JHeart Disease and C~anging Rttitudes

In the last decades of the ~ ?tie~ .s~n_wry,_ medical :esearcher8

showed that heart disease is asso~ with certam factors m our da.
lives: stress, smoking, poor nutrition, and lack of exercis~. octors
e healt experts egan to emp asize t e act that we can redu
the risk of heart disease by paying at~ention to t~se fac!2rs~ As c:
result, many people realize that there 1s a connectij)n 6a\veen hea
disease and lifestyle. 1
rt
. This new awareness is ~hanging public attit~d~s about heahh. In 1
~ 4 ' the past, peopl; tended to think that it was suff1c1en~ to have access
to doctors on whose expertise they could rely, Now.people understand
&_ that merely ~eceiving the best treatmentror ill~e~s. or " i n ~
~nou~_They have learned to take m9'effponsibiht~'Jor mamtain.

i 1JZ \~ ~
a11:d 1~pr?vi~g their own healt%( h~
~1ft !A.atti~udecan be seen m some_ behav10ral changes that
l,,-(j'have occurred since the 1970s. In the Umted State~ today, many
, & smokers have broken the habit and fewer people take 1t up. The per-
centage of smokers is far below the level of the 1960s and 1970s.
Peo_ple are ?ecomi!l,g more serious about reducing: stress. Many have
changed their diets and are eating food with less fat and c~sterol.
More people are aware of the benefits of regular and frequent exercise
like walking, running, and swimming; sonie even walk or bicycle to
work instead of driving or -using public transportation.
The health effects of these changes in attitude and behavior are
clear. Since the 1950s, the number of deaths from heart disease per
100,Jl.O0 has fallen. (See Figure I.I.) A partial explanation for this is
tha~e~~r diagnosis and treatment is helpi!}g people avoid or survive
h~a1:_ at~:~~~ _!!oweve__&, healt~,,experts have no dou5Cfh:at mucb of
_ ___g_____ -~nt has occurrea because a better-educated public has
become aware of the benefits o~vention. ,'Y\
FIGURE 1.1 U.S. Deaths from Heart Disease 1950-2000
 J Heart msease ana C~anging fltliluOes
In the last decades of the _J~e!,!tie~ .c~,JYry,_ medical _researchers
showed that heart disease is ass~ with certam factors m our d .
· ·· dl k f . aiJy
hves: stress, smoking, poor nutnt10n, an ac O exercise. octors and
e healt experts egan to emp asize t e act that we can redu
1:his isa continuing itlea. the risk of heart disease by paying at~ention to t~es~ c:
rs: As
.Checl< hack} nllitigolight· r~sult, many people re~at there 1s a connectlf)D between heart
'the, ·
l
d1s~ase and lifestyle. t4 \dI 1

* y. .
• _
mea
_This new awareness is changing public attit~d~s about health. In
the past, peopl; tended to ~ink that it was sufficien!l0 have access '
to doctors on whose expertise they could rely,~ ow.-peop~~
that merely ~eceiving the best treatmentror tll~e~s. or mJury_ 1s not
\
,-., ~-'i~e a~d i~pr?ving their own health/- fc_,r
They have learned to take m1fponsibihty for mamtain-

z.,J:i ~t' The ~~•ft-!!1-~!~~ude tan be seen m some_ behav10ral changes that
c4 have occurred since the 1970s. In the Umted State~ today, many
, & smokers have broken the habit and fewer people take it up. The per-
centage of smokers is far below the level of the 1960s and 1970s.
People are becoming more serious about reducing stress. Many have
changed their diets and are eating food with less fat and cholesterol.
More people are aware of the benefits of regular and frequentexercise
like walking, running, and swimming; sonie even walk or bicycle to
work instead of driving or using public transportation.
The health effects of these changes in attitude and behavior are
clear. Since the 1950s, the number of deaths from heart disease per
100,~0 has fa~len. (See Figure 1.1.) A partial explanation for this is
tha~ett~r_diagnosis and treatment is helpi1;1g'people avoid or survive
heart attacks.l .!:!,owev~ healt_!r,experts have no dou6ftl:fat much of
~ " . : ~ ~nt has occurrea because a better-educated public has
become aware of the benefits o~evention. ~,i) ,"'r\
d' - ~}..
FIGURE 1.1 U.S. Deaths from Heart Disease 1950-2000
MAIN IDEA CHECK
Identify the sentence that best expresses the main idea of the article.
f
a Betterhmethods
d' of d, iagnosis
· · an d treatment have
. reduced the number of deaths
ram eart isease in the United States.
h Medical research has shown that people should reduce the amount of fat they eat.
c As a result of information about the causes of heart disease people are changing
the way they think about health care and are leading healthier lives.
d The percentage of Americans who smoke today is much lower than it was in the
1970s. -·

