Intro To Public Health Final Exam
Vaccines are an example of:
Epidemiology is part of what function of public health?
Primary prevention refers to:
Prevention of exposure to risk factors
seat belt laws are an example of:
public health focuses on ___ of disease and ___ of health
enforcing laws and regulations falls under which core function of public health?
the core functions of public health are:
assessment, policy development, and assurance
public health focuses on populations, whereas medicine focuses on individuals
People’s behavior is strongly influenced by their ____
public health measures that contribute most to people being healthier today than they were a century ago are:
sanitation, better nutrition, and occupational safety
Restricting the legal drinking age in the US to 21 is an example of:
what expresses the social justice view of public health?
members of a community have collective responsibility for their common welfare
restricting individual freedoms for public health purposes is unconstitutional
what example of justification for limiting people’s freedom is likely to be the most controversial?
to prevent someone from harming himself
what statement best expresses the market justice view?
every adult individual is responsible for his/her own lot in life
the lesson of the “tragedy of the commons” for public health is that:
under some circumstances, individuals in a community may profit by agreeing as a group to limit each person’s freedom to act
what could be considered primarily an attempt to legislate morality
laws against homosexuality
Many public health measures have a negative economic impact on an industry. In some cases, public health advocates would consider this economic impact to be an acceptable consequence. However, sometimes this economic impact may have mixed consequences for public health. What is most likely to have negative as well as positive results for public health?
effect of banning pesticide use on the agriculture industry
the costs of public health measures are easier to calculate than are the benefits
What measure to limit the freedom of adults in the name of public health has not been taken by the U.S. or state governments?
laws against smoking cigarettes
do not have the power to restrict the actions of public health agencies
which governmental organization is the main assessment and epidemiological agency for the nation?
The federal government:
sometimes uses the interstate commerce provision of the Constitution to protect the health of the population
The level of government that, according to the Constitution, has the primary responsibility for the health of the population is:
What are some of the FDA’s responsibilities?
evaluate new drugs, ensure the safety of foods, and regulate vaccines and diagnostic tests
What are some of the NIH’s responsibilities?
conduct research on the basic physiology of diseases, test experimental medical therapies, and operate a reference library for medical information
What agencies are part of the Department of Health and Human Services?
NIH, FDA, CDC
The U.S. Constitution authorizes the federal government to do which activities relevant to public health?
tax and spend
What carries out core public health functions, such as sanitation?
local public health agencies
what are parts of the CDC’s responsibilities?
identify behavioral health hazards, control the spread of infectious diseases, and publish MMWR
The Framingham Heart Study identified these as risk factors for heart disease:
High cholesterol, high blood pressure, smoking
routine data collected by the british government enabled Snow to recognize the cause of cholera
john Snow is called the father of modern epidemiology because:
He was the first to use epidemiology by recognizing a natural experiment was occurring.
Epidemiological data can be used to directly develop policy and influence population health: T/F
from an epidemiological perspective, what are some factors of chronic diseases?
They usually have more than one cause, they usually take a long time to develop, they are more difficult to study than infectious diseases
The main purpose of epidemiological surveillance is:
to recognize when an outbreak is occurring so that control measures may be instituted
what were some findings of the British Doctors Study?
death rates from lung cancer increased with the amount smoked, death rates from lung cancer were lower in ex-smokers than current smokers, and deaths from heart attacks were higher in heavy smokers
What are some facts about epidemiology?
it studies disease occurrence in humans, it is a component of the assessment function of public health, and its objective is primarily to determine the causes of disease
What is true of heart disease?
moderate alcohol consumption protects against heart disease
What are some facts about the Framingham Heart Study?
it found that smokers’ risks of heart disease drops to normal after they quit, publicity about its findings helped to change people’s health – related behavior, and it found that high bp is associated with weight gain
an epidemic curve illustrates which questions of disease distribution?
The Long Island Breast Cancer Study tested the hypothesis that environmental pollution was causing the relatively high rates of breast cancer among residents of Suffolk and Nassau counties of New York. Epidemiologists identified a group of 1,420 women who were diagnosed with breast cancer between 1984 and 1986 and compared their residential histories over a 20 year period with those of a matched group of healthy women. What kind of epidemiologic study was this?
what is part of the “who” question of disease distribution?
age, sex, and race
the nurses’ health study is what kind of study?
Researchers want to identify the impact of cholesterol on the development of heart disease. They follow individuals who are vegan, vegetarian, and meat-eaters for 10 years and they record if any of them experience a heart attack. What kind of epidemiologic study was this?
Smoking is a(n) ____ of lung cancer
The New York State Health Department reported in 1997 that the death rate for AIDS in the state had fallen over the past year due to the efficacy of the new drugs. The incidence of HIV remained constant. What happened to the prevalence of HIV infections?
