Public Health 200 Final Exam Study Guide

What is the Fairness Doctrine?

A 1968 mandate that advertisements for cigarettes be balanced by public service announcements about their harmful effects

Offering insurance-premium discounts to people who meet health standards or engage in certain health behaviors is an influence from what level of influence within the socio-ecological model?

policy

What is most harmful in cigarettes

the smoke

Unintentional injury deaths, such as motor vehicle deaths, are sometimes described as 'accidents'. Why is the word 'accident' problematic in the context of public health?

'Accident' implies something is not preventable

Mental health problems are a leading cause of disability in the U.S. ________ of Americans experience mental health problems, while ________ experience serious mental illness

- 18% - 4%

The events of ________ including the attack on the World Trade Center and the anthrax bioterrorism attacks temporary provided funding and realigned public health priorities

2001

How much of the 30 year increase in life expectancy since 1900 can be attributed to public health?

25

Compared to passenger cars, for each 100 million passenger miles driven, the death rate for motorcycles is

25 times higher

It is estimated that tobacco is responsible for about _________ deaths per year in the US.

500,000

Which of the following gave the FDA the authority to regulate tobacco products and to restrict advertising and promotion?

Family Smoking Prevention and Tobacco Control Act (2009)

What country was the first to institute a system of national social insurance to provide income support to retirees?

Germany

Approximately what percentage of early deaths are linked to each factor

Health behaviors: 50% Healthcare: 10% Genetics: 20% Social and environmental factors: 20%

Women experience the greatest proportion of fatal occupational injuries for which of the following categories of fatal injury events?

Homicides

Which of the following categories is the cause of the greatest number of injury deaths in the United States today?

Poisonings

The difficulty in losing weight and the tendency for dieters to regain weight both support the concept of

Prevention

Match each of the following prevention factors for death from a motor vehicle crash according to the level of prevention

Primary prevention - better street lighting Secondary prevention - seat belts Tertiary prevention - helicopter transport of victims

Community organizations, faith based organizations, journalists, and politicians are examples of different groups that

Public health must form partnerships with

Age limits on alcohol sales represents an influence at which level of the ecological model

Societal/public policy

Match the tier of the pyramid to the type of public health intervention

Socioeconomic factors- Reducing poverty, increasing education Changing the context to make individual's default decisions healthy- Smoking bans Long-lasting preventive interventions- Vaccinations Clinical interventions- Blood pressure and cholesterol control Counseling and education- Smoking cessation education

Spending on medical care for the elderly near the end of life varies considerably by geography in the United States. Studies have shown that, compared to lower spending areas, high-spending areas have

Somewhat worse survival among the elderly

Mental illness is caused by

The interaction between biological, psychological, and social factors

The Great London Fog that killed over 10,000 people in 1952 alerted us to the dangers of

air pollution

Commercial hazardous waste facilities are disproportionately located in minority neighborhoods. This is considered

an environmental justice issue

Which of the following groups has the highest rate of death by homicide in the United States?

black males

this graph is

dose-response graph

According to the US Department of Transportation, the leading critical reason for motor vehicle crashes is

drivers

All of the following are considered physical hazards, except

driving

Compared to most other high-income countries, the mortality rate from injuries in the United States is

higher

Which of the following statements is true concerning homicide rates from firearms? The homicide rate from firearms in the United States is

highest among high-income countries

Since 1940, the elderly dependency ratio in the United States has

increased

From a public health perspective, which is more important

increasing access to treatment

Health insurance marketplace plans are designed to provide coverage to

individuals who are uninsured or who purchase private insurance on the individual market

Every year, more people die from occupational injuries and illnesses than die from

influenza

Pressure from your friends to smoke weed represents an influence at which level of the ecological model

interpersonal

According to the National Academy of Medicine and the Centers for Disease Control, interventions in which of the following domains will have the greatest impact on population health in future decades?

lifestyle

Which of the following government programs is designed to provide health care coverage for people with high health care needs?