A CLOS ER LOOK
Look back at the article to answer the following questions.
1 What facto! does the writer not associate with heart disease?
a Unhealthy food
b Cigarettes

d Lack of regular exercise

2 Tbe article suggests that doctors in the past did.not always inform their
patients about the importance of exercise and good nutrition for health.
True or False? y/1" - . .. . . - '.
3 According to the article, what happens to Ym,1r risk of getting heart disease il
you don't smoke, if you exercise regularly, and if you redute the fat in your
food? .- _,. -
a The risk increases. ·"/
b The risk decreas~s. 1'
c The risk remains the same.
d The
. article does not discuss this question. ~'<'"' '~\
"' 4 What cllange in attitude does the writer describel
a More and more people are realizing that medical science can ~.!'':art ~~sf .
@ any people are realizirig that thq ?<?~ d their h~ -
c More and more people are realizing that they need a good doctor.
d A decreasing number of people are dying from heart disease.
s It is still too early to see results from the change in attitude that the article
describes. True or FalseX... ·
MAIN IDEA CHECK
Identify the sentence that best expresses the main idea of the article.
f
a Betterhmethods
d' of dia
, gnosis· and treatment have
. reduced the number of deaths
rom eart isease m the United States.
own t at peop1e should reduce the amount of fat they eat.
b Medical research has sh h
c ~ea result of information about the causes of heart disease, people are changing
way they thmk about health care and are leading healthier lives.
d The percentage of Americans who smoke today is much lower than it was in the
1970s. -~

A CLOSER LOOK
Look back at the article to ans.wer the following questions.
1 What facto! does the writer not associate with heart disease?
a Unhealthy food .
b Cigarettes
~ e r t y -../
d Lack of regular exercise
2 The article suggests that doctors in the past did not always inform their
patients about the importance of exercise and good nutrition for health.
True or False? ~ · . ,. . · r

3 According to the article, what happens to 'yeµr risk of getting heart disease ii
you don't smoke, if you exercise regufarly, and if you reduce the fat in your
food? .
a The risk increases. '~/
b The risk decreases. \ i

c The risk remains the same.

d The article does not discuss this question.

' 4 Wh~t cnange in attitude does the writer describe?

a More and more people _are realizing that medical science can s_ure_]it..';!!!1.dj,se, .
@ any people are reahzmg that th<:y should tal<::~~9! their h~ - _
c More and more people are realizing that they need a good doctor.
d A decreasing number of people are dying from heart disease.
It is still too early to see results from the change in attitude that the article
0
describes. True or FalseV\._ .
 VOCABULARY STUDY: SYNONYM(..\. (}.M<,Q_ Wli-~3 )
Find words in the article that are similar in meaning to the following.
a period of ten Y~ears (n) Par. 1
2 to be connected with something or someone (v) Par. 1 Cl....½o~ '-0 ( R_
3 pressure (n) Par. 1 ·
4 the food the body needs (n) Par. 1 'l\U.W,' .
S to give special importance \o something (v) Par. 1 ~ a "' -.
6 . realization (n) Par. 2 u_~ ~ .\-4~ \
7 enough (ad;) Par. 2
8 to depend on someone or something (v) Par. 2
9 only (adv) Par. ~ · d. \ ·
10 to keep something m good condition (v) Par. 2 ~ -~ 'I\
11 the food a person eats (n) Par. 3 cl,d
12 happening often (ad;) Par. 3 f-~t..4-
1.3 the way people think and feel about something (n) Par. 4 o.:t¼tJe--
14 a feeling of not being sure (n) Par. 4 fl.~ t
15 helpful effect (n) Par. 4 \ a-.f '-"""- "'1.

