The Intersection of Health Sciences and Geography

A
While many diseases that affect humans have been eradicated due to improvements in vaccinations and
the availability of healthcare, there are still areas around the world where certain health issues are more
prevalent. In a world that is far more globalised than ever before, people come into contact with one
another through travel and living closer and closer to each other. As a result, super-viruses and other
infections resistant to antibiotics are becoming more and more common.
B
Geography can often play a very large role in the health concerns of certain populations. For instance,
depending on where you live, you will not have the same health concerns as someone who lives in a
different geographical region. Perhaps one of the most obvious examples of this idea is malaria-prone
areas, which are usually tropical regions that foster a warm and damp environment in which the mosquitos
that can give people this disease can grew. Malaria is much less of a problem in high-altitude deserts, for
instance.
C
In some countries, geographical factors influence the health and well-being of the population in very
obvious ways. In many large cities, the wind is not strong enough to clear the air of the massive amounts of
smog and pollution that cause asthma, lung problems, eyesight issues and more in the people who live
there. Part of the problem is, of course, the massive number of cars being driven, in addition to factories
that run on coal power. The rapid industrialisation of some countries in recent years has also led to the
cutting down of forests to allow for the expansion of big cities, which makes it even harder to fight the
pollution with the fresh air that is produced by plants.
D
It is in situations like these that the field of health geography comes into its own. It is an increasingly
important area of study in a world where diseases like polio are re-emerging, respiratory diseases continue
to spread, and malaria-prone areas are still fighting to find a better cure. Health geography is the
combination of, on the one hand, knowledge regarding geography and methods used to analyse and
interpret geographical information, and on the other, the study of health, diseases and healthcare practices
around the world. The aim of this hybrid science is to create solutions for common geography-based health
problems. While people will always be prone to illness, the study of how geography affects our health could
lead to the eradication of certain illnesses, and the prevention of others in the future. By understanding why
and how we get sick, we can change the way we treat illness and disease specific to certain geographical
locations.
E
The geography of disease and ill health analyses the frequency with which certain diseases appear in
different parts of the world, and overlays the data with the geography of the region, to see if there could be
a correlation between the two. Health geographers also study factors that could make certain individuals or
a population more likely to be taken ill with a specific health concern or disease, as compared with the
population of another area. Health geographers in this field are usually trained as healthcare workers, and
have an understanding of basic epidemiology as it relates to the spread of diseases among the population.
F
Researchers study the interactions between humans and their environment that could lead to illness (such
as asthma in places with high levels of pollution) and work to create a clear way of categorising illnesses,
diseases and epidemics into local and global scales. Health geographers can map the spread of illnesses
and attempt to identify the reasons behind an increase or decrease in illnesses, as they work to find a way
to halt the further spread or re-emergence of diseases in vulnerable populations.
G
The second subcategory of health geography is the geography of healthcare provision. This group studies
the availability (of lack thereof) of healthcare resources to individuals and populations around the world. In
both developed and developing nations there is often a very large discrepancy between the options
available to people in different social classes, income brackets, and levels of education. Individuals working
in the area of the geography of healthcare provision attempt to assess the levels of healthcare in the area
(for instance, it may be very difficult for people to get medical attention because there is a mountain

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between their village and the nearest hospital). These researchers are on the frontline of making
recommendations regarding policy to international organisations, local government bodies and others.
H
The field of health geography is often overlooked, but it constitutes a huge area of need in the fields of
geography and healthcare. If we can understand how geography affects our health no matter where in the
world we are located, we can better treat disease, prevent illness, and keep people safe and well.

Questions 1-6
Reading Passage has eight sections, A-H.
Which paragraph contains the following information?
Write the correct letter, A-H, in boxes 1-6 on your answer sheet
NB You may use any letter more than once.

1 an acceptance that not all diseases can be totally eliminated

2 examples of physical conditions caused by human behaviour
3 a reference to classifying diseases on the basis of how far they extend geographically
4 reasons why the level of access to healthcare can vary within a country
5 a description of health geography as a mixture of different academic fields
6 a description of the type of area where a particular illness is rare

Questions 7-13
Complete the sentences below.
Choose ONE WORD ONLY from the passage for each answer.

