Listening Lessons for Intermediate Students Based on cbc manitoba Radio Broadcasts November 27, 2008 Lesson 35: Self Study Edition Topic: Can Immigrating to Canada Make You Sick? Language Skills and Functions: Listening

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Learning English with CBC

Listening Lessons for Intermediate Students
Based on CBC Manitoba Radio Broadcasts
November 27, 2008

Lesson 35: Self Study Edition
Topic: Can Immigrating to Canada Make You Sick?

Language Skills and Functions: Listening – listening to a short interview for main ideas and details
Speaking – expressing opinions
Reading – reading a text for information and answering questions
Language competencies: Vocabulary, Pronunciation, Listening and Speaking Strategies, Sociocultural/sociolinguistic Competence

Language Tasks: Answer questions about stress and the symptoms of stress

Listen for main ideas and details in a radio interview with a cardiologist about immigrants and their risk of developing heart disease

Read statements about stress and decide if they’re fact or myth

Use language to express concern

Read tips for dealing with stress and rate whether you use these tips often, sometimes or never

Read a scenario and give advice on how to handle stress

Essential Skills: Reading text, thinking skills, problem solving

Appendices: Transcript of the podcast
Answers to worksheets

Attention students: You will need to print the lesson to be able to complete the activities.

Manitoba Memo

Most newcomers come to Canada healthy. In fact, when newcomers arrive they are generally in better health than the Canadian-born population. However, the longer they live here, the more their health deteriorates. Their risk of being affected by chronic diseases such as heart disease and diabetes increases each year they live in Canada.

Not all immigrants see their health decline. Immigrants of European descent tend to remain relatively healthy. But immigrants from countries other than Europe are twice as likely as the Canadian-born population to see their health deteriorate.
Doctors think they can explain this worrisome trend in immigrant health. They believe it is partly due to the fact that settling in a new country takes a lot of time and energy. Newcomers are so busy in their new lives it’s hard to find time to improve their health by making healthy meals, exercising regularly and managing stress levels.
The good news is that the trend toward deteriorating health in Canada’s immigrant population can be prevented. Awareness of the problem is the first step. Education about how to change behaviour and stay healthy is the second step. And regular monitoring by doctors and other health care professionals will not only help prevent the development of chronic disease, it will also ensure that any symptoms which develop are treated early, before they become serious.


1. Before you listen, think about the following questions about stress
Here are some background questions on today’s topic. Remember that thinking about the topic before you listen to the radio broadcast will provide a context for what you are about to hear.

    • Is there an actual word for stress in your country? Or is it described by its symptoms? For example, instead of saying you feel stressed would you say you feel tense or your neck hurts or you feel a lot of pressure?

    • What is stress? What are some of the physical symptoms of stress? What are some of the behaviourial symptoms (for example, being angry or upset)?

    • In your country, if you felt that stress was affecting your emotional or physical health in a negative way, would you go to a doctor? Why or why not?
    • Do you think newcomers and immigrants feel more stress or less stress in their lives than other Canadians? Why is that?

    • What are some of the ways you personally cope with stress?

2. Decide if it’s a stress fact or a stress myth

Read the following statements about stress. Are they a fact (F)? Or are they a myth (M)? A myth is something people may believe to be true, but which is not actually true. It isn’t supported by the facts. The first one is completed as an example.



M or F


Some types of stress are actually good for you.



Worrying cannot make your physically sick.


Some people are more likely to experience stress than others.


If you make a good income you are generally happier and experience less financial stress.


Children’s lives aren’t as stressful as adult lives. They generally don’t need help dealing with stress.


Stress can make your hair fall out.


Stress can lead to weight gain or weight loss.


Stress can cause serious illnesses like diabetes and heart disease.


If you get stressed, you often catch a cold.


Long-term exposure to stress can also lead to mental health problems, such as depression and anxiety.

