Lessons

The Debate Around Global Health Spending

Objective:

Students will be able to evaluate how a filmmaker’s point of view and reasoning are communicated in the news piece Life Equation in order to construct a summary of the project and evaluate its purpose

Warm up:

1. What are the greatest health concerns facing your community? Make a list and compare with a partner. Be prepared to share your responses

2. Facebook founder Mark Zuckerberg and his wife Priscilla Chan have pledged to donate 99% of their shares in Facebook, currently valued at about $45 billion, to charity. How do you think he should spend that money? Would you fund the health concerns you listed above, or other pressing issues? Would you spend the money in the US or overseas? Why? Consider the following:

  • Does the cause you chose mostly affect younger people or older people?
  • Would addressing this cause help people right away or in the future?

3. Read the following description of journalist Rob Tinworth’s project Life Equation.

“Who should decide who lives and dies: doctors on the front lines or a mathematical formula?”

Predict: What do you think this project will be about? What do you think the author’s purpose could be for this project?

Introducing the Resource:

1. In the PBS Newshour piece The Life Equation, journalist Rob Tinworth outlines his project exploring the use of data in deciding how money is distributed for global health initiatives.

2. View the film and answer the questions attached.

3. As you view the film, also consider the following:

  • What do you think is the author’s purpose for creating the film?
  • What do you think is the intended aim of the The Life Equation project? How do you know? Use evidence from the film to support your idea.

After Viewing the Film:

1. Review the questions in small groups. Be prepared to share your responses with the class

2. Discuss: How does the author structure the piece to support discussion around the issue of using data to inform global health funding?

3, Explore how changing the text can alter an author’s message:

1. View the alternate ending to the PBS NewsHour film and try to identify how the piece has been edited differently. Consider the following:

  • Does the piece have a different message/purpose?
  • What changes made that happen?

4. Review each of the following edits to the PBS NewsHour film and consider these questions: How does the change to the text alter the tone/message of the piece? Why do you think the author chose not to use this edit in the final piece?

  • EDIT 1: Changing one word

“The DALY bottom line shows suggests  the money would have had more impact if it had been spent on something else... like pap smears to catch cervical cancer early.”

  • EDIT 2: Cutting down a quotation

GFX: DALY Bottom Line

 

 

 

But some think this magic bullet approach is misconceived.

 

Dr Peter Rohloff is founder of The Maya Health Alliance.

 

He made the call to fund Crecencia’s treatment.

 

[SUPER]

PETER ROHLOFF

Chief Medical Officer, Maya Health Alliance

[SOT: PETER ROHLOFF]

Giving a mother four years with her children is precisely a conversation about living and not a conversation just about not dying.

 

GFX: Crecencia calculus

[NARRATION]

Dr Rohloff believes not everything can be captured by numbers.

 

 

 

[SOT: PETER ROHLOFF]

We should use big data right? We should be making smart decisions about how we spend our money.

But the other half of the global health equation is the right to health care. Dreaming about your life and where you want your life to go is a basic human right and we need to I think include that in our algorithm. If such a thing were possible right?

 

  • EDIT 3: Changing the context of Dr Murray’s soundbite

[NARRATION]

The baby’s lungs fill with air, and a cry echoes through the operating room. The lives of both mother and child are saved...just as the lights come back on.

 

[SOT: CHRIS MURRAY]

Individual clinical care is great for that patient. You change their lives. But you don’t change the circumstances of their health and if you want to do that you’ve got to see the bigger picture.

 

  • EDIT 4: Final Thought

[NARRATION]

DALYs make it possible to measure the impact of different interventions.

And show that some hit a lot more home runs.

 

5. Based on viewing the film, how do you feel about the idea of using data to decide how funding is distributed? What parts of the video helped inform your opinion? Do you think these tools should be used in your country? What do you still want to know more about?

6. Write a summary of The Life Equation project and its purpose. Use examples from the film in your summary and elaborate on what you would still like more information about as you decide your opinion on how money should be allocated to address global health challenges.

Extension Activities:​

Option 1: Look at the quotation below from Tinworth’s reporting and discuss. What is your opinion about the questions Tinworth poses? Why do you think Tinworth has included this question as part of his project:

 “José Federico is a new kind of health worker. His mission is to connect sick, impoverished Guatemalans with the care they need. When he meets Crecencia Buch, a mother of seven with late-stage cervical cancer, he faces a dilemma. The price tag to treat her disease is almost $10,000. And at best, it will buy only a few years of life. That money could instead fund a thousand pap smears — a cost-effective way of catching cancer before it’s too late.” What would you do?”
 

Option 2: Explore the Institute for Health Metrics and Evaluation’s (IHME) interactive and evaluate what health challenges are facing different nations.

Read the following explanation of the IHME tool from The Life Equation website: “GBD Compare is a square pie chart – the bigger the square, the bigger the health lost to a disease or injury. Red is infectious disease (like HIV or malaria), blue is non-communicable disease (like diabetes or cancer) and green is injuries. The data can be arranged by country and by year.”

  1. Explore the following chart comparing the United States and Nepal and identify where you see similarities and differences: http://ihmeuw.org/3r0f
  2. Use the chart settings to select two more countries to compare. What do you see as the primary concerns in those nations?
  3. Based on the four countries you have now investigated, what do you think is the primary health concern facing the international community today?
  4. Should health care dollars be focused on fighting diseases and injuries that cause the most ill health?
  5. Review the following quotations from The Life Equation interactive article:

“The other half of the global health equation is the right to health care. Global Health is not about just keeping the most number of people alive as possible under conditions in which they may not want to live. It’s about changing the conditions of life so that life can be worth living. Giving a mother with cervical cancer four years with her children is precisely a conversation about living and not a conversation just about not dying.” – Maya Health Alliance Director Peter Rohloff

  1. Can data capture everything we value in health care? Discuss.
     

Option 3: Peter Rohloff, founder of the Maya Health Alliance, says in The Life Equation, “The Maya population in Guatemala has THE highest rate of malnutrition in the whole world.” Look up at least three additional sources reporting the highest rate of malnutrition and consider the following:

  1.  Do they all report the same country as having the highest rate of malnutrition?
  2. Why might the different sources you find report different countries as having the highest rate?
  3. Where else in your life do you see statistics reported differently depending on the source? 
Educator Notes: 

CCSS.ELA-LITERACY.SL.11-12.3

Evaluate a speaker’s point of view, reasoning, and use of evidence and rhetoric, assessing the stance, premises, links among ideas, word choice, points of emphasis, and tone used.

The following global health lesson plan introduces students to journalist Rob Tinworth's The Life Equation project. It explores the debate around how data is used to help decide how money for global healthcare should be divided up. Students use the attached video and extension activities to analyze how the author structures the story and for what purpose. Ultimately, they are asked for their reactions to the information being presented, and what questions they would still like answered to help them form an opinion on the subject.

For a more in-depth explanation of how the data described in the film is gathered, check out the following resources:

  1. http://www.effectivealtruism.org/
  2. http://www.healthdata.org/
  3. http://www.who.int/healthinfo/global_burden_disease/metrics_daly/en/

Note: In addition to independent investigation of the attached resources, this lesson includes warm up and reflection exercises that are designed to be facilitated in small groups or by the instructor. However, the student instructions for this lesson can be adapted if students will be exploring these resources independently.

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