Intro To Public Health Final Exam

Vaccines are an example of:
Primary prevention

Epidemiology is part of what function of public health?
Assessment

Primary prevention refers to:
Prevention of exposure to risk factors

seat belt laws are an example of:
secondary prevention

public health focuses on ___ of disease and ___ of health
prevention; promotion

enforcing laws and regulations falls under which core function of public health?
assurance

the core functions of public health are:
assessment, policy development, and assurance

public health focuses on populations, whereas medicine focuses on individuals
true

People’s behavior is strongly influenced by their ____
social environment

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:
paternalism

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
false

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
true

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

Legislatures:
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?
CDC

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:
state

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
true

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
True

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?
when

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?
case-control

what is part of the “who” question of disease distribution?
age, sex, and race

the nurses’ health study is what kind of study?
cohort

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?
cohort

Smoking is a(n) ____ of lung cancer
determinant

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?
It increased

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?
diet

What is a common source of error in a large cohort study?
confounding variables

what is a common source of error in a small epidemiologic study?
random variation

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?
reporting bias

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?
selection bias

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?
confounding variable

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:
highly specific

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
highly sensitive

a concept used as a measure of premature mortality is:
YPLL

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?
suicide

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:
CDC

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?
typhoid

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…
pathogens

which disease is not considered eradicable? Rabies, measles, polio, smallpox
rabies

Herd immunity works by emphasizing the philosophy that vaccination of the___________ provides protection to __________ individuals.
majority; unvaccinated

which disease is transmitted by a vector? malaria, typhoid, tuberculosis, aids
malaria

What is the only virus to be eradicated worldwide?
smallpox

Which bacteria has a reservoir in water towers used for air conditioning?
Legionnaire’s disease

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
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
True

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
False

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?
Breast milk

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
False

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?
recessive

Most conditions tested for in newborn screening programs are autosomal recessive T/F
True

some cancers are caused by viruses T/F
True

According to the CDC, it is safe for pregnant women to consume small amounts of alcohol throughout their pregnancies. T/F
False

Huntington is caused by which kind of gene?
Dominant gene

Which cancer can be prevented by immunization?
cervical

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
self efficacy

people of low SES are to blame for their poor health T/F
False

Black Americans tend to have lower SES than whites. T/F
True

African Americans and whites of the same socioeconomic status are equally healthy or unhealthy. T/F
False

African Americans and Hispanics are on average poorer than whites. T/F
true

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:
ecological model

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
toxic agents

Which factor is considered the leading ACTUAL cause of death in the US?
tobacco

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
transtheoretical model

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
arthritis

the most important predictor of overall health is:
socioeconomic status

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:
smoking-related diseases

Which food/drink contribute the most to overweight in children?
soft drinks

nicotine is a carcinogen T/F
False

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
True

The Body Mass Index is a standard measure used by health professionals to determine health risks associated with obesity. T/F
True

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
False

The percentage of Americans who are overweight has increased over the past two decades T/F
True

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
True

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?
Nicotine

What is a method of secondary prevention of motor vehicle injuries?
Airbags

The only way to prevent firearms injuries is to ban guns T/F
False

Use of guns accounts for the high rates of suicide among American adolescents T/F
True

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
False

African Americans have higher injury rates than whites T/F
True

Traumatic brain injuries are common in these instances:
boxers, motor vehicle crashes, football players

Substandard housing increases the risk of house fires T/F
True

Poor people are more likely to use cell phones while driving T/F
False

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
children

This was created as a federal insurance program for the poor?
Medicaid

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
true

This federal program was created for individuals over the age of 65
Medicare

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
True

Public health in the United States is not affected by population growth in developing countries T/F
False

The percentage of Americans who lack health insurance is higher than that in other industrialized countries T/F
True

Most Americans who lack health insurance are over 65 T/F
False

Which of the following countries have the highest birth rate? US, Russia, Sub-saharan Africa, East Asia
Sub-saharan africa

Sick individuals requiring life saving treatment can be turned away from emergency rooms if they are unable to pay for medical services. T/F
False

Immunization for school children is required by law T/F
True

The US pays more health care costs than all other countries T/F
True

Most Americans’ health insurance is paid for by:
their employers