HD EXAM 1

Which are Course Goals (select all): 

- To understand how concepts, theories, and frameworks from interdisciplinary perspectives are foundational to applying a Determinants of Health approach to demonstrate how overarching factors (i.e., economic stability, education, health and health care, social and community context, neighborhood and built environment, and purchasing decisions) can affect health.

- To understand how concepts, theories, and frameworks from multidisciplinary perspectives are foundational to applying a Determinants of Health approach to demonstrate how overarching factors (i.e., economic stability, education, health and health care, social and community context, neighborhood and built environment, and purchasing decisions) can affect health.

- To engage academic, professional, and lay audiences and to demonstrate how a Determinants of Health approach can be applied to contemporary health challenges in the United States.

- To utilize evidence-based knowledge to engage in discussions on how Determinants of Health are produced and contribute to quality of life.

- To understand how concepts, theories, and frameworks from multidisciplinary perspectives are foundational to applying a Determinants of Health approach to demonstrate how overarching factors (i.e., economic stability, education, health and health care, social and community context, neighborhood and built environment, and purchasing decisions) can affect health.

- To engage academic, professional, and lay audiences and to demonstrate how a Determinants of Health approach can be applied to contemporary health challenges in the United States.

- To utilize evidence-based knowledge to engage in discussions on how Determinants of Health are produced and contribute to quality of life.

Which of the following are Course Learning Objectives (select all that apply): 

Question options:

Students will define, identify, and evaluate Determinants of Health data (e.g., policies and databases) using myriad sources, including but not limited to academic, governmental, and non-profit.

Students will look for someone to blame for health inequities.

Students will use a Determinants of Health approach to explore how population characteristics can result in measurable differences in health outcomes across populations.

Students will think through how Determinants of Health approach can be applied to health and commercial practices at various scales (e.g., local, state, and federal).

Students will utilize data to measure, analyze, and engage the limitations of the Determinants of Health. Students will identify and contextualize historical policies that have contributed to measurable differences in health outcomes across populations. 

Students will examine the complex social responses or lack of responses to measurable differences in health outcomes across populations.

Students will define the following concepts, theories, and frameworks, and apply a critical lens to analyze and evaluate how Determinants of Health can elucidate health outcomes.

Students will evaluate the influences of policy at various scales (e.g., local, state, and federal) on the Determinants of Health.

Students will understand how Determinants of Health can lead to measurable differences in health outcomes across populations.

• Students will define, identify, and evaluate Determinants of Health data (e.g., policies and databases) using myriad sources, including but not limited to academic, governmental, and non-profit.

Students will use a Determinants of Health approach to explore how population characteristics can result in measurable differences in health outcomes across populations.

Students will think through how Determinants of Health approach can be applied to health and commercial practices at various scales (e.g., local, state, and federal).

Students will utilize data to measure, analyze, and engage the limitations of the Determinants of Health. Students will identify and contextualize historical policies that have contributed to measurable differences in health outcomes across populations.

Students will examine the complex social responses or lack of responses to measurable differences in health outcomes across populations.

Students will define the following concepts, theories, and frameworks, and apply a critical lens to analyze and evaluate how Determinants of Health can elucidate health outcomes.

Students will evaluate the influences of policy at various scales (e.g., local, state, and federal) on the Determinants of Health.

Students will understand how Determinants of Health can lead to measurable differences in health outcomes across populations.

This is the correct protocol to communicate with Dr. McDonald.

If you have questions about the course, do not hesitate to contact Dr. McDonald. I am not on campus daily, so email is the best way to reach me. Use this language in the subject line: HODH 3650-03/HOD7500-05/Determinants of Health Question. I will reply to you within 48 hours, except on weekends. Therefore, plan and send questions early, or come by to talk with me during student hours or by appointment. You can email me to set up an appointment. If our student hours do not fit your schedule, email me to find another time to meet.

TRUE

Students may submit assignments as a PDF or a Word document.  

False

Systems theory is a helpful framework for understanding determinants of health. 

True

The social determinants of health (SDOH) approach is needed because it addresses why people get sick in the first place, and not simply as a result of a lack of access to healthcare. SDOH is an approach to addressing the fundamental drivers of health inequalities. 

True

Question from Marmot, Social Determinants of Health (3 minutes and 35 seconds) 

Does Professor Sir Michael Marmot claim that inequalities in life tell us about society? 

True

Question Health Equity in England: The Marmot Review 10 Years On (2:10) 

While Professor Sir Michael Marmot could be considered an interdisciplinary scholar, his primary training is:

Question options:

Social justice

Environmental justice

Epidemiology

Social determinants of health

Social work

epidemiology

What is epidemiology? *my own question

the scientific study of how often diseases and health events happen in groups of people and why they occur

Per Healthy People 2030, the five domains of social determinants of health are:

Question options:

Economic stability, educational access, healthcare access, neighborhood and built environment, and social and community context.