VOCABULARY STUDY: WORDS IN CONTEXT

Complete the-sentences with words from the list below. If necessary, review the

t "\°'
WQtds in the Key Vocabulary from e Readings on page 245. ·
l.::J 9'-:$~ d-,
y

~r

· A vitamin deficiency occurs when a person's diet does not have

;;:::, ·" 4 ~lici_~ ,~vitamins to maintain good health_......,./- -

cJ,t We ne~Y to ~ eart dis~ase as early as possible if_ w_e want to

increase our chances of treating1 t successfully. ·, · ·
.l Becallse early diagnOsis is fui;o-;;an;, yo~ ;hould have ~ - - -
examinations by your doctor. (J .
4 Some people _ _,t,~.e/1 _not to think about their health until they
become ill. Clearly they still don't understand the importance of prevention.
5 Stress and smoking are ~ f :,M~,J,_ that increase the risk of heart
disease. Two others are diu ; ~high blood pressure.
6 Medical scientists a're researching new ways to fight cancer. Some of these
have been successful in studies on human patients.
7 Bechuse of modern med1cme, many people -~.!J::l,. diseases and
injuries that would have killed them several decades ago.

1 n I l ~IIT 1
 VOCABULARY STUDY: SYNONYM( ,S OM<ii_ \Mll_l,\N\.ty\J ) .
Fmd
. wards m
. th e ar ti'cle that are similar in meanmg to the followmg.
1 a period of ten y_ears (n) Par. 1

2 to be connected with something or someone (v) Par. 1 Cl.M o~ VJ. (

3 pressure (n) Par. 1
4 the food the body needs (n) Par. 1 .
5 to give special importance to someth~ng (v) Par. 1 ~ a 'I\ '
u..~ ~ .\-Q"'-d_ i
6 . realization (n) Par. 2
7 enough (adj) Par. 2 /4,..t.pft'~
8 to depend on someone or something (v) Par. 2
9 only (adv) Par. 2 0 _
'1J.1.,.
10 to keep something in good condition (v) Par. 2 "'-
11 the food a person eats (n) Par. 3 d.._1 d
12 happening often (adj) Par. 3 r-~t..--1.
n the way people think and feel about something (n) Par. 4 e_..
14 a feeling of not being sure (n) Par. 4 d._~ t
15 helpful effect (n) Par. 4 ,· ~...-- a'4 '---- {I__ V'l.

VOCABULARY STUDY: WORDS IN CONTEXT

Complete the sentences with words from the list below. If necessary, review the
WQ!"ds in the Key Vocabulary from e Readings on page 245. . ·
C>\ 0::~-- .... ··• =" '
t./(),-. .v~11',)F' •
.. .
.. ,
ri
.

'.:> -exp~se ·-~

-4 'j
A vitamin deficiency occurs when a person's diet does not have
r- ,·____,__ v1·t amms
s.-1-.l,,,.1. . . goo d heat
. t o mamtam 1 h....__,,/'
2 We nee .to ~ru Ol'l. ,n.l, /l
increase our chances of treating'it successfully.
,eart dis~ase as early as possible iLw
L

·,
.e\ 'ant to
·
- ' . ~ , 4

-~ Because early diagnosis is important, you should have ...l1La,_t.J~1'_____

examinations by your doctor. (J

4 Some people - ~ not to think about their health until they

become ill. Clearly they still don't understand the importance of prevention. \ .

5 Stress and smoking are -.d._,t,.__r,,- ~ a that increase the risk o ~

cfJ1-r
disease. Two others are diu ;e~ high blood pressure.

