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PUBH 302 Exam 2 Questions And Answers, Exams of Public Health

Healthcare Training InstitutePublic Health

Explain the term: social determinants of health - ✔✔the circumstances in which people are born, grow up, live, work and age, and the systems put into place to deal with illness

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2024/2025

Available from 06/27/2025

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PUBH 302 Exam 2 | Correct Answers |
100% Verified | Latest 2025
Version
Explain the term: social determinants of health - ✔✔the circumstances in which people are born, grow
up, live, work and age, and the systems put into place to deal with illness
How do social determinants impact health outcomes? - ✔✔Social determinants, like poverty, lack of
education, and unequal access to healthcare can contribute to health inequities
Describe the Tuskegee Study - ✔✔- Study conducted by US public health services, working with the
Tuskegee Institute
- Involved 600 black men (some with syphilis, some without)
- Researchers told the men they were being treated for bad blood, but the men did not receive proper
treatment to cure their illness
- This study continued for 40 years (1932-1972)
How did the Tuskegee impact research and practice? - ✔✔- Made people more aware of the ethics in the
study
- Created many of the current policies to study, like informed consent
- 1974 National Research Act - requires researchers to get voluntary informed consent from all persons
taking part in studies
What are ACEs? - ✔✔Experiences that children (0-17yrs) have that fall into the following categories
- Abuse
- Neglect
- Household dysfunction
How can ACEs impact health outcomes? - ✔✔- early adversity has lasting impacts
- toxic stress from ACEs has direct effect on brain development
- Higher ACEs correlate to higher risks of injury, poor mental health, poor maternal health, infectious
disease, chronic disease, risky behavior, and lower opportunities
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PUBH 302 Exam 2 | Correct Answers |

100% Verified | Latest 2025

Version

Explain the term: social determinants of health - ✔✔the circumstances in which people are born, grow up, live, work and age, and the systems put into place to deal with illness How do social determinants impact health outcomes? - ✔✔Social determinants, like poverty, lack of education, and unequal access to healthcare can contribute to health inequities Describe the Tuskegee Study - ✔✔- Study conducted by US public health services, working with the Tuskegee Institute

  • Involved 600 black men (some with syphilis, some without)
  • Researchers told the men they were being treated for bad blood, but the men did not receive proper treatment to cure their illness
  • This study continued for 40 years ( 1932 - 1972 ) How did the Tuskegee impact research and practice? - ✔✔- Made people more aware of the ethics in the study
  • Created many of the current policies to study, like informed consent
  • 1974 National Research Act - requires researchers to get voluntary informed consent from all persons taking part in studies What are ACEs? - ✔✔Experiences that children ( 0 - 17 yrs) have that fall into the following categories
  • Abuse
  • Neglect
  • Household dysfunction How can ACEs impact health outcomes? - ✔✔- early adversity has lasting impacts
  • toxic stress from ACEs has direct effect on brain development
  • Higher ACEs correlate to higher risks of injury, poor mental health, poor maternal health, infectious disease, chronic disease, risky behavior, and lower opportunities

What are the prevention strategies for addressing ACEs? - ✔✔- strengthen economic support to families

  • promote social norms that protect against violence and adversity
  • ensure strong start for children
  • teach skills
  • connect youth to caring adults and activities
  • intervene to lessen immediate and long term harms Describe major issues that make the health system a PH concern - ✔✔- overmedication
  • over treatment
  • entrenched system
  • reimbursement Why does the US health care system cost so much compared to the rest of the world? - ✔✔- misuse of ER
  • reward doing more, rather than efficiency
  • inappropriate care/tests
  • defensive medicine
  • malpractice costs
  • greater use of high costs technology and procedures
  • brand name drugs
  • high costs of R&D
  • price variations/lack of transparency
  • high admin costs
  • higher wages for providers
  • limited competition
  • middlemen
  • profit
  • diversity in the population
  • income/insurance status
  • family structure
  • specific chronic conditions (cancer, HIV/AIDs) What are common characteristics of other countries' healthcare systems that could be incorporated into reform in the US? - ✔✔- British pay for healthcare out of tax revenue, hospitals compete to stay open
  • Tokyo has social insurance, mandates insurance paid for by work or community based insurer, no gatekeeper, fixed procedure and drug prices, insurance companies don't profit
  • Germany uses the Bismarck model, Germans split premiums with employers, insurance plans compete for customers, but do not profit
  • Taiwan has universal healthcare, that forces everyone to pay, smart cards to avoid high admin costs
  • Switzerland has high quality universal coverage, rich pay for the poor, non-profit insurers, benefit packages fixed Identify opportunities for innovation of the US healthcare system - ✔✔- types of insurance plans
  • empower patients/consumers
  • non-traditional setting care
  • drug pricing
  • more focus on social determinants of health Explain opportunities for innovation of the US healthcare system - ✔✔- types of insurance plans: engage employers in lowering costs
  • empower patients/consumers: call for increased transparency, shopping for care
  • non-traditional setting care: More than half expressed a willingness to receive care in a non-traditional setting if the care was less costly and more convenient
  • drug pricing: finding ways to lower costs of drugs, generic drugs
  • more focus on social determinants of health: Nonprofits working to increase to access to healthy foods and safe housing

