Uapp Quiz 3 study guide

All of the following food additives are added for the purpose of improving our health except:

Antibiotics

Based on Federal Lead & Copper Rule, the maximal allowed level of lead in drinking water is no more than _____ parts per billion, but when Leanne Walters' water was tested, it was found to contain more than ______ parts per billion.

15; 100

When it comes to chronic diseases, about _________% of the patients account for about ________% of the costs.

20;80

According to the documentary, at the time the film was produced, the United States spent $2 trillion per year on medical care, which translates to what percent of all health dollars spent in the world? (Note that experts estimate current spending at ~$3.6 trillion.)

50%

Analysts have studied the relative contributions of various factors on the overall health of the population, including healthcare, genetic predisposition, social conditions, environmental exposures and individual behavior. Although there is not consensus on the exact percentages, healthcare is believed to contribute approximately ___________%.

50%

Why did the National Heart, Lung, and Blood Institute (NHLBI) sponsor a campaign to raise women's awareness about heart disease?

All of the above

Which of the following statements about the U.S. healthcare system is false?

All of the above are false.

What do you think can/should be done to ensure something like this doesn't happen again?

As mentioned in the documentary, I strongly agree with Dr. Lawrence and Miguel who addressed the effects of having a poor corrosion system in place which continues the development of a water crisis. I believe that people should rise and learn about the effects of lead poisoning especially, in children. This will increase our concerns of our water system and make us eager to push towards protecting our community. We should all look into how our water system works, specifically were it comes from. In addition, hearing that several pipes around the country may have huge amounts of lead because they are old, makes me wonder if replacing all of the old pipes in the country is actually possible. Even though I do believe this is possible, we must take into consideration the process of changing a water system underground and its effects it will have in the community. Essentially, we don't know how long it will take or how much money is needed, but in order to secure a strong water filtration system we must come together and force solutions to provide safe water for all.

Based on your understanding of the health and social determinants of health portrayed in the film, why do you think the social gradient in health is so strong in the United States? (Suggest ~1 paragraph)

Based on information described in the film, social gradient in health is largely prominent in the United States because of the social determinants of health. Stress is one of the leading causes of developing various preventable diseases and health outcomes, such as diabetes, heart disease and strokes. Specifically, we can see the relation between socioeconomic levels and health outcomes that occur because of the difference of living communities and access to higher education. Throughout the film there were four stages of income portrayed in order to show how each person's background reflects their social and income status. The video further develops the connection between ownership, higher education, power, and job security with all of the stories intertwining. In addition the audience is able to notice how the difference of income can be prevalent due to proper education and life experiences. For example, we can see how the social gradients are disproportionately affecting black and brown people in comparison to white people even though poor white people form part of the population of low income individuals in the United States. The film further develops the concept of social gradients with the visualization of graphs on the different districts described in the film, we can see how in district 21, where Cory who is a 39 year old African American male that is already living with hypertension, is subject to a life expectancy of 73.4 years on average approximately 2 years younger than Tandra, a middle class Lab manager whole lives in district 15, and 5 years younger than Jim Taylor a CEO of a Hospital who lives in District 5. Even though most of these people will experience stress due to their jobs, Cory has twice the chance of developing chronic diseases in comparison to Jim Taylor an affluent worker and Tandra who is considered middle class.

According to Louisiana's environmental health director, why did the state's food safety program absorb the most significant portion of the funding cuts?

Because of the public perception that the food safety program was not very effective and burdensome on the food industry.

Which of the following is true of the experiment using Macaque monkeys described in the Unnatural Causes film:

Both of the above are true; neither is false

Which of the following statements does not represent findings that influenced the campaign development process?

Branding principles, as applied to products and services, are not compatible with health-related behaviors and attitudes.

Which of the following are identified as factors contributing to workforce shortages in environmental health departments?

Budgetary constraints Accelerated rate of retirement of environmental health professionals Lack of skill set and interest in environmental health Insufficient environmental health marketing efforts Correct! all of the above

Scientists believe that all of the following are responsible for the emergence of new infections except:

Campaigns that promote widespread immunization

Discharges from industrial sources are a major category of point-source pollution which is regulated by which piece of legislation?

Clean Water Act

Recent thinking (e.g. Public Health 3.0) about promotion of healthy behavior among low SES population groups focuses on which of the following?

Creating healthy places

The Safe Drinking Water Act of 1974 required ___________________________ to set standards for local water systems and mandated that ______________________________ enforce those standards.

EPA; state governments

Which of the following statements is false about health promotion and disease prevention programs?

Effective programs will be equally effective for all at-risk groups.

Which federal agency is responsible for creating regulations to protect the water supply?

Environmental Protection Agency (EPA)

A measure used to evaluate the success of The Heart Truth campaign reported in the case study was a decrease in the number of women who died of heart disease. The study proves that this decrease from one in three deaths to one in four deaths was a direct result of the campaign.