medicare

Which of the three major social programs for the elderly is in the worst fiscal shape now and going into the future?

medicare

Identify the level at which the following risk and protective factors for mental illness among children and young adults occur

negative self-image- individual level parental separation- family level economic resources- family level experience of community violence- community level good peer relationships- school level emotional self-regulation- individual level

On average, which of the following is the greatest source of income for persons 65 and older in the lower half of the income distribution?

social security

Which of the following programs had the greatest impact on poverty among the elderly prior to 1965?

social security

Your textbook discusses prevention strategies for reducing mortality and disability related to premature birth. Which is the focus of US prevention efforts

tertiary prevention

Which of the following are regarded as effective interventions for treating childhood obesity?

- A family-based approach focused on changing behaviors. - Ensuring that children get an adequate amount of sleep. - Encouraging families to eat their meals and engage in activities together. - Working with parents who struggle to establish healthy routines.

Which of the following are current and future challenges facing the U.S. public's health?

- Addressing health disparities - Chronic illnesses - Novel infectious diseases - Climate change - Equitable access to quality health care - COIVD-19 and related health consequences

Which of the following factors influences injury rates in the United States?

- Age - Race - Gender - Socioeconomic status

Overweight and obese children and teens are at increased risk for developing

- Cardiovascular disease - Type 2 diabetes - Endocrine dysfunction - Psychological problems

Which of the following are examples of long-lasting reversible contraception or LARCs

- Contraceptive implants - IUDs

Which of the following are elements of quality of care, according to the Institute of Medicine?

- Equitable - Safe - Effective - Efficient - Patient Centered - Timely

Mental illness is distinguished from temporary mental distress based on which of the following (check all that apply)

- Frequency of symptoms - Degree of impairment - Duration of symptoms

Which of the following are challenges for the US health care system?

- Growing health care costs - Aging population - Uninsured Americans - Shortage of health care providers - Health disparities

The EPA defines exposure assessment is the "process of measuring or estimating the magnitude, frequency, and duration of human exposure to an agent in the environment, or estimating future exposures for an agent that has not yet been released." Benzo[a]pyrene (BaP) in a hamburger which was cooked in a flame broiling process is a carcinogen. To assess exposure to this carcinogen, which question(s) would an exposure scientist ask?

- How burned is the burger? - How frequently does the person eat burned hamburgers? - How long have they been eating burned hamburgers?

Health behaviors encompass the daily choices you make, including

- How much you move your body - What (or how much) you drink - The risks you take - The risks you avoid - What (or how much) you eat - Other steps to promote health or prevent disease (i.e. brushing your teeth)

CDC estimates that about half of maternal deaths in the US are preventable. Mortality rates could be reduced by which of the following

- Improved provider training - Drills to prepare for pregnancy-related emergencies - Better assessment of high-risk patients before, during, and after birth - Increasing supply of specialists for complex or high-risk pregnancies

Elevated concentrations of lead were found in blood samples of people living in a town adjacent to a smelter. Assuming that the primary discharge of lead from the smelter was to the air, which of the following are possible pathways by which the townspeople could have been exposed to lead from the smelter?

- Inhalation of air contaminated by the smelter - Inhalation of contaminated soil - Ingestion of contaminated dust - Contamination of food/water sources

What are some of the public health concerns about e-cigarettes?

- Lack of regulation - E-cigarettes can still contain nicotine. - Aerosol from e-cigarettes contain harmful particles - E-cigarettes could be a gateway into tobacco use. - Lack of research of the potential risks

Which of the following are risk factors for tobacco use?

- Low socio-economic status - Low education level - Mental illness - Substance abuse

Which of the following statements is/are true about cigarette smoke? (check all that apply)

- Of the 7,000 compounds in cigarette smoke, 70 are known carcinogens - The tars in cigarette smoke cause cancer and lung diseases, and increase susceptibility to infectious diseases - Nicotine increases the risk of sudden cardiac death - Cigarette smoke raises total blood cholesterol levels and reduces levels of good cholesterol

In reports issued in 1988 and 2003 the Institute of Medicine found the US public health system to be "in disarray". In particular, which of the following issues were highlighted in these reports as underlying factors in the nation not meeting its potential in the area of population health?

