2. Health disparities are primarily a concern in developing countries: a. True b. False

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1 PH150 December 9, 2008 FINAL EXAMINATION Select the best answer for each multiple choice question. There are 92 questions and 14 pages on the examination. Notify the instructor if your examination does not have 14 pages. Clearly indicate on the scan form the one best answer to each question among the answers provided. Be sure that you have selected your choice correctly on the scan form. Be sure that you have entered your name and identification number on the scan form and filled out the columns for the letters of your name and numbers of your identification number correctly (see front and back). Use a #2 pencil and fill all circles completely. 1. Which of the following disease(s) is/are currently pandemics? a. HIV/AIDS b. H5N1 c. Measles 2. Health disparities are primarily a concern in developing countries: 3. The majority of chronic diseases globally occur in: a. Developed countries b. Developing countries c. Equally in both 4. The leading cause of ill health world-wide according to Professors Detels and Fielding is: a. Smoking b. Diabetes c. High blood pressure d. Recreational drug use e. Poverty 5. Communicable diseases cause more deaths than non-communicable diseases in which of the following regions? a. Africa b. Southeast Asia c. Western Pacific d. The Eastern Mediterranean e. Africa and Southeast Asia 6. Public health efforts have successfully reduced the gap between rich and poor within the United States: 1

2 7. Priorities for selecting diseases of primary interest for control should be based on: a. Number of people affected b. Severity (moribidy/mortality) of the disease c. Impact of the disease on the country 8. The epidemiologic transition refers to: a. The development of the discipline of epidemiology in developing countries b. The increase in chronic diseases and persistence of infectious diseases c. The increase in both chronic disease and infectious diseases d. The increase in both chronic disease and infectious diseases e. The reduction in both chronic and infectious diseases 9. The core of ethical research is: a. Involving local investigators in design of the research project b. Conducting research that is only relevant for the country in which the research will be conducted c. Compensating participants for their time d. Informed consent 10. Conventional concept(s) of ethical research in developing countries require(s)? a. Making successful outcomes of the research available to the country and participants b. Conducting research in developing countries that is relevant to the needs of the host country c. Having the approval of a host country institutional review board 11. Having a volunteer army is an example of: a. Condoned exploitation b. A necessity to assure security and stability c. An opportunity for gainful employment of the poor d. a. and b. above e. b. and c. above 12. Use of placebos (a control group that receives no active intervention) is never ethical: 2

3 13. Mutually advantageous exploitative research a. Should be a universal principal of ethical research b. Provides benefits, usually unequal, for both the research subject and the researcher c. Is particularly common in the United States and Europe e. a. and c. above 14. The most vulnerable group at risk of HIV infection is: a. Elderly men b. Elderly females c. Youth years d. Children 15. The incidence of HIV in 2007 was highest in which region of the world? a. Asia b. Europe c. Latin America d. Oceania e. Sub-Saharan Africa 16. Which of the following risk activities confers the lowest probability of HIV transmission? a. Receptive anal intercourse b. Vaginal intercourse c. Insertive anal intercourse d. Oral-genital intercourse e. All confer an equal risk 17. The HIV epidemic causes: a. A reduction in the proportion of producers in a population b. Disruption of the family unit c. Economic disruption 18. It is essentially impossible to successfully confront the HIV epidemic in a country without a strong commitment from the political leadership: 19. The leading cause of death in Los Angeles County in 2005 was: a. Coronary heart disease b. Stroke c. HIV/AIDS d. Lung cancer e. Homicide 3

4 20. The leading cause of premature death in males in Los Angeles County in 2004 was: a. Coronary heart disease b. Stroke c. HIV/AIDS d. Lung cancer e. Homicide 21. The two diseases projected to increase the most in the next 15 years in the United States are: a. Coronary heart disease and stroke b. High blood pressure and diabetes c. Cancers and mental disorders d. Pulmonary conditions and stroke 22. The leading behavioral cause of death in the United States in 2000 was: a. Alcohol b. Diet c. Toxic agents d. Use of illicit drugs e. Tobacco 23. Obesity is no longer a risk factor for death after age 65 in the United States, but is still an issue because it still is a source of disability: 24. Innate determinants of health include: a. Age b. Gender c. Genetics/biology e. a. and c. above 25. From , the prevalence of most diseases in Los Angeles County declined EXCEPT for which of the following? a. Coronary heart disease b. Diabetes c. Alzheimer s disease e. b. and c. above 26. Forty percent of children in Los Angeles are in families living below the poverty level: 4