False

The crisis in Flint, MI, was unavoidable because of the extremely high levels of lead in the Flint River.

False

The government tests all synthetic chemicals for adverse health effects to protect the public from potential hazards.

False

There is widespread agreement that the "war on drugs" has been successful in drastically reducing drug use.

False

If you were in John's position, what would you tell the state health commissioner about the importance of the food safety program? (Hint: what key facts or research findings would help John make his case to fight the budget cut?)

Food safety programs are highly needed for the public's safety in order to lower the risk of people contracting foodborne illnesses. However, if the state keeps on cutting food safety budgets then we will no longer have the opportunity to reduce the risk of people becoming sick from foodborne illnesses. Since the FDA reccommends to sustaint an effective risk based food safety program, state agencies are crucial to maintain the safety of the public. The FDA also recommends every food safety program in the United States to have at lest one full time staff member devoted to food for every 280-320 inspections. Due to all these regulations for food safety the state government of Louisiana should provide more financial stability, therefore we can work together to reduce food borne illness outbreaks.

What lessons or conclusions can we draw from the research on Macaque monkeys described in the film? (Suggest ~1 paragraph)

From the research on Macaque Monkeys we can draw and compare the differences between a dominant Macaque Monkey and a less dominant monkey. The dominant Monkey has more power because of the way he acts and puts other monkeys in line in order to avoid socially connecting with one another, while the submissive and maltreated monkey strains themselves to less power. Effectively the feeling of power and obtaining a higher ranking than the monkey who is undervalued results in striking connections to cortisol levels in the brain. For example, in the film they featured the dominant and non dominant Macaque Monkeys going into the MRI scan in order to record their levels of cortisol. The evidence taken from the Monkey study shows us how the monkey with the most dominant level of living had a lower amount of cortisol shown in his brain but, the second monkey contained high levels of cortisol due to having less control over their surroundings and life. The conclusion that spoke to me the most was the comparison of the monkeys social hierarchy and how similar their way of living is to humans. For instance, we can see from the film how jobs that urge employees to work nonstop with no sense of control tend to have higher chances of developing higher levels of cortisol and eventually leading to an increase of chronic conditions in comparison to individuals with better control of their work environment.

Which of the following is not a feature of the Hazard Analysis and Critical Control Point Approach (HACCP)?

HACCP provides a set of guidelines to food establishments on displaying nutrition and caloric intake information on their menus.

Describe one idea or concept from the film that you question (either in terms of accuracy or bias in the way it was delivered). Or if you agree with/believe everything from the film, describe an idea or concept that you think someone else (with a different perspective) might question or challenge. (Suggest 1-2 paragraphs)

I agree with everything described in the film, therefore I would like to point out the concept of the cold study done by Dr.Cohen and the different aspects the study portrays. This study focuses on how the cold virus affects different types of people all with different socioeconomic backgrounds in order to entail the ways their immune system reacts to the common cold. Evidently, the case discovered the difference of income and how symptoms of the cold virus relate to each other. For instance, Dr. Cohen found that those living with less toxic stress in their lives had milder symptoms or recovered faster from the cold virus. However, those living with predisposed conditions mostly low income individuals took longer to recover from the cold virus when exposed to it. The conclusion of the study further explains the concept of the social determinants of health and the causes it has on people due to their difference in economic backgrounds, most importantly the large amount of toxic stress that is evident within low income communities that are subject to more destruction. Education, power, wealth are essentially all interconnected which is why people who are able to obtain higher education and higher income will have a better chance of obtaining healthier life outcomes.

Which of the following statements about heart disease is true?

It develops over time. It can start as early as teen years. It's never too late for women to lower their risk of heart disease. Correct! All of the above statements about heart disease are true.

In addition to lead in the water, residents of Flint, MI, experienced one of the largest outbreaks of __________________________ in the US.

Legionnaire's disease

In addition to lead poisoning that resulted from the Flint water crisis, experts believe that nearly one hundred residents became ill (and 12 died) due to which of the following waterborne diseases?

Legionnaire's disease

All of the following programs were created to provide medical care for low income communities except:

Medicare

Which of the following statements is false?

Most chemicals released into the environment have been tested for harmful health effects.

According to the health belief model, a program that is effective in getting people to change their health-related behavior should convey all of the following messages except:

My social networks support the behavior

Which of the following is not one of the recommendations for effective risk communication developed by the Environmental Protection Agency?

Only provide objective information and keep your tone impersonal

Which of the following statements is false?.

People who lack health insurance can be turned away from emergency rooms.

Which of the following statements is false?

Private wells are regulated under the Safe Drinking Water Act.