6 ~:i:e:;;: ~:::e::::c:~!e::::i c:::~s;:::::hese

7 Bee use of mode n medicine, many people ~ ~v!,.. diseases and
injuries that would have killed them several decades ago.

10 UNIT 1
 . ,t J

·
'°"·
/J4f;:, till
From
PRACTICE 1
the
.
hst below,
·
fmdh~
sentence of each Item. T
e noun
first
that best continues an idea from the f1·
one has been done for you as an example.
rst
 rFl,-j
,.x .(,,;;} / •
3 It is possible to get excelleri.t medical care in the United States . However, 'r:
many other people don't have 0, C (.4k1 -k3J such care becau; e th ey have
no health insurance.
It t~kes many years of study, training, and hard work to develop the
~ i , . / J . £ . , , that is needed to become a world-class heart sUigeon.
J ifeaith educa~ion teaches people to help di sease, for
example, by ')following a .he~lthy d~et_a0:d e:e;;isipg re_gularly:
. Ft:~:earch -' . . . . ..
Do Int~inei' :Bf l i,bt a,r:y rese~rch to £ind additional, up-to-date infm::mation on heart
disease. .'· ··,> ' ,, . . . -
or~·cu~si,o_n,. , . ., .. . . ·..· .
D1SG,US.$'the following ·q uestioii;'with a partner. . .· .
.:. Yv:hat C:onnkt:tiq n might.th.Jie ;b e betw,e.~P:. hea\ t
•l,I ;,; ,xi6·~,. ,·'<'("S• ""

disease and pove.r ty'?

'
ing.: · .. , . . ,";t . . :'.' ·:'f~ . . .::\ ?;··,: ·,::t,,;;~"·t· . <' ( J.
Writ_ .,. . ·
Write a short t epot t ori .~he/;e~'lflf~gf~Y:P.Y,'r_Xe~~ireh :or your' discussion.
. . • . /'',\'.Jc;,>" .. P?_,\;:?}Ji/...·. ,,;:·, i ' .
 ·t·on of the patient ua"' ...:- ...
rhe _cond1_1 . ·
1 This -~ . president is more negative th.an it \.Y'aS six m
2 The publ1c's.0PI1!1on _o e . . . . . . onths
ago. This· ~ h f und the · · remains
· , of
. tenth-century
.· N orwegian
• hous
. ·, ..
In J960, researc ers o · ·. es_1n
3 Canada. This ~ ··· · . .· ·
4 s~me medical experts believe t~at there ~ l ' . ~ o n bet.w~en heart

disease and bacteria. T h i s ~ · · · . ·

5 The,chance of catching malaria is especially high .in some tropical countries.

This - - - · · · .
To graduate from that _uni_v~~si.tf yof
..n~ . tocli~ e)a.t least three computer .·
6 classes. This ~ -· · l_; ,'?- · .· ·. · • . · .· · . •· . ,
7 In_the _!2Zlls, researchers saiJ tt:iat ·¥".·.ople t.Pday~. ~ld wort on·. 1y)
. 1mr. A
wee~. This . . . L @fi_-..i't, I ~' \ . . . . . . . . • .
8 In many poorer co1tt s, th f!:..aff r. _ot enotigh dQctors or Other hea1t.¥ .
¼ workers. This Ul.., ~I/ .• · · ·
"""'!)' ~nations need t9 help po61er co~trii:.s de'velqp their healthcare
systems. This O,_}.J.l.u:!OJWe.: ~ ~ - - · · .,
IO Tb~ cost of health care10se by l 4 peri ent,¥sh#, '.f'hjs:I ,irl\cMGI.A,Q,..:.:'. ...