5 27. The majority of uninsured individuals in the United States are: a. Poor b. Women c. Workers and their families d. Unemployed e. In Massachusetts 28. Out of pocket costs for physicians and clinical services in the U.S. is: a. Increasing b. Decreasing c. Remaining constant 29. In the U.S., the cost-effectiveness of health care associated with increased expenditures is: a. Increasing b. Decreasing c. Unclear 30. According to the U.S. Centers for Disease Control, 80% of diabetes, heart disease and stroke could be prevented if Americans: a. Took their medication regularly b. Treated their high blood pressure, took insulin, and had coronary checkups c. Stopped smoking, ate a healthy diet, and exercised regularly d. Had a physical exam every 12 months, had regular dental check ups, and limited their intake of coffee to 3 cups per day. 31. What proportion of current smokers in Los Angeles County seriously considered stop smoking in 2007? a % b % c % d. 99% 32. The racial/ethnic group with the highest diabetes mortality in Los Angeles County was: a. African-Americans b. Hispanic-Americans c. European-Americans d. Asian-Americans 33. The role of a modern Department of Public Health is to control disease, NOT to spend precious tax dollars on reducing the many risk factors within the community: 5

6 34. City zoning laws play an important role in promoting health: 35. Which McDonald s menu option has the most calories? a. Big Macs b. Egg McMuffin c. Large shake d. Hamburgers 36. Who should public health leaders educate? a. Themselves b. The public c. Policy makers e. b. and c. above 37. The most prevalent and rapidly increasing sexually transmitted disease (STD) in California is: a. Syphilis b. Gonorrhea c. Chlamydia d. Chancroid e. HIV 38. Which of the following is not a reportable STD in California? a. Syphilis b. Gonorrhea c. Chlamydia d. Human papilloma virus e. HIV 39. Up to what percent of sexually active women experience asymptomatic chlamydial infections? a. 5% b. 15% c. 25% d. 35% e. 70% 40. The highest rates of chlamydial infection in women occur in which racial/ethnic group? a. African-American b. Asian-American c. European-American d. Hispanic-American 6

7 41. Gonorrhea is usually asymptomatic in males: 42. Syphilis can be transmitted by: a. Skin-to-skin contact b. Oral-genital intercourse c. Vaginal intercourse e. b. and c. above 43. Antibiotic-resistant gonorrhea is a major treatment problem in Los Angeles and globally: 44. The current syphilis epidemic in Los Angeles County is occurring primarily among: a. Heterosexuals b. Men who have sex with men c. Men over 45 years of age d. Women over 45 years of age e. Women in brothels 45. Bathhouses in Los Angeles are required to provide: a. Condoms b. Safer sex messages c. HIV testing onsite 20 hrs/week 46. Closing of bathhouses in Los Angeles was a very effective intervention to reduce STDs in Los Angeles: 47. Approximately 60% of men who have sex with men who are infected with syphilis are also infected with HIV: 48. The highest percentage of newly HIV-infected persons in Los Angeles County are: a. Heterosexual men b. Men who have sex with men c. Sexually active women d. Injection drug users e. Health care workers 7

8 49. InSPOTLA is: a. A new nightclub in West Hollywood that is popular among gays b. A website providing tourist information about hot spots in Los Angeles c. A website to facilitate control of STDs d. A website for meeting gays who are interested in mutually agreeable sex e. A great spot to have fun! 50. The proportion of the U.S. population infected with human papilloma virus (HPV) during their lifetime is approximately: a. 10% b. 20% c. 50% d. 80% e. 100% 51. What proportion of new HPV infections are usually cleared within two years? a. 10% b. 20% c. 40% d. 60% e. 90% 52. Which of the following is/are risk factors for HPV infection? a. Younger age b. Many sex partners c. Use of crystal methamphetamine 53. Those who are most in need of the HPV vaccine may not be able to receive it because of: a. Cost b. Requirement for three separate injections over six months c. Low literacy e. b. and c. above 54. HPV, HSV, and trichomonas are not reportable sexually transmitted diseases because: a. Their incidence is low b. There is no good curative treatment for them c. They only affect men who have sex with men d. They only affect women who sex with men who have sex with men e. They have no symptoms and are hard to diagnose 8

9 55. The treatment of choice for syphilis is: a. Tetracyclines b. Penicillin c. HAART d. Sulfa 56. A wise motto is It really matters what you partner does! 57. The HPV vaccine should be given to all sexually active women regardless of age: 58. Environmental threats need to be studied at: a. The ecologic level b. The individual level c. In the laboratory e. b. and c. above 59. The major elements of environmental risk assessment are: a. Hazard identification, exposure assessment, dose-response assessment, risk characterization b. Identification of diseases caused by environmental factors, damage assessment, and recovery c. Site inspection, hazard identification, and recovery d. Hazard identification, hazard mapping, and remediation 60. The Environmental Protection Agency does not routinely assess existing chemicals for hazards to health: 61. Which of the following is not an example of an environmental intervention? a. Elimination of lead from gasoline b. Setting vehicle emission limits c. Chlorination of drinking water d. Banning smoking from public places e. All the above are environmental interventions 62. The largest lead producer in the world is: a. United States b. China c. Taiwan d. United Kingdom e. Spain 63. Which of the following chemicals has the highest cancer-causing potential? 9