Reluctance by some parents to vaccinate their children strengthens heard immunity.

false

Since public health is solely a "public" function, the campaign focused exclusively on building partnerships with government agencies.

false

The reason Dr. Knight asked you to consider the ways in which you are privileged in relation to your health is because:

She wanted you to be more aware of the role of privilege in determining health.

Which of the following statements about lead is false?

Small exposures to lead are safe for young children.

The strongest predictor of overall health is:

Socioeconomic status

Which of the following statements about our food safety system is false?

The Food Safety System in the U.S. is considered the best in the world.

Who do you think is to blame for allowing this crisis to reach this point? How should they be held responsible?

The documentary addressed the inactions the government of Michigan made that led the Flint Water crisis to reach an irreversible point. Government inaction in Michigan lasted about 18 months and cost the lives of many children, including those affected by Legionnaires disease. Emergency managers, officials from Michigan's department of environmental quality, Department of Human Services and the Flint water Plant were all held responsible for the crisis. The crucial evidence of the Freedom for Information Acts filing by Marc Edwards , ACLU and others made it possible for officials to be held accountable for the water crisis. In addition, 13 criminal indictments followed which included members from the "Department of Environmental Equality, Department of Health and Human Services and the Flint Water Plant, as well as the Emergency Managers".

Which of the following statements is false?

The main reason people with high SES are healthier than people with lower SES is that they have better access to medical care.

Which of the following statements is true?

The percentage of Americans who lack health insurance is higher than that in other industrialized countries.

Which one of the following is the first component of the risk communication strategy?

The response period which focuses on preventing the situation from worsening

Describe at least three food safety practices that a health inspector looks for during a routine restaurant inspection?

The routine of a restaurant inspector is very intriguing, one of the several ways he/she inspect is by making sure all equipment is not contaminated or is at risk of cross contamination. Another aspect of their routine check is looking for improper cooking, they are looking for instances where either poultry, or beef may not be cooked to the appropriate temperature potentially allowing pathogens to stay alive. Another practice that health inspectors do during a routine restaurant inspection is checking for food from unsafe sources, for example, food past it's expiration date.

Which of the following statements about stress is false?

The stress experienced by CEOs (leaders in an organization) is more damaging to health than the stress experienced by lower level workers.

Why was the Minister of health faced with the issue of addressing mass panic among the population of Paraguay?

There was a lot of misinformation about the disease outbreak among the population Mass media exaggerated the risk of infection for the population and fueled perceptions that the government was ineffective and untrustworthy The number of vaccines in Paraguay was far short of the needed number to cater to the country's population Correct! All of the above

Which of the following regarding medical errors is true?

They are largely preventable.

Ring vaccination as an immunization strategy was used for which of the following reasons?

To stop further transmission of yellow fever by creating a buffer of immune individuals

Which of the following factors is considered the leading "actual" cause of death in the U.S. (in 2000)?

Tobacco use

The US spends more on medical care per person than any other country in the world.

True

The occurrence of two or more cases of a similar illness resulting from the ingestion of a common food is considered a foodborne disease outbreak.

True

The vaccine development process typically takes more than 10 years.

True

Those with high self-efficacy are more likely to adopt healthy behavior than those with low self-efficacy.

True

The major findings of the formative research conducted for the campaign included which of the following?

Women were not making the personal connection between their risk factors and their own personal risk of heart disease. Women were surprised to learn that heart disease was their No.1 killer. Women were of the belief that heart disease is a man's disease and not a woman's issue. Correct! All of the above

Which of the following research findings was not a factor in NHLBI's strategy development process?

Women with one risk factor are expected to have the same likelihood of getting heart disease as women with multiple risk factors.

Which of the following statements about the yellow fever vaccine is false?

Yellow fever vaccine is also proven to protect against malaria

Which of the following statements is false?

a. Health differences between racial and ethnic groups in the US are largely the result of genetic differences. b. Research comparing health and social spending across wealthy developed countries shows that higher levels of spending on healthcare is associated with better health. c.Resilience is a fixed trait (e.g., you are either born with it or not). d.correct! All of the above are false. All of the above are true.

Which of the following factors has been associated with the development of antibiotic resistance among many species of bacteria?

a. improper prescribing of antibiotics for viral infections b. improper use of antibiotics by patients who discontinue use when they feel better rather than continuing for the full prescribed course c. widespread use of low doses of antibiotics in animal feeds..... d. all of the above ( right answer)

In doing public health work, it is important to identify stakeholders and their interests because:_________________________________________________

a. it allows you to gain buy in and support for interventions b. it is more fair because people have a say in something that may affect them c. it creates social capital in the community. d. all of the above (right answer)

Which of the following diseases is transmitted by a vector?

a. malaria b. yellow c. lyme disease d. all of the above (right answer)

Which of the following is an infectious agent?

a. virus b. bacteria, c. parasite d. all of the above (right answer)