An epidemiologist investigating an outbreak of encephalitis in New York City reports that there have been 17 new cases this week. Which of the following terms best describes the number he reports?
Incidence of encephalitis
When epidemiologists are called on to investigate an outbreak of an infectious disease, what is the first thing they must do?
agree on a case definition
International comparisons of cancer mortality suggest that which of the following factors accounts for differences among countries in colon and rectum cancer?
What is a common source of error in a large cohort study?
what is a common source of error in a small epidemiologic study?
In a case-control study that found an association between breast cancer and air pollution, 500 women who had recently been diagnosed were asked what industries were within a mile of their home twenty years ago. The controls were 500 healthy women. What is the most likely source of error in this study?
what is a common source of error in a large case-control study?
subjects do not remember their past exposure
what is an Institutional Review Board (IRB)?
a committee that ensures studies are well designed and ethical
In an intervention study to determine whether a vegetarian diet can help college women to lose weight, 500 residents of a women’s dormitory were divided into two groups: one that ate in a vegetarian dining hall and one that ate a normal diet. Women were allowed to choose which group they wished to be in. After three months, the vegetarian group had lost an average of 10 pounds while the control group had not lost weight. What is the most likely source of error in this study?
what has been proven effective as a treatment for the disease indicated?
penicillin for syphilis
what is a common source of error in a large randomized controlled trial?
subjects do not adhere to the prescribed regimen
In a cohort study that found an association between alcohol consumption and bladder cancer, 20,000 middle-aged men were asked about their drinking habits and then tracked for five years to watch for the development of cancer. Researchers asked the men about their diet and exercise habits, but not about smoking. What is the most likely source of error in this study?
it is hard to conduct studies with human participants because:
it is hard to control human behavior, people may not have the motivation to adhere to the study protocols, and people may lie about their behavior during the study
a low p-value means:
there’s a low probability that the result occurred by chance
the death rate in Florida is higher than the death rate in Alaska because:
the population in Florida is older
to avoid false positives in a screening program to detect pregnancy, a test must be:
which of the following is the definition of the birth rate?
the number of live births per 1,000 people
If you want to compare death rates in two cities with populations that are different from one another with respect to age, you should compare:
age adjusted death rates
what is true about risk assessment?
it includes a judgment of the probability that a harmful event will occur
to avoid false negatives in a screening program to detect breast cancer among women over 50 years of age, the test must be
a concept used as a measure of premature mortality is:
the birth rate of a population in the U.S. will be affected by all of the following:
age of the population, proportion of females in the population, and ethnicity of the population
what cause of death has the greatest impact on YPLL?
What is true about data relevant to infant mortality?
birth certificates contain info that may help to explain why an infant dies, the info on birth certificates is used mainly for public health research, and birth certificates contain info on when the mother first received prenatal care
What is true of the BRFSS?
The data is self-reported by the individuals who are interviewed
data is collected on all of the following events as a part of vital statistics:
births, abortions, deaths
all of the following categories of people are likely to be missed in the Census:
poor minorities, illegal aliens, homeless
what pieces of data are part of the vital statistics system?
births, dissolutions of marriage, and deaths
what is true of the U.S. Census?
it obtains more details about the population by conducting the American Community Survey; starting in the 2000 census, people were allowed to check more than one race, and in the 2010 Census, everyone was sent the same, short form
What vital statistics record are linked to give additional public health information?
births and infant deaths
census data can be used for:
determining sex specific rates or race specific rates; tracking trends in interracial marriage; and determining age-adjusted and age-specific rates
the National Center for Health Statistics is part of which of the following agencies:
which population health surveys does not rely on people to report their own health?
national health and nutrition examination survey
What are some factors of measles?
it requires a repeat vaccination to be effective, it is caused by a virus, it can be fatal
what are some diseases caused by a virus?
polio, rabies, small pox, west nile, yellow fever, aids, cold, hepatitis, influenza, and measles
which disease can be treated with antibiotics successfully? Typhoid, Malaria, Smallpox, or Rabies?
what is a method of interrupting the chain of infection?
immunization, hand washing, quarantine
what diseases are caused by bacteria?
cholera, diphtheria, dysentary, plague, pneumonia, staph, strep, syphilis, tetanus, typhoid, tuberculosis
infectious diseases are caused by…
which disease is not considered eradicable? Rabies, measles, polio, smallpox
Herd immunity works by emphasizing the philosophy that vaccination of the___________ provides protection to __________ individuals.
which disease is transmitted by a vector? malaria, typhoid, tuberculosis, aids
What is the only virus to be eradicated worldwide?