How are social determinants of health shaped by wider forces? - ✔✔Economics, social politics, and policies For ACEs, what does abuse refer to? - ✔✔physical, emotional, and sexual abuse For ACEs, what does neglect refer to? - ✔✔physical and emotional neglect For ACEs, what does household dysfunction refer to? - ✔✔mental illness, incarcerated relative, mother treated violently, substance abuse, and divorce What was the CDC-Kaiser ACE study? - ✔✔Landmark study surveying over 17 , 00 people in the US and showed the breakdown of how many people reported having experienced ACEs What did the CDC-Kaiser ACE study find? - ✔✔- almost 2 / 3 reported at least one ACE

  • people with 6 + ACEs died nearly 20 years earlier on average than those without ACEs For impacts of ACEs, what does injury refer to? - ✔✔traumatic brain injury, fractures, burns For impacts of ACEs, what does mental health refer to? - ✔✔depression, anxiety, suicide, and PTSD For impacts of ACEs, what does maternal health refer to? - ✔✔unintended pregnancy, pregnancy complications, fetal death For impacts of ACEs, what does infectious disease refer to? - ✔✔HIV, STDs For impacts of ACEs, what does chronic disease refer to? - ✔✔cancer, diabetes For impacts of ACEs, what does risky behavior refer to? - ✔✔alcohol and drug abuse, unprotected sex

For ACEs, what approaches can be used to help connect youth to caring adults? - ✔✔- mentoring programs

  • after-school programs For ACEs, what approaches can be used to help intervene to lessen immediate and long term harms? - ✔✔- enhanced primary care
  • victim-centered services
  • treatment to lessen the harms of ACEs
  • treatment to prevent problem behavior and future involvement in violence
  • family-centered treatment for substance disorders What are the three levels of potential determinants of disparities? - ✔✔- patient level
  • provider level
  • system level What are the determinants of disparities at the patient level? - ✔✔- knowledge and attitudes
  • behavior intention and social norms
  • perceived susceptibility to health problems
  • mistrust What are the determinants of disparities at the provider level? - ✔✔- training and skills
  • knowledge and attitudes
  • bias and stereotyping What are the determinants of disparities at the system level? - ✔✔access to health care Describe how knowledge and attitudes can contribute to health disparities - ✔✔Ex. African americans and black teens are more likely to have unintended pregancies
  • sometimes has to do with attitudes and knowledge around contraceptives

Describe how behavior intention and social norms can contribute to health disparities - ✔✔- intending to eat healthy = behavior intention

  • higher intention, more likely to do the behavior Describe how perceived susceptibility to health problems can contribute to health disparities? - ✔✔- perceived risk impacts your behavior
  • can be related to positive and negative behavior
  • boys more likely to take bigger risks than girls Describe how mistrust can contribute to health disparities? - ✔✔- think about the Tuskegee study
  • women of color found to be less likely to use a form of contraception that makes them rely on a health care provider Describe how training and skills can contribute to health disparities? - ✔✔- young people less likely to be honest about sexual activity and require more trust with provider to be honest
  • having culturally confidence training is important Describe how knowledge and attitudes can contribute to health disparities? - ✔✔providing recommendations in a way that makes the patients feel respected, valued, and not judged Describe how access to health care can contribute to health disparities? - ✔✔Ex. African american men are more likely to have premature death due to preventable causes
  • prenatal care through Medicaid What CDC programs have been implemented to address social determinants of health? - ✔✔- working with sector such as housing, education, and transportation
  • in partnership with communities because working together can have greater impact than working alone
  • zoning laws
  • WIC program
  • ranked well for treatment of chronic diseases
  • responsible for most important recent medical innovations What is defensive medicine? - ✔✔Medical practices done not for the patient's benefits but in order to protect physicians from malpractice suits T or F: a majority of the uninsured make below the poverty level - ✔✔False; majority of those uninsured make ABOVE the poverty level List the government insurance programs - ✔✔- medicare
  • medicaid
  • VA programs How does medicaid benefit low income families? - ✔✔- Pregnant women: prenatal care and delivery costs
  • Children: routine and specialized care for childhood development (immunizations, dental, vision, speech therapy)
  • Families: affordable coverage to prepare for the unexpected (emergency, dental, hospitalization, antibiotics) How does medicaid benefit individuals with disabilities? - ✔✔- Child with autism: in-home therapy, speech/occupational therapy
  • Cerebral palsy: assistance to gain independence (personal care, case management and assistive technology)
  • HIV/AIDS: physician services, prescription drugs
  • Mental illness: prescription drugs, physician services How does medicaid benefit elderly individuals? - ✔✔- Medicare beneficiary: help paying for medicare premiums and cost sharing
  • Community waiver participant: community based care and personal care
  • Nursing home resident: care paid by medicaid since medicare does not cover institutional care