7 Certain diseases have disappeared, thanks to better _________ and healthcare.

8 Because there is more contact between people, _________ are losing their usefulness.
9 Disease-causing ________ are most likely to be found in hot, damp regions.
10 One cause of pollution is _________ that burn a particular fuel.
11 The growth of cities often has an impact on nearby __________.
12 _________ is one disease that is growing after having been eradicated.
13 A physical barrier such as a _________ can prevent people from reaching a hospital.

The Columbian Exchange

A
Millions of years ago, continental drift carried the Old World and New World apart, splitting North and South
America from Eurasia and Africa. That separation lasted so long that it fostered divergent evolution; for
instance, the development of rattlesnakes on one side of the Atlantic and of vipers on the other. After 1492,
human voyagers in part reversed this tendency. Their artificial re-establishment of connections through the
commingling of Old and New World plants, animals, and bacteria, commonly known as the Columbian
Exchange, is one of the more spectacular and significant ecological events of the past millennium.
B
When Europeans first touched the shores of the Americas, Old World crops such as wheat, barley, rice,
and turnips had not travelled west across the Atlantic, and New World crops such as maize, white potatoes,
sweet potatoes, and manioc had not travelled east to Europe. In the Americas, there were no horses,
cattle, sheep, or goats, all animals of Old World origin. Except for the llama, alpaca, dog, a few fowl, and
guinea pig, the New World had no equivalents to the domesticated animals associated with the Old World,
nor did it have the pathogens associated with the Old World’s dense populations of humans and such
associated creatures as chickens, cattle, black rats, and Aedes aegypti mosquitoes. Among these germs
were those that carried smallpox, measles, chickenpox, influenza, malaria, and yellow fever.
C
As might be expected, the Europeans who settled on the east coast of the United States cultivated crops
like wheat and apples, which they had brought with them. European weeds, which the colonists did not
cultivate, and, in fact, preferred to uproot, also fared well in the New World. John Josselyn, an Englishman
and amateur naturalist who visited New England twice in the seventeenth century, left us a list, “Of Such
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Plants as Have Sprung Up since the English Planted and Kept Cattle in New England,” which included
couch grass, dandelion, shepherd’s purse, groundsel, sow thistle, and chickweed.

One of these, a plantain (Plantago major), was named “Englishman’s Foot” by the Amerindians of New
England and Virginia who believed that it would grow only where the English “have trodden, and was never
known before the English came into this country”. Thus, as they intentionally sowed Old World crop seeds,
the European settlers were unintentionally contaminating American fields with weed seeds. More
importantly, they were stripping and burning forests, exposing the native minor flora to direct sunlight, and
the hooves and teeth of Old World livestock. The native flora could not tolerate the stress. The imported
weeds could, because they had lived with large numbers of grazing animals for thousands of years.
D
Cattle and horses were brought ashore in the early 1600s and found hospitable climate and terrain in North
America. Horses arrived in Virginia as early as 1620 and in Massachusetts in 1629. Many wandered free
with little more evidence of their connection to humanity than collars with a hook at the bottom to catch on
fences as they tried to leap over them to get at crops. Fences were not for keeping livestock in, but for
keeping livestock out.
E
Native American resistance to the Europeans was ineffective. Indigenous peoples suffered from white
brutality, alcoholism, the killing and driving off of game, and the expropriation of farmland, but all these
together are insufficient to explain the degree of their defeat. The crucial factor was not people, plants, or
animals, but germs. Smallpox was the worst and the most spectacular of the infectious diseases mowing
down the Native Americans. The first recorded pandemic of that disease in British North America detonated
among the Algonquin of Massachusetts in the early 1630s. William Bradford of Plymouth Plantation wrote
that the victims “fell down so generally of this disease as they were in the end not able to help one another,
no, not to make a fire nor fetch a little water to drink, nor any to bury the dead”. The missionaries and the
traders who ventured into the American interior told the same appalling story about smallpox and the
indigenes. In 1738 alone, the epidemic destroyed half the Cherokee; in 1759 nearly half the Catawbas; in
the first years of the next century, two thirds of the Omahas and perhaps half the entire population between
the Missouri River and New Mexico; in 1837-38 nearly every last one of the Mandans and perhaps half the
people of the high plains.
F
The export of America’s native animals has not revolutionised Old World agriculture or ecosystems as the
introduction of European animals to the New World did. America’s grey squirrels and muskrats and a few
others have established themselves east of the Atlantic and west of the Pacific, but that has not made
much of a difference. Some of America’s domesticated animals are raised in the Old World, but turkeys
have not displaced chickens and geese, and guinea pigs have proved useful in laboratories, but have not
usurped rabbits in the butcher shops.
G
The New World’s great contribution to the Old is in crop plants. Maize, white potatoes, sweet potatoes,
various squashes, chiles, and manioc have become essentials in the diets of hundreds of millions of
Europeans, Africans, and Asians. Their influence on Old World peoples, like that of wheat and rice on New
World peoples, goes far to explain the global population explosion of the past three centuries. The
Columbian Exchange has been an indispensable factor in that demographic explosion.
H
All this had nothing to do with superiority or inferiority of biosystems in any absolute sense. It has to do with
environmental contrasts. Amerindians were accustomed to living in one particular kind of environment,
Europeans and Africans in another. When the Old World peoples came to America, they brought with them
all their plants, animals, and germs, creating a kind of environment to which they were already adapted,
and so they increased in number. Amerindians had not adapted to European germs, and so initially their
numbers plunged. That decline has reversed in our time as Amerindian populations have adapted to the
Old World’s environmental influence, but the demographic triumph of the invaders, which was the most
spectacular feature of the Old World’s invasion of the New, still stands.