ILL PRACTICE 2 C ,-1¼1.~/ ~ 1 11..t1 . ' .. . .· . . :

or e:ich pair of sentences, circle the Continuin '@ell . .' . . , . .:
se!'_~ce._Tben answer the question that cillo . : . . ~ -arker m the secpnd . .
you as an 'example. • · . •• ~s, .'fhe h,rst gne -h as beeµ 4<>ne for

1 The
. traffic w;s very Iow on. th
. e Interstate
· this•· . •·· · . ···· . ·. ·. ·. . · .· ·
5
mmutes late for my class. . · · . ·mornmg.@h~~made me thirfY
Question: What _caused.the $peakei to ·b·· ,·I .. ··f'." . • . .., ,.,
Answer·• n,"y" wa~ . ow . ·
m · , e ~te or cla.ss·l
. -- - . -1 . . ffu:, on
I <
fhe, tnfe.~M J.h'
,, ' , , w •
. ,.•-
In high school stud • --- -~ · - c::. ·, ' ,,; MDYnloc• ·
2 c ~ss.~ a
'
kes i
ents who hav
-- --, e no
·
l!JJ$Jest in the .
·
, ,
o .· . •.· . , '
. "' .
1 ion· t harder for students wh 1- .subJ~ct often disturb the ·-'
Wh
, at may stop good h. h h
o rea, Iy want to learn · · ,-
Quest
- - .. ig · sc o_ol students from _I~a~n1ng? -. . . ·
-

4 · UNIL1 ,' ,
 r ~1
3 A lot of people realize1.___that exer •
,w f\J_A .
i -. A .,,o.~A _
n=~;;;;'ll;\Jl-.!t!ill
J 1~
0
one ·reason for the i;;~reisiilg fo_i:_~~~e;i)l~ ion is
of health clubs. - .. th
-- of Nor ~mencans who are membe~s/
Question:
. What
· realization
· · is· causin .
· g mofe Amenc~ns to join· health ·clubs?
4 The ancient
. Greeks
- · and Egyptians
- ·. r b,nA·•
kne w a great d l'J ' ' 'l · ~ - • )
:!'e Ea~th and the positiOJ?-S of the s~ars §.Qme eoei !1 out tlie ":'ev~m . ts of .
knowledge helped sailors rom anc,entG ·- .'..I? . p _e_bcl,!'ve that ~h~s
three thousan;i-Yem--;go. . . . reec_e ?r E~t tci reach AmeriCa over
Question: Accor~ing to some people, what d · . . .. . - .. ,
• G k ·E - · . ma e 1t possible for the ancient
, f{;!e s or gyptians to _sail .to America i . ·. . . • . :· ..
5 The workers a_re asking·for a -~O percell,t ~n~rease 1 - · . • . -- --
·a· ·. I _. .
etter me 1ca 1 1 n,mra"" h
e d· · . · ---. ~ .--.,--" ' .o.ng~r vacations, and ·
a· · · · · · ·· -·· -- ·
b-·•:--- ------~ ~--t.-~ se . eman s . ~y be .tO'O expensive for the
company to ~_gree to. ' · .· . . · · ,
Question: What demands _ . , will ,the eompany probably
_ . n o t a~cept.
., 2

6 Tom .....f:.r \!!,cJ _nQt geLl!,_ngr _With,him whe~i:~ had ~J!..!Cc~dent an~. _
,,,f~_gir!Y~f!.I
•
'is surprised 'Tom. ..
L___.:.....-- ........ "<":,
. . . ,
Question: What surprise 'Tom? • ..
7 In the sollili~tn: lrnit'ea: st:ii~:~<;:"Kc!'i..i!Qtt;P.'.Wer~ not aUowed to go to t_b~
same _s_cho(JlS as White Chil-<lr.i!! S(J.~~ri:t,!flt;
~-!iilf ~o am.a-sch~olSTThi0 -
( pracf~ontmue until th.e; iy60~, ; _ -:AJ••
1
~\tf · . · · __ · -- · ,
Question: What piactice i;onti,nued !,11:1.tfithi: _196p_s1_• , .. --· .tt .
,- , > • , :r; ,
8 A number of :deVelopin __countries liave''tri~d 'ttit~&ice \>~rth-control .
prograrij :ri1~~
a_!!;~J11~ qve oftimfail~fubeclini~5;t~e ~ilY: 1/ . 1?13°~
experts did not know•··
enough,abouqhe ,4_y;~tl.t l :. a ~
,.,... ,,. ., ........,...--"·» "'--""" •.,.,
of die people,
Q~;ti~-;;; What itt€µipt5'have freq\lently fail~d l , --