Economic stability, educational access and quantity, healthcare access and quantity, neighborhood and built environment, and social and community context.

Economic stability, educational access and quantity, healthcare access and quality, neighborhood and built environment, and social and community context.

Economic stability, educational access and quality, healthcare access and quality, neighborhood and built environment, and social and community context.

Economic stability, educational access and quality, healthcare access and quality, neighborhood and built environment, and social and community context.

Which of the following are examples of social determinants of health (SDOH) (select all that apply):

Question options:

Discrimination and violence

Education, job opportunities, and income

Access to nutritious foods and physical activity opportunities

Polluted air and water

Language and literacy skills

Safe housing, transportation, and neighborhoods

All

Social determinants are relevant to communicable and non-communicable diseases alike.

True

A non-communicable disease (NCD) is a medical condition that cannot be spread from person to person

The argument is made that examining the “causes of the causes” of why populations act is critical to reducing health inequalities, meaning applying this lens is needed to examine the social conditions that give rise to the high risk of non-communicable disease (e.g., smoking and drinking), whether acting through unhealthy behaviours or through the effects of impossibly stressful lives. 

True

Among high-income countries, the correlation between gross national product per person and life expectancy is well documented.

False

The circumstances in which people live and work are as important for communicable diseases as they are for non-communicable diseases. Social conditions powerfully influence both the onset and response to treatment of the major infectious diseases that kill.

True

There are no differences in health between and within a country.  

False

Which countries have similar under-5 mortality rates per 1000 livebirths by the poorest fifth and 2nd poorest fifth quintile of households? 

Indonesia and India

India and Kenya

Kenya and Indonesia

India and Kenya

The social gradient refers to the higher the socioeconomic level of the household, the lower the mortality rate. 

True

There is a direct correlation between gross national product per person and life expectancy. 

False

• the total economic value produced by a country's residents and businesses

Marmot (2025) does not include healthcare access as a component of the Social Determinants of Health Inequalities in his foundational article. One reason for this omission is that residents in the United Kingdom have access to universal health care coverage. A benefit of this system is that healthcare is not directly tied to employment. 

True

Class status correlates with health outcomes (select all that apply):

People who are middle to lower on the class pyramid are exposed to more health threats (material deprivation to chronic stressors) and have less access to the opportunities and resources needed to control their destinies.

Our economic, social and built environments shape health

People middle to higher on the class pyramid have access to more power and resources and in general live longer, healthier lives. This is true not only for the bottom and top but at every level.

Chronic activation of the body's stress response wears down our organs over time and increases disease risk.

All

The authors present a conceptual framework based on fundamental determinants of health scholarship to seek to identify pathways that could inform interventions. What are the components they argue comprise the intermediate factors of their framework (select all that apply)?  

Rural culture

Rural built and natural environment

Public health and health care

all

The authors argue that, irrespective of whether higher or lower socioeconomic position, rural White Americans' common cultural aspects of rurality— such as local beliefs and values (e.g., individualism, mistrust of outsiders)^50,53,56,57 or attitudes (e.g., normative racial resentment)^53,54,58,59 may contribute to health disparities among rural White Americans. 

True

Studies have found that meritocratic Ideology (i.e., blaming oneself or providers for developing lifestyle diseases and illnesses, along with the stigma of using medication for illnesses that are within one’s control) can inhibit one from seeking out and using health services because of adherence to local norms and values. 

True

The lack of mental health services in rural communities can have cascading intra- and intergenerational adverse effects because children living in rural areas are more likely to experience Adverse Childhood Experiences. The lack of adult and child mental health care in rural areas puts children at a greater risk for poorer lifetime economic and health outcomes. 

True

Rural communities are heterogeneous, and studies of rural health may mask significant regional and intra-rural differences. For example, rural communities in the United States with a larger proportion of racial and ethnic minorities are consistently burdened with less healthcare access and have worse health outcomes, such as being more likely to lack access to hospital obstetrics, and rural black mothers are at particularly high risk for poor birth outcomes.

True

Dr. Richard Horton states that one of the reasons that under-five mortality and maternal mortality have remained stagnant since the era of the Sustainable Development Goals is the predatory commercial practices that shape the behaviors, the choices, and the life chances of women and children. 

