SPH 200 EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026
what is public health? - Answers the science and art of preventing disease, prolonging life and
promoting health through the organized efforts and informed choices of society, organizations, public
and private, communities and individuals
- emphasizes the promotion of health and populations as a whole
Miasma Theory - Answers belief that diseases such as cholera & Black Death were caused by noxious
clouds of "bad air"
describe the seven steps of assessment, planning, action, evaluation - Answers 1) Identify gaps that
prevent proper action through assesment
2) adapt to the local context
3) assess barriers to knowledge use
4)select, tailor, and implement interventions (use knowledge translation)
5) monitor knowledge use
6) evaluate outcomes
7)sustain knowledge use
Food and Drugs Act - Answers lays foundation for distributing food and drugs safely
health - Answers The combination of physical, mental/emotional, and social well-being (not just the
absence of disease)
1978 WHO definition of health - Answers level of health that permits people to lead socially and
economically productive lives
mortality based measures of health - Answers a binary measurement of health that is often easy to
attribute
what are two mortality based measures of health? - Answers infant mortality rates
life expectancy at birth
- lower socioeconomic status & lower education resulted in an increase chance of death
Disability Adjusted Life Year (DALY) - Answers A statistical measure combining in one number years
lost to premature mortality and years lived with disability. One DALY equals one lost year of healthy
life.
average life expectancy - Answers the number of years the average newborn in a particular
population group is likely to live
65 years in the US (11 yrs are lost to DALY)
biological risk factors - Answers genetic endowment, aging
environmental risk factors - Answers food, air, water, risk of infectious diseases
Psychosocial risk factors - Answers poverty, stress, personality and culture
absolute wealth - Answers Current market cash value of all of your assets
relative wealth - Answers your wealth compared to others
Gini Coefficient - Answers A measure of income inequality within a population, ranging from zero for
complete equality, to one if one person has all the income.
Epidemiology - Answers the study of distribution and determinants of disease in human populations
determinants of disease - Answers are answered using WHO, WHEN, and WHERE questions
how do epidemiologists study human populations? - Answers observational methods are used more
commonly than experimental methods (with the exception of intervention studies)
intervention studies - Answers studies the efficacy of a drug or vaccine (like in clinical trials)
has a placebo (control) group & experimental group
is done with randomized double-blind trials
randomized double-blind trials - Answers have participants randomly assigned to the group, neither
the patient nor investigator knows which group which patient is in
cohort studies - Answers exposing a normal (relatively healthy) population to a risk factor, and
studying them for many years to see if exposure has an association with disease
- has no intervention, is just observational
relative risk - Answers The Incidence Rate of a disease in a population exposed to a particular factor ÷
the Incidence Rate of those not exposed
needs iof a cohort study - Answers time, large population
,Case-control study - Answers A type of epidemiologic study where a group of individuals with the
diseases, referred to as cases, are compared to individuals without the disease, referred to as controls
- control for everything as much as possible except for the disease (ie age, gender etc)
are done RETROACTIVELY to determine their exposure to risk factor
odds ratio - Answers The likelihood of a disease among individuals exposed to a risk factor compared
to those who have not been exposed
part of CASE CONTROL STUDIES
sample size error - Answers The observed association may be due to chance.(one individual could
skew the data)
cause & effect may not be obvious
the timeframe between exposure + outcome might be long
confounding variable - Answers a factor other than the independent variable that might produce an
effect in an experiment
selection bias - Answers An error in which the sample is not representative of the population being
studied, so that some opinions are over- or underrepresented (ie those who are most satisfied/
disatisfied tend to answer)
most prevalent in case control studies
- can also be seen in cohort studies where there's a higher risk of participant drop out
recall bias - Answers Systematic error due to differences in accuracy or completeness of recall to the
memory of past events or experiences.
reporting bias - Answers A synonym for recall bias is very common in case-control studies where the
control and study group report differently even if their exposure to the risk factor is the same
disease prevalence - Answers It is the number of all cases of a disease (both old and new) identified in
a specific population at a given time.
disease rate - Answers expression of disease in a population in a given period of time
social determinants of health - Answers Aspects of society and the social environment that impact on
health, such as poverty, early life experiences, social networks and support.
Income and Social Status - Answers - Greatest DOH, influences others in terms of the overall diet, the
extent of physical activity, quality of life
- especially pronounced in places where healthcare, education, guaranteed basic income are not
guaranteed
what are some services not covered by the government in canada? - Answers prescription drugs,
dental care, eye care
-> these take a more significant portion of people's entire pay cheque when they are of lower SES
what are some causes of stress in the workplace? - Answers -not being able to use skills
-having a low decision-making capacity
-job uncertainty
- working pace, physical conditions, etc.