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Questions 1-8
Reading Passage has eight paragraphs A-H.
Which paragraph contains the following information?
Write the correct letter A-H in boxes 1-8 on your answer sheet.

1 A description of an imported species that is named after the English colonists

2 The reason why both the New World and Old World experienced population growth
3 The formation of new continents explained
4 The reason why the indigenous population declined
5 An overall description of the species lacked in the Old World and New World
6 A description of some animal species being ineffective in affecting the Old World
7 An overall explanation of the success of the Old World species invasion
8 An account of European animals taking roots in the New World

Questions 9-12
Do the following statements agree with the claims of the writer in Reading Passage?
In boxes 9-12 on your answer sheet write

TRUE if the statement agrees with the information

FALSE if the statement contradicts the information
NOT GIVEN if there is no information on this

9 European settlers built fences to keep their cattle and horses inside.
10 The indigenous people had been brutally killed by the European colonists.
11 America's domesticated animals, such as turkey, became popular in the Old World.
12 Crop exchange between the two worlds played a major role in world p

Questions 13-14
Answer the questions below using NO MORE THAN THREE WORDS from the passage for each answer.

13 Who reported the same story of European diseases among the indigenes from the American
interior?
14 What is the still existing feature of the Old World's invasion of the New?

Ants Could Teach Ants

The ants are tiny and usually nest between rocks in the south coast of England. Transformed into research
subjects at the University of Bristol, they raced along a tabletop foraging for food -and then, remarkably,
returned to guide others. Time and again, followers trailed behind leaders, darting this way and that along
the route, presumably to memorize land- marks. Once a follower got its bearings, it tapped the leader with
its antennae, prompting the lesson to literally proceed to the next step. The ants were only looking for food
but the researchers said the careful way the leaders led followers -thereby turning them into leaders in their
own right -marked the Temnothorax albipennis ant as the very first example of a non-human animal
exhibiting teaching behavior.

"Tandem running is an example of teaching, to our knowledge the first in a non-human animal, that involves
bidirectional feedback between teacher and pupil," remarks Nigel Franks, professor of animal behavior and
ecology, whose paper on the ant educators was published last week in the journal Nature.

4
No sooner was the paper published, of course, than another educator questioned it. Marc Hauser, a
psychologist and biologist and one of the scientists who came up with the definition of teaching, said it was
unclear whether the ants had learned a new skill or merely acquired new information.

Later, Franks took a further study and found that there were even races between leaders. With the
guidance of leaders, ants could find food faster. But the help comes at a cost for the leader, who normally
would have reached the food about four times faster if not hampered by a follower. This means the
hypothesis that the leaders deliberately slowed down in order to pass the skills on to the followers seems
potentially valid. His ideas were advocated by the students who carried out the video project with him.

Opposing views still arose, however. Hauser noted that mere communication of information is
commonplace in the animal world. Consider a species, for example, that uses alarm calls to warn fellow
members about the presence of a predator. Sounding the alarm can be costly, because the animal may
draw the attention of the predator to itself. But it allows others to flee to safety. “Would you call this
teaching?” wrote Hauser. “The caller incurs a cost. The naive animals gain a benefit and new knowledge
that better enables them to learn about the predator’s location than if the caller had not called. This
happens throughout the animal kingdom, but we don’t call it teaching, even though it is clearly transfer of
information.”

