, Commissioner for the Department of Health Services of Suffolk County. Given the general affluence of the area, he finds the CVD mortality rates "a paradoxical situation. We need to determine strategies to address this high priority health issue for our county." Teaching note available for faculty/instructors .

Quelch, J.A. , 2014. Dumb Ways to Die: Advertising Train Safety (Parts A, B & C) , Harvard Business Publishing. Available from Harvard Business Publishing Abstract The case series focuses on Melbourne Trains' viral advertising campaign to improve safe behaviors around trains among young people. This iconic, low budget campaign swept the Cannes Lions advertising awards in 2013 and became a social media sensation.

Quelch, J.A. & Knoop, C.-I. , 2014. Mental Health and the American Workplace , Harvard Business Publishing. Available from Harvard Business Publishing Abstract Mental illness has been described as an epidemic affecting nearly a quarter of all Americans in their lifetimes, often during their most productive working years. Managers who can design organizations that maximize mental health can minimize these risks and boost productivity. This note serves as a guide to understanding mental health in the American workplace. It provides an overview of the most prevalent mental health conditions among employees and the aspects of the work environment that can exacerbate the issues. It also looks at the costs, both to individuals and to companies, of treating or not treating mental health conditions, and outlines the legal framework, insurance plans, and managerial responses to accommodating employees who struggle with mental health issues. To engage students in a role play, the note includes a vignette featuring a struggling CEO.

Quelch, J.A. & Rodriguez, M.L. , 2015. Mérieux NutriSciences: Marketing Food Safety Testing , Harvard Business Publishing. Available from Harvard Business Publishing

IMAGES

Health education Assignment Example
Better Health Assignment
Health education and community pharmacy mcq with answers pdf
Health Education
Health Teaching Plan
2024 Grade 7 CBC Health Education Lesson Notes Term 1

COMMENTS

PDF Health education: theoretical concepts, effective strategies education
Health education: theoretical concepts, effective strategies education disciplines and related concepts. It also offers a framework that clarifies the relationship between hea
PDF National Health Education Standards: Model Guidance for Curriculum and
The National Health Education Standards 3rd Edition is an initiative of the National Consensus for School Health Education (NCSHE). The National Consensus is a collaborative that was created to address the need to update health education standards for schools.
(PDF) Health Education and Health Promotion lecture notes
The fact that health education is also concerned with behavior change communication and it. is one of the tools of health promotion in addition to social marketing, social mobilization. and ...
PDF Microsoft Word
In health education and health promotion we communicate for a special purpose - to promote improvements in health through the modification of the human, social and political factors that influence behaviors.
PDF A Guide for Health Education Teacher Preparation Programs in
This Guide provides a series of lessons for use by instructors in Institutions of Higher Education (IHE) who are responsible for professional teacher preparation programs in health education, and in pre-service courses that focus on improving health education curriculum selection and instruction.
Health Education
Readers will learn about the nature of health, health education, health promotion and related concepts. This will help to understand the social, psychological and physical components of health.
PDF 10 Ways to Create a Skills-Based Health Classroom
Weighing the Pros & Cons Could create a similar assignment for topics on sexual health, nutrition, fitness, stress management and mental health.
PDF National Health Education Standards
The eight National Health Education Standards are: STANDARD #1: Students will understand concepts related to health promotion and disease prevention to enhance health. This standard includes essential concepts that are based on established health behavior theories and models. STANDARD #2: Students will consider the influence of family, peers ...
PDF Health Education Pacing Guide and Unit Planner
Use the pacing guide to develop unit plans for specific topics/skills throughout the health education unit or curriculum. Unit planning is an organizational tool to help teachers determine what students need to accomplish in each unit, and how and when they will accomplish it through lesson-specific details.
Teaching Health Education Through the Development of Student Centered
The objectives of the assignment included (1) to explore a complex public health problem, (2) practice developing a corresponding health education plan, and (3) develop and fully execute a multimedia video to deliver high impact health education and or promotion to a diverse audience. The assignment referred to as the student centered video ...
Health Education Individual Assignment #4 (Case Study)
The document describes an assignment for a health education case study on developing a diabetes management program for participants ranging from 6 to 75 years old. The program will have four initial teaching sessions grouping participants by developmental stage (school-aged, adolescent, young adult, middle-aged adult, older adult) followed by a final session with families. The response ...
PDF Sample High School Health II Scope & Sequence
The Health Education leader assignment may take more than the 4 lessons allotted for the project at the end of the course depending on what you decide for the scope of the project.
PDF Stress and Health: A Six-Lesson Unit Plan for High School Psychology
Introduction This lesson plan is designed to support the teaching of a broad range of concepts related to stress and health in a variety of psychology classroom contexts. Each lesson includes a content outline, critical thinking exercises, and class activities to support the unique needs of different teachers, learners, and classrooms. This unit plan allows for a great deal of flexibility ...
Education Improves Public Health and Promotes Health Equity
Education is a critical component of health and, we argue, education is a major, long-term, multifaceted cause of health. In particular, education is a powerful means of breaking the cycle of poverty (which greatly affects ethnic and racial minority populations) and promoting health equity.
PDF Introduction to Health Careers: Instructional Materials
Introduction to Health Careers Lesson Plan Mission: High school students will explore career opportunities available in the healthcare industry.
Community Health Education Assignment
Community health education plays a vital role in society by educating the public to promote wellness and prevent disease. It draws from various sciences to drive voluntary behavior change through educational programs. Community health educators address a variety of public health issues and work in various settings to design educational programs that meet the specific needs of the communities ...
Printable Materials and Handouts
Find printable handouts and fact sheets that can be used for health fairs, classes, and other food or nutrition-related events.
HIV and AIDS Education, Training Module.
The HIV and AIDS Education Training Module is a training programme for Teachers involved in the delivery of Basic and Higher Education. It consists of 22 similarly structured lessons covering an array of useful topics such as HIV and AIDS: the basics, History and Prevalence of the HIV and AIDS epidemic, HIV and the Immune System, Life Cycle of ...
Characteristics of Effective Health Education Curricula
An effective health education curriculum has the following characteristics, according to reviews of effective programs and curricula and experts in the field of health education 1-14: Focuses on clear health goals and related behavioral outcomes. Is research-based and theory-driven. Addresses individual values, attitudes, and beliefs.
Frontiers
The overall purpose of the assignment was to provide students with a robust, collaborative, innovative, learning opportunity in which a complex public health problem are identified, explored, and responded to through the creation of a culturally appropriate health education video. The assignment was completed in four phases over a 12 weeks ...
Case Library
Case Library. The Harvard Chan Case Library is a collection of teaching cases with a public health focus, written by Harvard Chan faculty, case writers, and students, or in collaboration with other institutions and initiatives. Use the filters at right to search the case library by subject, geography, health condition, and representation of ...
Health Education Assignment
Health Education Assignment - Free download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or read online for free. Florence Nightingale is revered as the founder of modern nursing. She led a team of 38 nurses to provide care at a British army hospital during the Crimean War in 1854. Upon arriving, she found the hospital conditions to be far worse than reported - wards were ...
76 questions with answers in HEALTH EDUCATION
Health Education - Science topic Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.