3. Words you need to know

Here are a few words you need to know to understand the podcast.
insight A clear understanding of something. For example, Dr. Chow’s own experience as an immigrant has given him greater understanding or insight into the health problems that immigrants experience.

cardiologist A doctor who specializes in cardiology or treating heart disease.

designated spokesperson The person who is designated or chosen by an organization to speak on their behalf on a topic or an issue.

hardening of the arteries The arteries are the tubes that carry blood from the heart to the rest of the body. If cholesterol plaque builds up on the artery walls, the arteries become harder and narrower. This makes it more difficult for blood to flow.

shed light To make something easier to understand by providing new or better information. For example, sometimes a study may shed light on or provide information about the cause of a particular health problem.

heart attack A sudden serious medical condition where the heart stops working. Symptoms include pain, shortness of breath, nausea, sweating and anxiety. Anyone with these symptoms should call (or have someone else call) 911 or their local emergency number right away.

stroke When someone has a stroke, the artery carrying blood to their brain is blocked or bursts. Symptoms include weakness or numbness in the face, arm or leg, trouble speaking, vision problems, severe or unusual headaches and dizziness. Anyone with these symptoms should call (or have someone else call) 911 or their local emergency number right away.

stress Most people think of stress as something that involves an event (being injured, moving, losing a job) and our physical or emotional response to that event. But while certain situations in life do lead to stress, it is how we perceive these situations and our ability to cope with them that determine our stress levels and whether they affect our health.

speculate To guess about the cause or effect of something, even though you don’t know all the facts or details.

aspect of something A part or feature of something. For example, a research study may explore several aspects or parts of a topic.

Heart and Stroke Foundation A non-profit organization that works toward the goal of eliminating heart disease and stroke. The organization undertakes research and promotes healthy living.

processed food Processed food has substances added to preserve it or to make it look more appetizing. For example, processed cheese has artificial flavour and colouring.

prepared meals Prepared meals are ready to eat. All you need to do when you get them home is eat them (some may need to be heated). Examples include sandwich meat, a frozen TV dinner or a sushi plate.

fast food Fast food are foods you can eat quickly. Certain kinds of restaurants specialize in fast foods, including MacDonalds, Kentucky Fried Chicken and A and W. Typical fast food items in Canada are hamburgers, hot dogs and french fries.
4. Listen to the podcast
In this story, Marilyn Maki interviews Dr. Chi Ming Chow about a study which shows that immigrants, and especially non-European immigrants, are at greater risk for heart disease and stroke the longer they live in Canada. What else do you think the study might have found out about the health of immigrants to Canada?
I think the study might have found that stress is affecting the health of immigrants to Canada.

Perhaps the study found that immigrants are changing their diet after they move to Canada.

One possible finding is that …

It’s quite likely that the study found that...

I don’t have any idea what the study might have found.
5. Get ready to listen

In this podcast, you will hear several speakers. You will hear:

Marcy Markusa – host

Marilyn Maki – host/interviewer

Dr. Chi Ming Chow – cardiologist
Play the audio for the first time.
6. Listen for main ideas and details
When you listen to the interview this time, listen for main ideas and details. Read the questions below before you listen so you will know what to listen for. Reading the questions in advance may also give you clues which will help you better understand the interview.
1. Dr. Chow talks about the stress immigrants face when they first come to a new country. What are some of the reasons he gives for the high levels of stress immigrant’s experience?

He gives several reasons why immigrant stress levels are high. For example, he says

that __________________________________________________________________


2. Are there other stress factors immigrants experience which Dr. Chow doesn’t mention? What are they?

Other stress factors include________________________________________________


3. How does Dr. Chow think immigrant’s eating habits change after they come to Canada?
He thinks immigrant’s eating habits change in several ways. For example,


4. Do you think immigrants usually change their eating habits in a new country? Why?
Yes, I think they do/ No I don’t think they do because ______________________


After you listen

a) Review your pre-listening predictions
Quickly review your pre-listening predictions. Were you able to correctly predict what the study found?
b) Match stress symptoms and descriptions
If you want to talk to someone your stress symptoms, it’s helpful to be able to name the symptom and describe how it makes you feel. In this exercise, match the symptom from the box below with the description. The first one is completed for you as an example.
headache fatigue gastrointestinal problems unable to focus isolation
sleep disturbance or insomnia anxiety heart palpitations irritability

weight loss weight gain

1. Your clothes are getting tight. weight gain
2. Your heart beats loudly and quickly. _________________________________________
3. You keep losing your temper and
are easily annoyed. _________________________________________
4. You feel worried almost all the time. _________________________________________
5. Your stomach is upset. You have
cramps and gas. _________________________________________

6. Your head hurts and throbs. _________________________________________

7. You are not very efficient. You
are worrying about a lot of things. _________________________________________
8. You aren’t sleeping well. Some
nights you don’t sleep at all. _________________________________________
9. Your clothes are getting loose. _________________________________________
10. You feel alone and isolated. _________________________________________
11. You feel tired almost all the time. _________________________________________
c) Use language to express concern
Sometimes, we need language to respond to information that concerns us. We also need to be able to say that we are not concerned. One of the times when we need language to express concern is when we talk about issues which affect our health, or the health of others. What do we say? How do we respond? The statements below provide additional information about the health risks many immigrants to Canada experience. Read each statement and then make a note about how you would respond.