The public health approach to control infectious diseases includes strategies to interrupt or break the chain of infection including which of the following:

a.eliminating the reservoir that harbors the pathogen b. killing the pathogen c. preventing transmission between hosts or from the reservoir to a host d. increasing the resistance of hosts Correct! All of the above None of the above

An individual's sense of self-efficacy can be promoted or developed using which of the following strategies (check all that apply):

aa.Practice b.Correct! Peer education c.Correct! Watching others do something successfully

The FDA is responsible for assuring the safety of which of the following:

all of the above

At the time the film was produced, where did the United States rank in life expectancy?

below 25th

About 40% of healthcare spending goes towards prevention.

false

According to research done by the Commonwealth Fund that compared health systems across 11 wealthy developed countries, the US healthcare systems ranks #1.

false

Flint was a thriving urban center prior to the switch.

false

In Louisiana, the ratio of sanitarians to number of expected food inspections meets the FDA recommendations.

false

The FDA (Food & Drug Administration) is solely responsible for food safety in the United States.

false

The Minister of Health decided that vaccines must be equally distributed to the public, with recipients being chosen randomly.

false

The authors of the case study argue that the workforce shortages in environmental health are offset by the collaboration of public health agencies in food outbreak surveillance and response.

false

The authors reported that over time there was a decrease in the number of women who died from heart disease in the US (from 1 in 3 to 1 in 4). This research proves that the decline was a direct result of The Heart Truth campaign.

false

The crisis involving lead in the water supply in Flint was the first of its kind in the US.

false

In the field of public health, differences in disease prevalence, outcomes or access to care/services that are unnecessary, avoidable, unfair and unjust are referred to as__________________.

health inequities

The social gradient in health demonstrates how health outcomes _________ as socioeconomic position improves.

improve

Which of the following is true about rabies?

it is a zoonotic disease

From an environmental health perspective, which of the following poses the greatest threat to children?

lead

Which of the following is believed to contribute to the high costs of healthcare in the US compared with other wealthy developed countries? (Check all that apply)

our population has a higher prevalence of chronic disease Correct! we have more inefficiencies/higher administrative costs Correct Answer the public's tendency to sue for malpractice when something goes wrong and doctors' use of defensive medicine to protect against malpractice suits Correct! financial incentives for doctors and hospitals to provide more services, especially high-tech, expensive services Correct Answer the Field of Dreams Effect

Lead gets into drinking water primarily through which of the following?

pipes

The leading cause of death in 1900 was ____________; while the leading cause of death approximately 100 years later was ____________.

pneumonia; heart disease

Which of the following is not part of the chain of infection for infectious diseases?

risk factor

The major forces that shape the health outcomes of people and communities are known as

social determinants

A program planning approach that uses commercial marketing techniques to promote voluntary, socially-desirable behavior change is called:

social marketing

A critical public health activity that includes systematic collection and analysis of data to detect infectious disease outbreaks and inform the development of interventions to break the chain of infection is called:

surveillance

The first phase of clinical trials required by the FDA for developing a vaccine consists of:

testing the vaccine on a small number of healthy volunteers to determine safety

Most Americans' health insurance is paid for by________________________.

their employers

Why did the City of Flint switch their source of water to the Flint River?

to save money

Although health education is at the ____________ of the health impact pyramid, using _________________ in developing health education interventions is likely to lead to more positive impacts.

top; behavior change theories

Experts believe that most emerging infectious disease outbreaks are caused by zoonotic pathogens.

true

Health services research has documented that racial and ethnic minorities often receive poorer quality care than whites in the US.

true

Much of the damage done to the residents of Flint could have been avoided if the city had implemented corrosion control measures.

true

On average, citizens of the United States live shorter, often sicker lives than almost every other industrialized nation.

true

Quarantine is a public health intervention intended to interrupt the chain of infection by reducing transmission.

true

River water is generally more difficult to treat than water from lakes.

true

The Minister of Health was aware of the need to effectively communicate accurate information to the public to address mass panic and to re-establish people's trust in government.

true

The Patient Protection and Affordable Care Act mandated that insurers allow children to stay on their parents' health insurance until the age of 26.

true

The social gradient in health is a phrased used to describe the phenomenon whereby people who are less advantaged in terms of socioeconomic position have worse health (and shorter lives) than those who are more advantaged.

true

Treating water from rivers to remove particulate matter and toxins is a common practice across US cities.

true

While the idea of "rationing" healthcare as a policy strategy to allocate scarce resources makes many people uncomfortable, rationing already exists in healthcare.

true

The case on Yellow Fever in Paraguay highlighted how we often make decisions about resource allocation based on consideration of justice in the distribution of benefits and burdens. In public health, treating people "justly" means:

using limited resources for the most in need and or most likely to benefit

Which of the following statements about infectious diseases is false?

vaccines are available for all known infectious diseases