Tim Caro, a zoologist, presented two cases of animal communication. He found that cheetah mothers that
take their cubs along on hunts gradually allow their cubs to do more of the hunting -going, for example,
from killing a gazelle and allowing young cubs to eat to merely tripping the gazelle and letting the cubs
finish it off. At one level, such behavior might be called teaching -except the mother was not really teaching
the cubs to hunt but merely facilitating various stages of learning. In another instance, birds watching other
birds using a stick to locate food such as insects and so on, are observed to do the same thing themselves
while finding food later.

Psychologists study animal behavior in part to understand the evolutionary roots of human behavior,
Hauser said. The challenge in understanding whether other animals truly teach one another, he added, is
that human teaching involves a “theory of mind” -teachers are aware that students don’t know something.
He questioned whether Franks’s leader ants really knew that the follower ants were ignorant. Could they
simply have been following an instinctive rule to proceed when the followers tapped them on the legs or
abdomen? And did leaders that led the way to food -only to find that it had been removed by the
experimenter -incur the wrath of followers? That, Hauser said, would suggest that the follower ant actually
knew the leader was more knowledgeable and not merely following an instinctive routine itself.

The controversy went on, and for a good reason. The occurrence of teaching in ants, if proven to be true,
indicates that teaching can evolve in animals with tiny brains. It is probably the value of information in social
animals that determines when teaching will evolve rather than the constraints of brain size.

Bennett Galef Jr., a psychologist who studies animal behavior and social learning at McMaster University in
Canada, maintained that ants were unlikely to have a “theory of mind” -meaning that leader and followers
may well have been following instinctive routines that were not based on an understanding of what was
happening in another ant’s brain. He warned that scientists may be barking up the wrong tree when they
look not only for examples of humanlike behavior among other animals but humanlike thinking that
underlies such behavior. Animals may behave in ways similar to humans without a similar cognitive system,
he said, so the behavior is not necessarily a good guide into how humans came to think the way they do.

Questions 1-5
Look at the following statements (Questions 1-5) and the list of people in the box below.
Match each statement with the correct person, A, B, C or D.
Write the correct letter, A, B, C or D, in boxes 1-5 on your answer sheet.
NB You may use any letter more than once.

5
1 Animals could use objects to locate food.
2 Ants show two-way, interactive teaching behaviors.
3 It is risky to say ants can teach other ants like human beings do.
4 Ant leadership makes finding food faster.
5 Communication between ants is not entirely teaching.

List of People
A Nigel Franks
B Marc Hauser
C Tim Caro
D Bennett Galef Jr.

Questions 6-9
Choose FOUR letters, A-H
Write your answers in boxes 6-9 on your answer sheet.
Which FOUR of the following behaviors of animals are mentioned in the passage?

A touch each other with antenna

B alert others when there is danger
C escape from predators
D protect the young
E hunt food for the young
F fight with each other
G use tools like twigs
H feed on a variety of foods

Questions 10-13
Do the following statements agree with the claims of the writer in Reading Passage?
In boxes 10-13 on your answer sheet, write
YES if the statement agrees with the claims of the writer
NO if the statement contradicts the claims of the writer
NOT GIVEN if it is impossible to say what the writer thinks about this

10 Ants' tandem running involves only one-way communication.

11 Franks's theory got many supporters immediately after publicity.
12 Ants' teaching behavior is the same as that of human.
13 Cheetah share hunting gains to younger ones.

What’s the purpose of gaining knowledge?