Language to Express Concern

Language to Use if You Are Not Concerned

I was concerned to hear that.

That’s a real concern to me because…

What concerns me the most is…

That finding concerns me because...

That worries me because…

That should concern all of us.

That doesn’t concern me.

That’s doesn’t concern me at all.

That’s less of a concern to me.

That finding doesn’t concern me because…

That doesn’t worry me at all.

  1. Immigrants face so many challenges in a new country that they often don’t pay attention to their own health.

    Your response:____________________________________________________

  2. Immigrants who aren’t from European countries are at greater risk of developing risks for heart disease and diabetes than immigrants from European countries.

Your response:____________________________________________________

  1. In Manitoba, family doctors recommend annual physicals (check-ups) to help prevent the development of serious risk factors for heart disease and diabetes. But some newcomers do not realize annual check-ups are free under Medicare or they are concerned they don’t have the language skills they need to discuss their health with a doctor. Their symptoms are not treated and become more serious over time.

Your response: ____________________________________________________

  1. An immigrant to Canada can be healthy on arrival but their health can begin to deteriorate within their first six months in their new country.

Your response: ____________________________________________________

d) Rate yourself: How do you deal with stress?
The Heart and Stroke Foundation offers 12 Quick Tips for dealing with stress. They call it their “G-E-T-S-T-R-E-S-S-F-I-T” plan. Read each of the tips and then decide whether this is something you do when you are feeling stressed. If it is something you do often when you are feeling stressed, check  that column. If it is something you do sometimes, check  that column. If it is something you never do, check  that column.





Give yourself a break. Go for a walk; get a good night’s sleep; get away from it all.

Eat a healthy diet.

Talk it out.

Spend time with family and friends.

Take a course, for fun or self-improvement.

Relax…with a good book, a great movie or your

favourite music.

Exercise, for example, walk, jog, swim, dance or go to the gym.

Set priorities. Review your goals. Decide what’s most important and focus.

Schedule your time. Set realistic deadlines.

Find alternative sources of satisfaction in your life. What do you enjoy doing? Try to do more of it.

Increase your awareness of what causes your stress. Think about why you are under stress and about your reaction to the situation.

Take action! Deal with the person or situation that’s causing your stress. Find information or resources to help you. Talk to your doctor.

Which of these tips do you think you could use more often to lower your stress level?

e) Give advice on dealing with stress

In this lesson you have learned about the symptoms of stress and ways to cope with stress. Now you can put that knowledge to work and problem solve for Carlos and Maria. First, list the stress related symptoms Carlos and Maria are experiencing. Then write down what advice you would give them to help them deal with the stress they are experiencing. Use the chart below to help you.


Carlos and Celia arrived in Canada a year ago. They are happy to be safe in Canada, but they are both experiencing a lot of sadness and homesickness. This past year has involved many major changes in their life and these changes have created stress. Sometimes the pressure gets to be too much. Celia has problems sleeping, so she is always very tired at work. She is losing weight because she never feels like eating. Carlos is frustrated at work, because he can’t find a job in his profession. He is underemployed. Celia has noticed a big change in Carlos’ temperament. There are many angry outbursts and then Carlos is very quiet. Celia is afraid to say anything to anybody. In her culture, people do not talk about personal problems like these outside of the family.

Carlos’ symptoms

Advice to Carlos

If I were advising Carlos, I would advise him to…

Cecilia’s symptoms

Advice to Cecilia

If I were advising Cecilia, I would advise her to…

Want to know more…
This lesson focuses on stress, but Learning English with CBC lesson 31, The Zimbabwe Hand Jive, covers issues related to healthy eating.
CBC news in Toronto did an excellent series on immigrant health. There are four videos related to physical and mental health which you could watch. View the videos at:
The Canadian Mental Health Association has a good website on stress which includes a “first aid kit for stress. Go to:

The Heart and Stroke Foundation has a lot of good information on their website. There are some translated and targeted materials under multicultural resources:

For CTV news coverage of this story, go to:

(Note: CBC does not endorse and is not responsible for the content of external websites)

Appendix 1: Transcript

Nov 27, 2008





Hi I’m Marcy Markusa and you’re listening to Learning English with CBC. A new study has shown that immigrants to Canada have a greater risk of developing heart disease the longer they live in this country. Marilyn Maki interviews a doctor who has some insight into the study’s findings.