What is medicare part A? - ✔✔Covers inpatient hospital care, as well as care provided in skilled nursing facilites, hospice care, and home health care What is medicare part B? - ✔✔Covers medically necessary doctors' services, outpatient care, other medical services (including some preventive service not covered under Medicare Part A) What is medicare part D? - ✔✔Prescription drug coverage Characteristics of the medicare population - ✔✔- 32 % functional impairment ( 1 + ADL limitations) ADL = activities of daily living

  • 25 % fair/poor self-reported health
  • 22 % 5 + chronic conditions
  • 15 % under age 65
  • 12 % age 85 +
  • 3 % long term care facility resident How much of health expenditure goes towards prevention and population based health? Why? - ✔✔- Just a tiny slice of the pie goes to public health initiatives
  • Hard for private sectors to make money on public health initiatives What is a core component of the ACA coverage expansions? - ✔✔- Expanding medicaid to low-income adults is a core component of the ACA coverage expansions
  • Prior to ACA, medicaid eligibility was limited to specific low-income groups
  • Pregnant women, children, elderly & persons with disabilities
  • As enacted, the ACA medicaid expansion would cover adults up to 138 % FPL in all states, filling long- standing gaps in coverage
  • Gap in coverage for adults in states that do not expand medicaid under the ACA What is HOP? - ✔✔South Carolina's Health Outcome Plan

Gatekeeper - ✔✔- Person in charge of patient's treatment

  • Primary care provider Healthy Savings Account (HSA) - ✔✔- Put money in health savings account, pre-taxed, can use this money to pay towards health care expenses
  • You keep the money year after year - can build up
  • Good to couple with savings plan Standard Plan - ✔✔Pay a slightly higher premium, but have lower deductible Savings Plan - ✔✔- Pay less per month for premium, but higher deductible
  • Couple with HSA just in case you do acquire high medical deductibles Aging Population - ✔✔A demographic trend that occurs as the average age of a population rises Half of Medicare beneficiaries had incomes below $ 26 , 200 per person in 2016. Why does this matter? - ✔✔Limited income to cover basic expenses
  • If you have to spend $ 6 ,0 00 on health care, that's $6, 000 less to spend towards groceries, bills, etc Average out-of-pocket spending on services and premiums by traditional medicare beneficiaries in 2016. What is the main component that drives up the cost of medicare to individuals and tax payers? - ✔✔Assisted living By 2034 , the 65 + population will outnumber children for the first time in US history. What implications does this have for healthcare? - ✔✔- Older persons tend to use more healthcare services
  • Often have comorbid (chronic) conditions
  • Living on fixed incomes How is medicare funded? - ✔✔- Payroll taxes, premiums, etc
  • Medicare Part A is paid by payroll taxes (employers & employees)
  • Medicare Part B paid partially by premiums Diversity in the US population - ✔✔- Population is no longer a majority of whites
  • Seeing tremendous projected growth in Hispanic population
  • As time goes on, we have become more diverse What are the implications for how we provide healthcare to an increasingly diverse population? - ✔✔- Different characteristics of different people
  • Have to treat in a way that shows cultural respect
  • Training to provide good quality care to anyone
  • Importance of including all kinds of races and ethnicities in healthcare. Research shows people want to go to people who look like them Family Structure - Income - ✔✔- More african american children live in single parent households than white children
  • 18 % of US children live in poverty, leading to less access to resources (such as healthy foods, safe neighborhoods conducive to good health, etc)
  • Married parents are more likely to have college degrees
  • Married parents earn more (health wealth gradient) Low income patients with or without insurance coverage - ✔✔- More likely to forgo care because of cost
  • Worries about affordability are exacerbated by not knowing the cost of services in advance
  • Time away from work and other responsibilities (Non-traditional hours for appointments; telehealth?)
  • Poor experiences with care and distrust of providers What trend was seen after the ACA was implemented for 10 years? - ✔✔increased # of americans with health insurance, mostly from medicaid expansion T or F: the ACA stopped high, rapidly rising health care costs - ✔✔false
  • Walmart clinics What are vertical integrators? - ✔✔companies looking to control the costs of their supply chain by owning more of it ex. CVS What are employer activists? - ✔✔employers seeking to limit the growth of their healthcare costs ex. Safeway, Amazon What are technology invaders? - ✔✔technology companies seeking to grab a greater foothold in healthcare ex. Google, Apple, Amazon, Uber What are health retailers? - ✔✔retailers looking to gain market share by better understanding consumer desires and behavior, and providing some types of healthcare directly ex. Walmart, CVS, Amazon T or F: Consumers are generally more comfortable with buying medicine from tech companies than they are with receiving health care services from them - ✔✔true T or F: Consumers generally more comfortable seeking routine care in nontraditional settings if the cost is less than it would otherwise be - ✔✔true; cost seems to be the number one driving force for decisions