Which bacteria has a reservoir in water towers used for air conditioning?
With which of the following diseases would you be most likely to be infected if you were stuck in an elevator for several hours with a patient suffering from the disease? Cholera, Malaria, aids, tuberculosis
HIV can be transmitted by:
being pricked by a contaminated hypodermic needle, heterosexual intercourse with an infected person, homosexual intercourse with an infected male
What practices contribute to widespread antibiotic resistance?
physicians prescribing antibiotics for viral infections, routine use of antibiotics in animal feed, and easy spread of hospital acquired infections
The flu vaccine must be changed every year based on specific strains that are circulating worldwide. T/F
These viruses originate in animals and spread readily among humans:
West Nile virus, hantavirus, and SARS
people infected with a prion can be easily treated. T/F
Which practices are effective in preventing HIV transmission?
use of clean needles for injections, using condoms for sex, treating pregnant women with antiretroviral drugs
scientists believe that all of the following are responsible for the emergence of new infections:
ecological change, changing social conditions, and inappropriate use of antibiotics
In an HIV positive person, exposure to what can lead to HIV transmission?
A high fat diet increases the risk of:
Cancer, diabetes, cardiovascular disease
According to the genetic screening guidelines from the Institute of Medicine (IOM), newborn screening should only be done when:
it benefits the newborn, it can confirm disease diagnosis, and treatment is available for the infants
Diabetes increases the risk of cancer T/F
the main sources of cholesterol in the american diet are:
eggs, meat, and milk
congenital anomalies may be caused by:
some bacteria and viruses, some drugs and chemicals, genetics
What are some known teratogens?
tetracycline, alcohol, diethylstilbesterol (DES)
what are some conditions associated with cardiovascular disease?
atherosclerosis, hypertension, high LDL
smoking is known to increase the risk of all the following diseases:
cardiovascular disease, bladder cancer, lung cancer
Sickle cell disease is caused by which kind of gene?
Most conditions tested for in newborn screening programs are autosomal recessive T/F
some cancers are caused by viruses T/F
According to the CDC, it is safe for pregnant women to consume small amounts of alcohol throughout their pregnancies. T/F
Huntington is caused by which kind of gene?
Which cancer can be prevented by immunization?
Which pathogens are known causes of birth defects?
syphilis, rubella, toxoplasma parasite
diet has not been implicated as a cause of which of the following diseases? Cardiovascular disease, type 1/2 diabetes, cancer
type 1 diabetes
What is a goal of genomic medicine?
to create specialized drug regimens based on genetic makeup
What is a practical application of the human genome project?
predicting individuals’ response to therapeutic drugs
The risk of which diseases increase with age?
cardiovascular disease, type 2 diabetes, cancer
The intrapersonal level in the ecological model of health behavior is most influenced by which of the following factors? self efficacy, school/work, family/friend, laws
people of low SES are to blame for their poor health T/F
Black Americans tend to have lower SES than whites. T/F
African Americans and whites of the same socioeconomic status are equally healthy or unhealthy. T/F
African Americans and Hispanics are on average poorer than whites. T/F
What are some responses to the war on drugs?
financial incentives for drug dealers, increased rates of incarceration for minor drug offenses, high prices of drugs
Which educational efforts by the government has been shown to significantly reduce the prevalence of the targeted behavior?
surgeon general’s 1964 report on smoking and health
high SES is associated with what factors that affect health behavior?
high educational level, strong social support, high self efficacy
recent thinking about promotion of health behavior focuses on which factors?
the social environment
which factor is associated with self efficacy?
a sense of control over one’s behavior
The model that describes five levels of influence on health behavior (interpersonal, intrapersonal, institutional, community, and public policy) is called what:
poor people have higher mortality rates for all of the following reasons:
poor nutrition, adverse environmental conditions, more stress
A program that is effective in getting people to change their health-related behavior must convey all of the following messages:
there is something that i could do that would reduce my risk, i am at risk, i am strong enough to make these changes
which of the following actual causes of death is least under the control of individual behavior? poor diet and inactivity, misuse of alcohol, tobacco, toxic agents
Which factor is considered the leading ACTUAL cause of death in the US?
socioeconomic status is determined by all of the following:
education, income, occupation
Which model describes perceived severity, susceptibility, barriers, and benefits?
health belief model
The model that describes five stages of change of health behavior (precontemplation, contemplation, preparation, action, and maintenance) is called which of the following
Which of the following diseases is not known to be — in part at least — preventable by practicing healthy behavior? cancer, type 2 diabetes, cardiovascular disease, arthritis
the most important predictor of overall health is:
poor diet and inactivity contribute to all of the following causes of death:
diabetes, cancer, cardiovascular disease
Which intervention has proven most successful in reducing the prevalence of smoking among young people?