9 To improv~ hea_ith ;¥e: the idVi~eritW~m!d ~€ri\i$¢ taxes by niore

than 10. ~ercen t. (!iicli]m incr\¾IS~ now; ~~~i!!:~:~~;~i:!1!.~5.'1::~~::tion,
would be unpopular with most.politicians. : · · ·· · · · ·
QuestiOn: What Would m~st politicians notw,ru1Ho do at this tirod ·
The year 1968 ~as .very~bad for the U~ited sta~es. Both(~ar~L~ t
Jr., leader of-the civil rights mov(:lllellt, and Robe t Kennedy, Who wanteii fo
run for president, were murdered. These events hocked the country.
Question: What events shockedthe United States in 19681
• , • .. . • . j
 .

3 A lot
. of people
f realize(that IIAf
h . , . . e. xercise N.~impQilfillt for health ~eahzat10n
. . 1s
.
one reason or t e increasing numbers of. North A - ~-:-- h~ -- -b ·
·f h l h. 1 b - - . mencans w o are mem ers
o eat cu s. /
Question: What. realization
• . is.·causing
. mof~ Amencans. to join health clubs?
4 The ancient <;;reeks and Egyp_tians knew a gre_at dea½ b~th~ ~of
the Earth
. .. and the pos1t1_ons
. -:---r of
• .the star;l
., Some•. n
~- :.....eop1:_e ·bel'ieve th at''tii·is · ··
knowledge help~d sailors
~ :----- " . rrom. ,ancient Greec·e or· Egypt · ·to reac· h Amenca
_._ • over
three t h ousan d years ago. ·
Question: According. t~ ~ome .people, what made i·t possi'bl e..for t h e ancient . ·
Greeks or Egyptians to _sail _to A'.meric~ i · · ·· · ·
5 The workers are asking for a.20 percen_t ~E::r~§_e, longer vacatiotl~, and
bett~ Q!_Cal msura~, hese demands . ay be ,tO'O expen~ive f~r the
company to agree to. · ' · · . ,
Question: demapd~ will the e?mpany l'_robably not _acCep~l
6 Tom~ r cli<l!iot ge~~,!lgr __with hi1:11 when 'Io~ ha4 .~~~c~dent an~_.
WE~~ e f~~i\y_f_!r
'
Question: What surprise Tom?
~-
'is s~rprised Tom.
'
' . .

7 In the southern United States, ~ -c,k chil~r.en :were not allowed to go to th_e
same s_chools as white childi:~n ~o they were sent to aIF15Iack schOolS.\This]
(11ract~ ontmue until the, 1260s,
Question: Wh:1t pracdce continued untitthe
: , ,•

8 A numbe.r of developm countnes have tned mtroduce \J1rth-corttrol

· ·
. · -

programj ! 4.l)SI' atteJDJ?l:"+ ave often failed bec_ause the ~ly_11!annin!__

experts did not know enoug~ a~ ~t ~h_tliy:ea.and.trad,i.tiop.,s-of the people.
Q~stio~: What· itteµipts have frequently failed1
• "t .'

9 To improv~ hea~th Care, the g~vernme-,;t w-;,uld nee~ raise tax~s by more
0

than 10 percen~- ~~fi]m incrc,ase no:"': ~.!!!:.~~efore,_ ~.'.:._~~:t_':~'::tiCJU,

would be unpopu ar with moi,t ~oht1c1ans. . ·
Question: What •'w ould m~st.politicians
. . .
notw~ntto do at this _. . J " ,,,
'r< '-'V,J~'-0

10 The year 1968 was very bad for the United States. Both~artin Luther Kip_g, •
Jr., leader of the civil rights movement, and Robert Kenne?y, Who w3\nteifi'o
run for president, were murdered. These events hocked the country.
Question: What events shocked-the United States in 1968?
• ' ' • J