True

Social Determinants of Health (1991)

Why does Dr. Rob Moodie argue that it is time to focus on the Commercial Determinants of Health (select all that apply):

The great difficulty many governments have in managing this size, power, and influence

The need to replace all forms of capitalism

The need to slow down economic growth so that regulation can be applied to every contaminant used in manufacturing processes

The need for researchers (and practitioners) to align across different industries/sectors

The need to define, conceptualize, and understand the Commercial Determinants of Health

The rapid growth in size, power, and influence of corporations- particularly in relation to nation states

Escalating evidence of the harm to people and the planet from an increasingly market-driven world

The need to disaggregate the vast array and diversity of commercial entities

The need for alternatives – for higher business standards, for stronger governments, for greater profits from health practices and products

The great difficulty many governments have in managing this size, power, and influence

The need for researchers (and practitioners) to align across different industries/sectors

The need to define, conceptualize, and understand the Commercial Determinants of Health

The rapid growth in size, power, and influence of corporations- particularly in relation to nation states

Escalating evidence of the harm to people and the planet from an increasingly market-driven world

The need to disaggregate the vast array and diversity of commercial entities

The need for alternatives – for higher business standards, for stronger governments, for greater profits from health practices and products

Which four industries cause at least 1/3 of global deaths?

• fossil fuels

• ultra Processed foods and beverages

• tabacco

• alcohol

Dr. Anna Gilmore states her paper had two primary purposes: to define and then to conceptualize the Commercial Determinants of Health. She proposes a neutral (neither positive nor negative) definition of the Commercial Determinants of Health because commercial actors' roles vary, many play essential roles in health and society, and they will play a key role in solutions.

True

Dr. Anna Gilmore proposes the following as a definition of the Commercial Determinants of Health: “The systems, practices, and pathways through which commercial actors drive health and equity.” because there are good and bad.

True

Dr. Anna Gilmore states that Commercial Determinants of Health is solely focused on human health. 

False

In a nutshell, the researchers argue that the Commercial Determinants of Health can be summarized as a few industries selling harmful products for profit. 

False

The three key elements of Dr. Anna Gilmore’s conceptual Commercial Determinants of Health model are (1) commercial sector, (2) determinants of health, and (3) systems and underlying drivers.

True

Dr. Anna Gilmore states that evidence has found that diverse corporations have also used their political practices to establish “upstream” policies to establish rules on policymaking that advantage their interest and do so to make it harder to pass public health or environmental policies, and have been effective. 

True

Dr. Jenn Lacy-Nichols states it is important to be able to make meaningful distinctions between commercial actors based on the nature of their health impacts. A commercial actor only includes corporations; it does not include the government or non-profits.  [Read this carefully]

False

Dr. Sharon Friel states there is extensive evidence that a combination of actions by different actors really offers the possibilities, together offers the possibilities for systemic change that we need.  All actors have power, and we can use a range of strategies and instruments to advance human and planetary health interests. 

True

Paula Jones states that there is not one country that has developed best buys around non-communicable diseases. 

True

False

B Impact Assessment is a collaborative tool that measures a comapany's sustainability and impact, identifies performance, and provides access to best-practice guides; you can include all team members and download it to work offline.  A tool like this matters because you can only manage what you can measure. 

True

During the question and answer, reputation management is a practice that is part of the Commercial of Determinants conceptual model.

True

Question from Lecture and Marmot (2005) Social determinants of health inequalities, The Lancet, 365: 1099–104 and class lectures 

The socioeconomic gradient in health is described as stepwise rather than a simple linear or threshold-based relationship because health outcomes improve at every sequential increase in social and economic status, rather than progressing at a perfectly uniform rate or stopping at a certain wealth threshold, such as the poverty line.

True

Question from Week Four Lecture 

The definition of absolute poverty is its relation to the standards that exist elsewhere in society. It can be associated with adverse health outcomes. 

False

Question from Week Four Lecture 

The American Association of Physical Anthropologists issued a 2019 statement on why we should abandon race as a biological category in biomedical research by stating “pure races, in the sense of genetically homogeneous populations, do not exist in the human species today, nor is there any evidence that they have ever existed in the past.” 

True

Race is a socially constructed set of categories historically based on physical features such as skin color, hair texture, and facial features. 

True

The United States Census race categories based on standards set by the U.S. Office of Management and Budget in 1997 are (select all that apply):

black

white

some other race

american indian or alaskan native

native hawaiian or other pacific islander

Hispanic

black

white

some other race

american indian or alaskan native

native hawaiian or other pacific islander

In the 1930s, the federal government created redlining maps for every city in the United States. Between 1935 and 1940, an agency of the federal government, the Home Owners' Loan Corporation, graded the "residential security" of thousands of American neighborhoods. By "security," they meant the relative security or riskiness of those areas for banks, savings and loan, and other lenders who made mortgages. For each of these cities, they produced maps showing those grades. Neighborhoods they deemed "best" and safe investments were given a grade of A and colored green. Those that were deemed "hazardous" were given a grade of "D" and colored red. 