- Overemphasis on medical care rather than preventive services - Overemphasis on biomedical research rather than prevention research - Persistent health disparities related to race, gender, ethnicity, and socioeconomic status

Which of the following government programs are designed to provide health care coverage to low-income children and families?

- SCHIP - Medicaid

Which of the following statements is correct

- Since 1990, maternal mortality has increased in the US - Since 1990, maternal mortality in other wealthy countries has decreased

What's the future of tobacco control?

- Smoke-free environments - Graphic warning labels on cigarette packs - Laws prohibiting smoking in cars with kids - Increasing the minimum age of purchase from 18 to 21

Why did a 2005 Institute of Medicine report call childhood obesity a "critical public health threat"?

- The prevalence of childhood obesity has been increasing. - Overweight and obese children are particularly vulnerable to stigma and its psycho-social implications. - Overweight children are more prone to becoming overweight adults.

Which of the following are factors that could increase breastfeeding?

- The sacred hour: not separating mothers and infants until after first breastfeeding - Providing lactation education and support - Providing mothers with longer maternal leave - Requiring workplaces to provide lactation rooms

Dr. Frieden argues that public health investments at the lower levels of the pyramid are more effective than those at the top because

- They have the greatest potential population impact - They require the least amount of individual effort

Climate change is a major reason for the spread of Lyme disease because

- Ticks have a broader geographic range due to higher winter temperatures. - Warmer temperatures help ticks reproduce.

Why was the individual mandate included in ACA?

- To ensure that healthy people sign up for insurance - Because ACA required insurers to cover individuals with pre-existing conditions, premiums would be unaffordable unless healthy people are required to participate

What are the ways that the U.S. should consider going about reforming our health care system?

- Using a social justice approach - Competition, or allowing the market to help improve quality and reduce costs - By shifting professional norms - Utilizing a comparative institutional analysis approach

Stress affects our bodies via two different pathways. Pathway one is ________ , causing biological or physical effects to our bodies. Pathway two is ________ , which operates by reducing our willingness or ability to engage in behaviors that promote health

- direct - indirect

People may engage in an unhealthy behavior (like eating cupcakes) because the benefits _________ are while the costs are ________

- immediate - deferred

People with mental illness are _______ likely to be perpetrators of violent crime and _______ likely to be victims of crime

- less - more

Over the last 20 years, the proportion of the US population that is overweight has ________ , and the proportion that is obese has ________

- remained the same - increased

The 2012 Supreme Court Case was a split decision regarding the fate of two key ACA provisions. The Supreme Court upheld the _________ as constitutional, but struck down a requirement for __________

- the individual mandate - Medicaid expansion

Have we achieved the following Healthy People 2010 goals? Increase life expectancy Improve the quality of life Reduce health disparities

- yes - mixed evidence - no

Rank the following tobacco control policy interventions from least effective (4) to most effective (1)

1. increasing the price of cigarettes 2. media campaigns 3. health education 4. labels on cigarette packs

Obesity is a significant burden on our healthcare system. It is estimated that the costs of treating the diseases caused by excess weight account for up to _____ % of total US medical expenditures

20

Which if the following racial/ethnic groups has the highest rate of death by suicide in the United States?

American Indians/Alaska Natives

Disparities in mental health prevalence by socioeconomic status can be attributed to

Experiences of economic deprivation

Which of the following is true

Colleges can play an important role in preventing, identifying and providing treatment to students

Over the last few decades, life expectancy has increased, but the average age of onset of disability among the elderly has increased even more. This pattern is described as

Compression of Morbidity

Over the course of the 20th century an increasing fraction of all deaths have occurred among the elderly. This pattern is described as

Compression of Mortality

In recent decades, while life expectancy has increased, the prevalence of chronic disease has also increased among the elderly, but the rate of disability has declined. This pattern of change is described as

Compression of morbidity

After smoking, the most important modifiable determinant of health among the elderly is

Diet and exercise

The most common type of health care coverage in the US is

Employer-sponsored coverage

According to Schneider, which of the following was more effective at reducing motor vehicle deaths?

Environmental changes, like safer highways and motor vehicles

Where it has been implemented, menu labeling has been an effective public health intervention to reduce the number of calories that people consume

It's hard to say: the evidence is mixed

Match the type of care to the typical setting where care is provided

Long-term care- Nursing homes Acute or emergent care- Hospitals Preventive care- Primary care office

Match each of the following major social programs with it's primary function for the elderly

Medicare- Health insurance for elderly Social Security- Retirement income for elderly Medicaid- Nursing home support for elderly

Mental health symptoms are described as having a u-shaped relationship with age because

Mental illnesses are most common among the young and the elderly

Over the next 40 years, the largest source of projected population growth in the United States will be the result of

Net immigration

The University of Michigan is a tobacco-free campus. Are e-cigarettes also banned on campus?

No (e-cigs banned on medical campus)

Why is it more difficult for people to lose weight than to quit smoking?

Obesity is a complex condition that results from the interplay of genetic, personal, cultural, and social factors

Where do most fatal falls occur?

On the flat in the home

Which of the following drug categories accounts for the greatest fraction of poisoning or overdose deaths?

Opioids (e.g., heroin)

The civilian jobs with the highest rates of fatal work injuries share which of the following features?

Outdoor jobs

Which of the following statements is true

There are large disparities in receipt of mental health treatment by race and ethnicity

What was the primary goal of the Affordable Care Act?

To address insurance coverage and access to care

The increase in US maternal mortality is largely attributable to

chronic disease

When a hazard is identified it is best practice to

eliminate the hazard

To lose weight, a person must

expend more calories than are consumed

According to recent survey data, the majority of Americans view the Affordable Care Act unfavorably

false

Filtered cigarettes and low tar & nicotine cigarettes are less harmful than regular cigarettes

false

Low alcohol consumption is linked with lower rates of heart disease than moderate alcohol consumption

false

The Affordable Care Act was largely based on the health care plan crafted by Hillary Clinton during President Clinton's first term in office

false

True or false: The infant mortality rate in Michigan meets the Healthy People 2020 goal

false

True or false: health spending in the US is strongly informed by return on investment (the degree to which health of the population is improved)

false

True or false: the US and the state of Michigan have adequate surveillance systems to track maternal deaths and maternal morbidity

false

While national or total spending on health care has increased considerably over the past 50 years, due to population growth, per capita health care costs have remained about the same

false

Harm reductionists look at e-cigarettes

favorably

An area where public health has failed to significantly impact behavior change is

firearm use

The sense of having control over one's life is the concept of __________?

self efficacy

Dr. Lipson explains that mental health is a continuum and that everyone falls within the continuum. True or false: an individual's position on the continuum can fluctuate with changes in mood or emotional states

true

Having a gun in the home is an important risk factor for death by suicide

true

On average, each nonsmoker costs Social Security more compared to someone who smokes

true

Prior to the implementation of the Affordable Care Act a person could lose their health insurance if they became very sick and their insurance provider decided their health care costs were too high

true

The ACA was successfully in reducing the number of Americans who lacked health care insurance

true

True or false: a sense of thriving or flourishing is part of mental health

true

True or false: increasing women's access to health care before pregnancy can reduce preterm births

true

True or false: most people who die as a result of suicide had a diagnosable mental illness

true

The 1964 Surgeon General's report resulted in more demand for tobacco control, which reduced smoking rates, which led to norm changes, which gave rise to more policies and further reduced smoking rates. This phenomenon is called

virtuous cycle