A
‘I would found an institution where any person can find instruction in any subject' That was the founders
motto for Cornell University, and it seems an apt characterization of the different university, also in the
USA, where I currently teach philosophy. A student can prepare for a career in resort management,
engineering, interior design, accounting, music, law enforcement, you name it. But what would the founders
of these two institutions have thought of a course called Arson for Profit’? I kid you not: we have it on the
books. Any undergraduates who have met the academic requirements can sign up for the course in our
program in 'fire science’.
B
Naturally, the course is intended for prospective arson investigators, who can learn all the tricks of the trade
for detecting whether a fire was deliberately set, discovering who did it, and establishing a chain of
evidence for effective prosecution in a court of law. But wouldn’t this also be the perfect course for
prospective arsonists to sign up for? My point is not to criticize academic programs in fire science: they are
6
highly welcome as part of the increasing professionalization of this and many other occupations. However,
it’s not unknown for a firefighter to torch a building. This example suggests how dishonest and illegal
behavior, with the help of higher education, can creep into every aspect of public and business life.
C
I realized this anew when I was invited to speak before a class in marketing, which is another of our degree
programs. The regular instructor is a colleague who appreciates the kind of ethical perspective I can bring
as a philosopher. There are endless ways I could have approached this assignment, but I took my cue from
the title of the course: 'Principles of Marketing’. It made me think to ask the students, 'Is marketing
principled?’ After all, a subject matter can have principles in the sense of being codified, having rules, as
with football or chess, without being principled in the sense of being ethical. Many of the students
immediately assumed that the answer to my question about marketing principles was obvious: no. Just look
at the ways in which everything under the sun has been marketed; obviously it need not be done in a
principled (=ethical) fashion.
D
Is that obvious? I made the suggestion, which may sound downright crazy in light of the evidence, that
perhaps marketing is by definition principled. My inspiration for this judgement is the philosopher Immanuel
Kant, who argued that any body of knowledge consists of an end (or purpose) and a means.
E
Let us apply both the terms 'means' and ‘end' to marketing. The students have signed up for a course in
order to learn how to market effectively. But to what end? There seem to be two main attitudes toward that
question. One is that the answer is obvious: the purpose of marketing is to sell things and to make money.
The other attitude is that the purpose of marketing is irrelevant: Each person comes to the program and
course with his or her own plans, and these need not even concern the acquisition of marketing expertise
as such. My proposal, which I believe would also be Kant's, is that neither of these attitudes captures the
significance of the end to the means for marketing. A field of knowledge or a professional endeavor is
defined by both the means and the end;hence both deserve scrutiny. Students need to study both how to
achieve X, and also what X is.
F
It is at this point that ‘Arson for Profit’ becomes supremely relevant. That course is presumably all about
means: how to detect and prosecute criminal activity. It is therefore assumed that the end is good in an
ethical sense. When I ask fire science students to articulate the end, or purpose, of their field, they
eventually generalize to something like, ‘The safety and welfare of society,’ which seems right. As we have
seen, someone could use the very same knowledge of means to achieve a much less noble end, such as
personal profit via destructive, dangerous, reckless activity. But we would not call that firefighting. We have
a separate word for it: arson. Similarly, if you employed the ‘principles of marketing’ in an unprincipled way,
you would not be doing marketing. We have another term for it: fraud. Kant gives the example of a doctor
and a poisoner, who use the identical knowledge to achieve their divergent ends. We would say that one is
practicing medicine, the other, murder.

Questions 1-6
Reading Passage has six sections, A-F.
Choose the correct heading for each section from the list of headings below.
Write the correct number, i-viii, in boxes 1-6 on your answer sheet.

1 Section A
2 Section B
3 Section C
4 Section D
5 Section E
6 Section F

List of Headings
i Courses that require a high level of commitment
ii A course title with two meanings
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iii The equal importance of two key issues
iv Applying a theory in an unexpected context
v The financial benefits of studying
vi A surprising course title
vii Different names for different outcomes
viii The possibility of attracting the wrong kind of student

Questions 7-10
Complete the summary below.
Choose NO MORE THAN TWO WORDS from the passage for each answer.
Write your answers in boxes 7-10 on your answer sheet.

The ‘Arson for Profit’ course

This is a university course intended for students who are undergraduates and who are studying
(7)__________. The expectation is that they will become (8)___________ specialising in arson.
The course will help them to detect cases of arson and find (9)____________ of criminal intent,
leading to successful (10)___________ in the courts.

Questions 11-14
Do the following statements agree with the claims of the writer in Reading Passage?
In boxes 11-14 on your answer sheet, write
YES if the statement agrees with the claims of the writer
NO if the statement contradicts the claims of the writer
NOT GIVEN if it is impossible to say what the writer thinks about this

11 It is difficult to attract students onto courses that do not focus on a career.

12 The ‘Arson for Profit’ course would be useful for people intending to set fire to buildings.
13 Fire science courses are too academic to help people to be good at the job of firefighting.
14 The writer’s fire science students provided a detailed definition of the purpose of their studies.