False

bc it is not every city

Fairness, Justice, and Equity are the glue that connects Dr. Bullard’s scholarship. Hint: This approach informs his books.

True

All communities are created equal. 

False

What is the best predictor of health and well-being (select one)? 

Household

Country

State

County

Zip Code

Zip code

The South or Dixie is the most environmentally degraded region in the United States. 

True

The authors cite Tessum CW, Paolella DA, Chambliss SE, Apte JS, Hill JD, Marshall JD. (2021) to support that “The quality of the air we breathe is itself a critical social determinant of health long shaped by structurally racist and classist policies that result in measurably higher exposure to PM_2.5 in Black, Hispanic, and Asian neighborhoods.” 

true

It does not matter if a pregnant individual is exposed to high levels of PM_2.5, as there are no adverse health effects that can affect a person’s health later in life.

False

The same policies that resulted in systemic disinvestment from neighborhoods, allowing polluting industries to move in, have also resulted in poorer housing stock, poorer access to healthy food choices, less green space, higher rates of racist policing, and less economic opportunity.

true

To improve health outcomes, physicians can familiarize themselves with federal and state-funded weatherization programs that low-income households can apply for to facilitate HVAC installation and improve indoor air quality, among other important health interventions, and share this information with patients who live in housing conditions that contribute to poor respiratory health. 

True

If you overlay a map of environmental hazards onto a map of rates of obesity or hypertension or low-birth weight, it is common to see all of these dimensions cluster. 

true

People who live in lower-socioeconomic-status neighborhoods often face a poverty tax, paying more for services like check cashing and groceries than people in more affluent areas. 

True

After the shipyards closed in Richmond, CA, no families could obtain government-backed mortgages to buy homes in the new suburbs. 

False

Once a community starts to decline, nobody wants to invest in it. Living in disadvantaged neighborhoods is related to an increased risk of developing heart disease.

true

Low-income neighborhoods are the most affected by the cost of asthma in healthcare and lost school and workdays. 

true

Housing policy is health policy. Educational policy is health policy. Anti-violence policy is health policy. Neighborhood improvement policies are not health policies, but solely economic policies with no health benefits.

false

According to the Chapter, when is health and risk communication essential?

Only after impact, once damage has been assessed

Both before and after disaster impact, for example to publicize protective behaviors that prevent drowning or heat illness

Only during the evacuation itself

Only for technological disasters involving hazardous materials

Both before and after disaster impact, for example to publicize protective behaviors that prevent drowning or heat illness

Which of the following is the best example of risk avoidance?

Buying flood insurance for a home in a floodplain

Restricting logging on unstable hillsides to prevent landslides

Placing hospital generators on upper floors in flood-prone areas

Opening emergency shelters after a hurricane makes landfall

Restricting logging on unstable hillsides to prevent landslides

In the chapter's framework, vulnerability (demographics, education, minority status, health status) is classified as:

An extrinsic risk factor

An intrinsic risk factor

A form of capacity

A type of hazard

An intrinsic risk factor

The chapter summarizes public health preparedness capabilities as "the E's." Which of the following is NOT one of them?

Early warning

Exercises and drills

Engagement of the public

Enforcement of curfews

Enforcement of curfews

According to the chapter, what may be the single most important risk factor for vulnerability to all environmental disasters?

Age over 65

Poverty

Lack of disaster training

Living near the coast

Poverty

The concept of "all-hazards preparedness" is based on the idea that:

Each hazard type needs its own separate, scenario-specific plan

Common capabilities serve well across many disasters, with needs varying more by severity and scale than by disaster type

Natural hazards can be fully prevented, so planning should focus on technological ones

Only the most frequent hazard in a community needs to be planned for

Common capabilities serve well across many disasters, with needs varying more by severity and scale than by disaster type

In the chapter's table of public health consequences and capabilities, "public concern for safety" is addressed by which capabilities?

Mortuary care and social services

Pest and vector control

Risk communication, public information, and security

Solid waste management

Risk communication, public information, and security

Which of these is an example of FEMA's "education and awareness" type of mitigation?

Building berms around chemical storage tanks

Restoring wetlands to protect against flooding

Community participation in programs such as StormReady or Firewise Communities

Providing drought-tolerant seeds to farmers

Community participation in programs such as StormReady or Firewise Communities

A city issues heat-wave warnings only in English, only on local TV. Which vulnerability factor named in the chapter does this approach fail to address?

Language barriers

Malnutrition

Property loss

Family position

Language barriers