10 a. Diesel exhaust b. Methylene chloride c. Chromium VI 64. Construction of tube wells in Bangladesh and West Bengal resulted in poisoning of the local populations by what chemical? a. Lead b. Chromium VI c. Arsenic d. Selenium e. Nitrite 65. Anxiety is a negative emotion and should play no part in promoting public health interventions: 66. Supplying clean water, safe disposal of community wastes, regulations to protect workers, and laws banning smoking in public places are all examples of what kind of public health intervention? a. Biologic b. Behavioral c. Structural d. Personal e. Targeted interventions 67. The reduction in the spread of tuberculosis in the United States during the 20 th century is primarily due to: a. Better sanitation b. Provision of clean water c. An increased standard of living and decreased crowding in poor living quarters d. Increased access for refrigeration for food e. Development of an effective vaccine 68. Eradication of smallpox in the 20 th century was primarily due to: a. The availability of an effective vaccine b. The development of effective treatment c. Developing a containment strategy based on the epidemiologic characteristics of smallpox d. The realization by governments that smallpox was a major problem that should be addressed. e. Economic improvement 10

11 69. A vaccine should prevent which of the following? a. Initial infection b. Development of clinical disease c. Transmission of the causative agent 70. Producing an effective vaccine against influenza is complicated by: a. Mutations in influenza hemagglutinins b. Mutations in influenza neurominidases c. Changes in animal vectors e. Mutations in both influenza hemagglutinins and neurominidases 71. Public health: a. Saves millions of lives b. Prevents disease and disability c. Promotes healthy lifestyles e. b. and c. above 72. What proportion of health dollars in the United States is spent on population health? a. 3% b. 10% c. 25% d. 35% e. 80% 73. Which of the following diseases/disorders has the highest proportion of cases resulting from occupational risk hazards? a. Low back pain b. Hearing loss c. Asthma d. Chronic obstructive respiratory disease e. Leukemia 74. The segment of the population that is projected to experience the highest proportional increase in the global workforce is: a. Women b. Minorities c. Youth d. Those over 55 years e. Men 11

12 75. A switch to a primarily part-time workforce allows companies to reduce costs for health and other employee benefits: 76. Which of the following countries has the highest average annual hours worked by the workforce? a. China b. Japan c. Russia d. Canada e. The United States 77. In the United States, the percent of businesses providing employer-sponsored health insurance in the last 20 years has: a. Decreased b. Remained stable c. Increased 78. The current total fertility in the United States is sufficient to maintain but not expand the population: 79. Why is America aging? a. Declining birth rates b. Declining mortality rates c. Decreased premature births 80. Risk factor(s) for falls resulting in injury is/are: a. Increasing age b. Low income c. Unemployment 81. Rehabilitation of elderly persons who have suffered an injury as the result of a fall is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Quartenary prevention 12

13 82. Secondary prevention involves: a. Immunization b. Screening for disease c. Improving nutrition d. Physical activity to reduce child obesity e. All of the above 83. Designing houses with no stairs, low counters, and assistance rails in bathrooms and other areas is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Quartenary prevention 84. Professor Breslow described the three phases of public health. The goal of the third (future) phase of public health is? a. Extension of life b. Reduction of chronic diseases c. Reduction of infectious diseases d. Sustaining optimal function e. Reducing accidents 85. Food insecurity is associated with: a. Increasing age b. Low income c. Environmental conditions 86. The objective of the Photovoice project described by Professor Virginia Li was: a. An example of a participatory methodology of health education b. A process of engaging participants in education to promote critical consciousness c. A process to improve agricultural techniques and yield 87. According to Professor Virginia Li, what was the most effective method of quitting smoking? a. Nicotine patch b. Stopping cold turkey c. Nicotine gum d. Counseling e. Health education 13

14 88. According to Professor Virginia Li, what was not a driving factor in the success of China s family planning program? a. Coercion b. Free family planning services c. Reward system d. Community participation e. All were important components of the program 89. A mental disorder is a behavioral or psychological syndrome associated with: a. Distress b. Disability c. Significantly increased risk of unfavorable outcome e. a. and c. above 90. Which of the following statements is/are false? a. Compared with men over the age of 70, women have a greater number of depressive symptoms b. Among those with a single depressive symptom and over the age of 70, men outnumber women c. The majority of women over the age of 70 have had depressive symptoms d. The majority of men over the age of 70 have had depressive symptoms e. All the statements are true 91. Smoking rates are highest among which racial/ethnic group? a. European-Americans b. Asian Americans c. African-Americans d. Native Americans 92. Which of the following strategies was NOT used to decrease the numbers of smokers in the US? a. Prohibiting sales of cigarettes to youth b. Increase taxes on cigarettes c. Prohibit smoking in public spaces d. Decrease the social acceptability of smoking e. All the above were strategies used to decrease smoking 14