raising cigarette taxes
All of the following factors have contributed to a reduction in the prevalence of smoking:
laws against smoking in indoor public places, taxes, evidence that tobacco companies use dishonest practices to hook new users
All of the following public health measures to increase physical activity have had success in some places:
walking school bus, aerobic dance programs in school, pedometers
Cigarette smoking is known to be a major cause of death and disability from all of the following diseases:
heart disease, low birthweight, cancer
All of the following factors contributed to the increasing prevalence of smoking in the first half of the 20th century:
fallacy of women’s immunity, distribution of free cigarettes to soldiers, mass marketing campaigns
lack of physical activity raises the risk of all of the following:
high blood pressure, death from cardiovascular disease, diabetes
the cause of the greatest number of deaths annually in the US is:
Which food/drink contribute the most to overweight in children?
nicotine is a carcinogen T/F
The 2009 Family Smoking Prevention and Tobacco Control Act permits all of the following actions by the FDA:
restriction on advertising of cigarettes, requirement for disclosure of ingredients of cigarettes, regulation of nicotine in cigarettes
Cigarette companies purposefully manipulate nicotine levels in order to make cigarettes more addictive to consumers. T/F
The Body Mass Index is a standard measure used by health professionals to determine health risks associated with obesity. T/F
All of the following public health measures to combat obesity have been implemented in some places:
“5-a-Day” educational campaigns, requirements for food labeling, weight report cards
federal guidelines recommend that americans eat more of all these foods:
whole grains, fruits, veggies, low fat milk products
Weight carried in the midsection is less harmful to health than extra weight in the hips. T/F
The percentage of Americans who are overweight has increased over the past two decades T/F
Federal guidelines recommend that Americans eat less of all these foods:
sweetened beverages, processed foods, meat
All of the following factors contributed to the tobacco industry’s agreement to the Master Settlement Agreement:
lawsuit by state attorneys general, publication of tobacco industry internal documents, lawsuits by injured smokers
Cigarette advertising on television was banned in agreement with the Federal Communications Commission. T/F
The Master Settlement Agreement included these provisions:
restrictions on billboard advertising, payment of $206 billion to 46 states over a 25 year period, creation of the American Legacy Foundation
Which component of tobacco smoke keeps people addicted?
What is a method of secondary prevention of motor vehicle injuries?
The only way to prevent firearms injuries is to ban guns T/F
Use of guns accounts for the high rates of suicide among American adolescents T/F
These are methods of primary prevention of motor vehicle injuries:
laws that require annual inspection of automobile brakes, divided highways, laws against drunk driving
Old people have higher injury rates than young people T/F
African Americans have higher injury rates than whites T/F
Traumatic brain injuries are common in these instances:
boxers, motor vehicle crashes, football players
Substandard housing increases the risk of house fires T/F
Poor people are more likely to use cell phones while driving T/F
The leading cause of occupational injury death is:
motor vehicle crashes
These contribute to motor vehicle injuries:
youth, alcohol, cell phone use
What are some effects of population?
social breakdown, emerging infections, global warming
Which group of Americans do not have a right to medical care? Children, Veterans, the elderly, children
This was created as a federal insurance program for the poor?
The world population…
Is currently at about 7 billion, is growing rapidly, growth rate is decreasing
The earth’s capacity is limited by all of the following:
amount and productivity of the land, amount and disposition of wastes, supply and availability of fresh water
The U.N. has decided that the best strategy for controlling population growth is:
ensuring women’s rights
All of the following approaches to controlling medicare spending have been tried:
DRGs, Price controls, Managed care
Demographic transition is the phenomenon where…
birth rates fall because of falling death rates
All of the following programs were created to provide medical care for the poor:
local health department clinics, community health centers, medicaid
Which effect of population growth has not yet occurred? depletion of fish stocks, depletion of soil, water shortages, global population control
global population control
more money is spent on medical care than on public health T/F
This federal program was created for individuals over the age of 65
What is defensive medicine?
Ordering more diagnostic tests and procedures than necessary to safeguard doctors’ practices
Public health improvements have contributed to world population growth T/F
Public health in the United States is not affected by population growth in developing countries T/F
The percentage of Americans who lack health insurance is higher than that in other industrialized countries T/F
Most Americans who lack health insurance are over 65 T/F
Which of the following countries have the highest birth rate? US, Russia, Sub-saharan Africa, East Asia
Sick individuals requiring life saving treatment can be turned away from emergency rooms if they are unable to pay for medical services. T/F
Immunization for school children is required by law T/F
The US pays more health care costs than all other countries T/F
Most Americans’ health insurance is paid for by: