BBH 302 final exam

The misconception that Asian and Pacific Islander populations are the ________________, ignores the great deal of diversity in the group, and potential health disparities in subgroups. (Choose the Correct term)

"model minority"

There are five areas that experience the greatest rural health disparities in the US, choose all that apply.

- delta region - rural appalachia - american indian / alaska native

Landrine & Corral (2009) The Landrine and Corral (2009) reading used the dissimilarity or segregation index to describe pathways to Black health disparities...we can think about effects on any group living in residentially segregated areas. The authors described 3 separate DIRECT pathways by which residential segregation can impact health disparities. Choose all that apply below.

- disparities in built environments - disparities in healthcare quality - disparities in environmental exposures

In the Cycle of Poverty model, exposures refers to which of the following? Choose all that apply.

- parents ability to cover the costs of preventative medical and dental care - housing quality, neighborhood safety - access to amenities like parks, walking paths, and full-service grocery stores

On average, how much longer do White men live compared to their African American counterparts?

10 years

Approximately _____________________ percent of Latinos live in urban areas.

90%

A dissimilarity index of 100 indicates _______, while a dissimilarity index of 0 means ________.

Complete segregation; Complete integration

Which of the following refers to the belief that a family history of disease determines your health/disease destiny? This belief may impact individuals' medical adherence and disease management.

Genetic fatalism

Which of the following describes Black-White disparities in breast cancer?

Higher incidence rates in Whites and higher mortality rates in Black women

Match the TUBERCULOSIS fact to the correct racial or ethnic group. There is only ONE correct answer per question

Highest rate among U.S.-Born populations: black americans Second highest rate among U.S.-Born populations: non-hispanic whites Highest rates among foreign-born populations: asians

Match the health disparity to the correct racial/ethnic group. Use the process of elimination to match the disparity to the group that is most highly affected. There is only ONE correct answer per question.

TB- foreign born asians breast cancer mortality: black females septicemia: black americans suicide: white males diabetes: native american/ alaskan native

There is not a clear health-wealth gradient for which of the following illnesses?

cancer

Bus depots and toxic waste treatment plants are often located near low-income neighborhoods, which is associated with asthma rates. To which aspect of residential segregation (from the model in the Landrine and Corral reading) does this refer?

environmental exposures

Which of the following terms refers to the rate of death in a specified population above the expected rate for other populations

excess deaths

We watched a movie about the conditions on two islands in the Marshall Islands. One was wealthy and spacious and mostly inhabited by white Americans. The other was over-crowded and had poor living conditions and was inhabited by indigenous Marshallese people. Which of the following was stated as a potential cause of health problems in the Native/indigenous population? (choose all that apply)

high rates of TB lack of septic and water

Hispanics face health disparities due to some unique exposures: choose all that apply

high rates of agricultural work high rates of urbanization high percentage of migrant farm workers

What is the biggest contributor to the Black-White Wealth gap?

home ownership

Household income and education --> children's educational attainment --> future employment opportunities --> health insurance coverage --> lack of preventative care --> poor health --> lower household ____________ and ______________. Fill in the gaps & what is this model is referred to:

income & education; the cycle of poverty

The ONLY way to eliminate the health-wealth gradient is to (to eliminate the cycle of poverty):

increase income equity (or put another way to decrease income inequity)

There are fewer dentists in rural areas than in urban areas.

inequity or difference

Hospitals in residentially-segregated communities have fewer board certified specialists than hospitals in non-segregated communities.

inequity or disparity

Rural hospitals often lack basic diagnostic tests, procedures, and facilities.

inequity or disparity

For Native American tribes (shown in the video Bad Sugar), in an attempt to combat the hunger that followed after the dam was built on the Gila rive, the U.S. Government began to supply commodity foods to the population, which had a direct impact on diabetes rates for American Indian groups. This type of racism is an example of an act of ______________.

institutional racism

Minorities receiving health-care at lower-quality, lower-resourced health clinics close to their homes is an example of which level of racism?

institutionalized

We saw how the Marshallese people were displaced and marginalized by the U.S. government for military purposes, so that the US government could conduct nuclear bomb testing which led to environmental health hazards for the Marshallese. Which level of racism is represented here?

institutionalized

Placing public housing units in isolated areas of a city is an example of:

institutionalized ism

Marisol is a 50-year-old Latina woman who lives in Philadelphia. She is diabetic and hypertensive and has been waiting for a kidney transplant for 2 years. In conversations with her physician, Marisol says that she is worried that her body would reject a new kidney because Hispanics/Latinos do not take care of their health, so it probably would not work out. Which form of racism is at play in this situation?

internalized

For American Indians/Alaska Natives, apart from loss of land, income and food access because of reduced agriculture, ______________ was also discussed as a major determinant of health disparities in this population.

loss of culture

The Syphilis Study at Tuskegee was an egregious act of racism that impacted generations of Black families, and the cause of lingering ________________ in Black populations to this day.

mistrust in the medical system

Match the health disparity to the correct racial/ethnic group. Use the process of elimination to match the disparity to the group that is most highly affected. There is only ONE correct answer per question.

motor vehicle accidents: american indians skin cancer: white women chronic liver disease: hispanics h. pylori: asians

For which 2 populations are disparities in mental illness (leading to higher suicide rates) greatest?

native populations and whites

Which of the following are the TWO best measures of socioeconomic status?

net worth, standard of living

Which racial ethnic group experiences the greatest amount of residential segregation according to the country-wide maps we examined in class?

non-hispanic white americans

When studying the maps of US population distribution by race, we see how each group is distributed across the U.S. Based on the definition of dissimilarity (distribution of a racial/ethnic group across a residential area) which group is most segregated?

non-hispanic whites

Lower rates of kidney transplants in low-income, minority patients is an act of:

omission

Physicians not referring Black patients for kidney transplants due to assumptions about Black patients' willingness to consume a healthy diet is an example of which level of racism?

personally-mediated

What does it mean to fall off of the cliff, with nothing there to catch you?

to due from the disease

Which health phenomenon did the landmark Whitehall Study uncover?

wealth related disparities in health

_______________ are two explanations for the phenomena that Black women are more likely to experience higher rates of prenatal and maternal mortality rates than all other groups of women. (Select TWO answers)

weathering hypothesis minority stress hypothesis

Which 2 populations experiences the greatest degree of homelessness?

whites native/indigenous populations

What percentage of American Indians own their own home?

1%

How many Native American tribes are recognized by the Federal Government?

560

One of the causes of rural health disparities is the lack of qualified specialist physicians in those areas.In fact, only ______________ of the nations OB-GYNS work in rural areas.

6%

The US Health Disparities Heckler report revealed that there are ______________________ excess deaths in the US.

60,000

When we create built environments such as public parks and play spaces for children and distribute them evenly throughout the residential areas in a city, and we create other residential designs like this, in order to reduce disparities due to residential segregation, how do those public spaces impact access to health outcomes in that region?

Access would not be determined solely by where you live

_________________ is when an immigrant adopts all of the norms and customs of the new country; _________________ is when an immigrant adopts some of the norms and customs of the new country, but also keeps some from their country of origin.

Assimilation, Acculturation

Which of the following is an example of an INTERNALIZED "ism?"

Bisexual women not disclosing their sexual orientation because of an assumption that they will be mistreated

Which of the following is one of the top leading causes of death ONLY for American Indian/Alaskan Native and Hispanic/Latino populations?

Chronic Liver Disease and Cirrhosis

Indigenous land created wealth for all of the land grant institutions of higher education through land cessation, land seizures without compensation, and broken treaties with Native American tribes. ____________________ land comes from more than 112 tribes across 16 states and resulted in more than $439,000 in profit—about $7.8 million, when adjusted for inflation. ​. This institution currently sits on land formerly owned and occupied by the Erie, Haudenosaunee, Lenni Lenape, Shawnee, Susquehannock tribes.

Penn State

Match the level of racism to the way in which it manifests in society.

Poor quality medical facilities: institutionalized racism Not referring people of color for diagnostic medical tests: personally mediated Believing that your race/ethnicity is biologically inferior: internalized racism

Which of the following is true about the mobility seen in poor neighborhoods?

Poor residents tend to move to similar, poor neighborhoods

Helicobacter Pylori (H. pylori) infection is a risk factor for stomach cancer. H. pylori infection is highly prevalent in India and Thailand, however, stomach cancer rates are low in these countries. This is referred to as the:

asian enigma

Which groups are most likely to experience the combination of being poor AND living in a poor neighborhood?

blacks and hispanics

Which of the following are the leading causes of DEATH in Hispanic populations? Select all that apply.

cancer heart disease unintentional injuries

Match the health disparity to the correct racial/ethnic group. Use the process of elimination to match the disparity to the group that is most highly affected. Choose only ONE answer per question.

chronic lower resp disease: white americans fetal alcohol syndrome: american indians septicemia: black americans drug/opioid overdose: whites

What major health disparity is associated with the high prevalence of Non-alcoholic fatty liver disease and primarily for which racial ethnic group?

cirrhosis; hispanic/latino

Prescribing patients a drug that was found to be ineffective for their race, ethnicity, sex or some other personal characteristic is an act of:

commission

From the Health in All Policies Approach model, ________________ is the process of engaging communities in the research process in order to improve the development of relevant interventions.

community based participatory research

Which dimension of residential segregation would be most highly associated with illnesses that are due to overcrowding?

concentration

Lung cancer rates are higher in smokers than non-smokers

difference

Testicular cancer is higher in men than women

difference

The vocabulary below is critical to understanding the unequal distribution of health in the U.S. - Match the words with their definitions.

differences: differences in health that can be explained using biology disparities: differences in the incidence, prevalence, or burden of disease, that are due to systematic injustices and social justice issues inequities: differences due to unequal treatment or access

Appalachian populations have higher opioid drug abuse problems than non-Appalachian populations.

disparity

In 2011, Black women account for 42% of all the pregnancy-related deaths in the US, while White women account for only 12.5%.

disparity

What is the term for what is described in the previous question? (That is, living in a poor neighborhood and being poor.)

double jeopardy

Dr. Camara Jones (from the flowerpot analogy for racism) says that the chronic stress of racism is like "gunning the engine of a car, and never letting up." Her research showed that poor maternal health outcomes in Black women in the U.S. are the result of the negative impact of racism _____________________________.

experienced over a lifetimeWhich of the following are the leading causes of DEATH in Hispanic populations? Select all that apply.

In general, your zip code is a poor predictor of your health.

false

What is the term that refers to the risk of immigrants being deported if the government feels that they are a drain on the economy?

fear of public charge

______________________ refers to people immigrating to the USA may be healthier than those who remain in their countries of origin.

healthy immigrant effect ????

What is the scientific term for the work-related disease that miners are at high risk for, which is ________% preventable.

pneumoconiosis, 100%

Tony Debrum, a former Minister of Foreign Affairs and Health on the Marshall Islands, stated the following regarding health problems on Ebeye: "providing more doctors or nurses on Ebeye is not going to solve that problem. There has to be a political decision made." To which part of the cliff model would "providing more doctors or nurses on Ebeye" belong? Choose the BEST answer.

primary prevention

Racial segregation in most cities is connected to a history of ___________________ that was practiced by the Federal Housing Authority and the Homeowners Loan Corporation for a period of over 40 years.

redlining

Which of the following is PRIMARY PREVENTION (representing the FENCE in the Cliff Model) for septicemia for Black Americans?

reducing or eliminating smoking

Using Chronic Liver Disease in Hispanic/Latino populations as an example, match the description to the area of the model to which it applies. Hep B and C are high in Hispanic/Latino populations.

safety net program/secondary prevention: free community program that provides Hep B screenings fence/primary prevention: Hep B vaccination in newborns moving people back away from the edge of the cliff: policies that increase access to culturally competent prenatal care for hispanic/ latino women ambulance/tertiary prevention: antiviral meds to prevent liver damage in infected individuals

Thinking of all of the racial and ethnic groups we have discussed thus far, which of the following ONLY appear in the top 10 leading causes of death for Black Americans?

septicemia and homicide

Match the highest SUICIDE rates on the left to the correct racial or ethnic group on the right. There is only ONE correct answer per question.

suicide mortality in youth: american indians highest suicide mortality: american indians second highest suicide mortality rate: asian/pacific islander high rates that increase with age: non-hispanic white males

Which level of prevention for cardiovascular disease is described in the previous question?

tertiary

In the CLIFF MODEL, pacemaker surgery is an example of:

the ambulance

In the CLIFF MODEL, eating a healthy diet and exercising to prevent hypertension is an example of:

the fence

Match the level of prevention on the CLIFF model to the intervention for BLACK LUNG DISEASE.

the fence: miners wearing protective breathing equipment moving people back away from the edge of the cliff: policies that mandate the mining companies take preventative measures to reduce overall risk for black lung safety net programs: mobile units that test for black lung symptoms and risks tertiary prevention: needing to go on oxygen due to black lung disease

In class, we reviewed a New York Times article that showed socioeconomic outcomes for White and Black boys who grew up in rich households. The image below shows striking (and sobering) inequities in income in adulthood. From the lecture on socioeconomic disparities, what does this illustrate?

the generational racial gap in wealth

Which of the following is TRUE about disparities in drug poisoning/opioid death rates over time?

the rates are highest and increasing in non-hispanic whites

The gap in mortality rates for rural and urban areas is getting wider.

true

Zitkála-Šá composed the first Native American opera.

true

A geographic area with a core population of more than 50,000 inhabitants is referred to as a(n)

urbanized area