Dr. Chi Ming Chow is a cardiologist at St. Michael’s hospital in Toronto and he’s a designated spokesperson for the Heart and Stroke Foundation. Hi Dr. Chow

Dr. Chow



So you said that you find there was greater hardening of the artery. Do you know why?


Dr. Chow

So this is actually a very interesting study, this particular case, it raised more questions ah than answers at this point. It was one of the first studies that actually shed light onto this particular issues of immigration, ah, in terms of affecting, our our risk of developing future heart attack or stroke. So uhm we don’t actually have a lot of answers why, but one can speculate, ah being an immigrant myself, as well as a physician, who have a lot of immigrate, immigrant population in my practice, ah we see that a lot of immigrants when they first came to Canada, the first 3 to 5 years very stressful for a lot of them. There are lots of things that is involved in moving to an new country, for example, finding a new job, setting, settling into a new place, finding ah schools for your children and many other things.



Dr. Chow


Often the income is reduced. I’ve lots of patients who ah were professionals back in their own country but once they moved to a new country ah then they they have to take lower paying jobs, longer hours, extra shifts that prevent them from actually ah having enough time for themselves, to take care of their own health, ah to exercise, to eat properly as well.




You mentioned stress and you mentioned diet. How does diet change when people come here?

Dr. Chow

Ya, this is a very interesting ah study ah aspect which I think we need more investigation. I think Heart and Stroke is actually gonna pay more attention to it in the future ah in terms of looking how immigrants change the way they eat. But we do from a personal as well as practical point, I see that from a lot of patients, when they’re busy and they don’t have time to prepare meals so they end up buying processed food or prepared meals or they eat fast food because they just don’t have time to do the shopping or actually eat properly during the day.



Answers to Worksheets

Fact or Myth?




Some types of stress are actually good for you.

Fact. The stress you experience when you are excited or having fun, and which lasts for short periods of time, is good for you. But chronic stress which leads to health related symptoms is not good for you.


Worrying cannot make your physically sick.

Myth. If you are constantly worrying and feeling stressed, you can actually become “worried sick” or physically ill.


Some people are more likely to experience stress than others.

Fact. Personality factors contribute to how people experience stress. For example, people who are perfectionists, Type A personalities or pessimists may experience more stress.


If you make a good income you are generally happier and experience less financial stress.
Myth. Making more money does not necessarily equal less stress. This is especially true if you have a lot of debt.


Children’s lives aren’t as stressful as adult lives. They generally don’t need help dealing with stress.

Myth. Children can also experience serious or chronic stress. They can also develop physical and behaviourial symptoms.


Stress can make your hair fall out.

Fact. But you need to check the symptom with your doctor to make sure it is caused by stress and not another medical condition. Stress doesn’t cause baldness.




Stress can lead to weight gain or weight loss.

Fact. Stress can affect eating patterns and digestion. It can lead you to crave less healthy food and/or more food than your body needs. It can affect blood sugar levels and the amount of fat stored around our middle.

Weight gain can also happen because the stress levels in our lives mean we don’t have time to cook good food and we don’t take time to exercise.

Alternatively, you may lose weight because you don’t take time to eat or you don’t feel hungry.


Stress can cause serious illnesses like diabetes and heart disease.

Fact. Stress can lead to weight gain, which is a significant risk factor for diabetes and heart disease. And stress affects your immune system, which means your body is less able to fight off disease.


If you get stressed, you often catch a cold.

Fact: Stress affects your immune system which makes you more likely to catch a cold or the flu.


Long-term exposure to stress can also lead to mental health problems, such as depression and anxiety.

Fact. Serious or chronic stress can lead to mental health problems and illnesses like depression.

Match symptoms and descriptions
1. weight gain

2. heart palpitations

3. irritability

4. anxiety

5. gastronintestinal problems

6. headache

7. unable to focus

8. sleep disturbance or insomnia

9. weight loss

10. isolation

11. fatigue

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