job stress is linked to heart disease incidence
benefits of higher education - Answers better job security & upward motility
- more likely to promote their own health through individual action
single-payer system - Answers health care system in which the government collects all health care
fees via taxes and pays out all health care costs
aka universal healthcare, like in Canada
public policy - Answers the course of action the government takes/ doesn't take in response to an
issue or problem
health policy - Answers decisions, plans, and actions that are undertaken to achieve specific health
care goals within a society
,economic lens of health policy - Answers determines the allocation of health resources
public health lens of health policy - Answers influences the DOH to improve population health
health care lens of health policy - Answers influences the health services available for individuals
including wait times, drugs, etc
health policy triangle - Answers context (political, economic, etc.) factors about where the policy is
being acted on
content (what is the policy)
process(how is the policy being implemented)
actors: individuals who make or enact policy (individuals, groups, organizations)
agency - Answers the capacity of an actor to act independently and influence policy development
situational factors that affect policy - Answers transient conditions or events that can influence policy
(ie war, pandemic)
*unpredictable
structural factors that affect policy - Answers unchanging elements of society including
the politcal system and demographic features
What is the Lalond framework and why is it significant? - Answers A framework that considers health
as encompassing of human biology, health care organizations, lifestyle, and environment. It makes up
the "new" public health that was used from the 1970s and onwards
What was "A New Perspective on the Health of Canadians" significant? - Answers Recognized that
growing life expectancy is associated with changes in living conditions and sanitation, more so than
medical advances. Recognized the importance of public health
What is the definition of health promotion as defined in the Ottawa Charter For Health Promotion? -
Answers The process of enabling people to increase control over, and to improve, their health.
How did the Ottawa Charter for Health Promotion view and define health as a more positive concept?
What was the view of the health sector's role in health? - Answers Health was seen as a resource for
everyday life, not the objective of living. It is not just the responsibility of the health sector, but goes
beyond healthy lifestyles to wellbeing.
What are the perquisites for health according to the Ottawa Charter for Health Promotion? How can
they be addressed? - Answers Peace, shelter, education, food, income, a stable eco-system,
sustainable resources, social justice and equity. Must advocate, enable, and mediate to address these
prerequisites.
What are the Ottawa Charter Action Strategies? - Answers 1. Building Healthy Public Policy
2. Create Supportive Environments
3. Strengthen Community Action
4. Develop Personal Skills
5. Reorient Health Services
What is the ecological model of health promotion? - Answers Recognizes that individual skills,
knowledge, and attitudes are not enough to have good health. Interpersonal (family, friends, social
networks), organizational (organizations, social institutions) community (relationships among
organizations), and public policy (national, state, and local laws) factors all work together to
contribute to the health of an individual.
Why do we use theories of behavioural change in health promotion and what are some frequently
used theories? - Answers -interventions to change health behaviour are more effective if based on
theory
-someone may be well motivated and has the resources, but doesn't have the skills or knowledge to
make a change to health behavior, so we use theories to help them develop these skills
-most frequently used theories: social-psychological, motivational, stage-based
What specific things can theory-based interventions help us achieve in helping people develop
personal skills in terms of their health? - Answers -theories can provide a framework from which
interventions can be developed
-can help us determine what to target and why
-can help us ensure all components of an intervention are in place
What are some types of motivational theories in health promotion? - Answers -social cognitive theory
-theory of planned behavior/ reasoned action
, -protection motivation theory
What is the most commonly used model for behavioral change in health promotion? What kind of
model is it? - Answers -the transtheoretical model
-is a multi stage model with stages of change
What are the components of the transtheoretical model - Answers -has stages of change
-recognizes that there needs to be a decisional balance (weighing the pros and cons, if more pros, are
more likely to make the behavioral change)
-self efficacy (belief that you can carry through on an intention that you indicate that you want to do
eg: belief you can quit smoking)
-change goes through processes
Explain all the stages of change in the transtheoretical model of health promotion - Answers 1. Pre-
contemplation: you are not thinking about making a change at this stage
2. Contemplation: are thinking that it may be a good idea to make a change sometime in the next 6
months eg: quitting drinking as a new year resolution
3. Preparation: intend to change in the next 30 days. You are planning and taking steps to change
4. Action: actively going through the process of changing but have been doing it for less than 6
months. eg: directly after the new year you stop drinking
5. Maintenance: have been successfully doing the new action for more than 6 months
Explain why the stages of change in the transtheoretical model are not depicted as a linear diagram? -
Answers Because people may regress as they move through the stages eg: often times people will be
very good about keeping their resolutions after the new years, but then it will die off
What is a precontentemplation approach to promote health? - Answers -oftentimes health
promotion programs are not designed for or matched to the needs of people in this stage
-increase awareness and importance of the recommended behaviour
-listen and try to understand (oftentimes people have. more important priorities that do not allow
them to make a change)
What is a contemplation approach to health promotion? - Answers -also not ready for traditional
action oriented HP programs so:
-focus on benefits if change and identify barriers
-make a decisional balance list; build and focus on "pros" (focus on building up pros)
-start bolstering self-confidence
What is a preparation approach to health promotion? - Answers -ideal stage for recruitment into
action-oriented HP programs eg: weight loss, more physical activity
-encourage goal setting
provide specific alternative
-help set a change date (date change starts)
-establish a reward system
-evaluate progress to date
-provide helpful resources
What is the action approach for health promotion? - Answers -a mentally challenging time; risk for
relapse (need for support) is greatest
-reassure person on goal setting
-coach on useful skills to reinforce correct behaviour
-support person to fight temptations/lapse
-promote social support
What is the maintenance approach to health promotion? - Answers -less tempted to relapse;
increasingly more confident that they can continue their change
-review "goals"
-discuss slips; plan strategies in case of relapse
-refine/ add variety to the program
What is the regression/ relapse profile? What is it, and at what stages can it occur? - Answers -occurs
when an individual reverts to an earlier stage of change (dynamic, non-linear process)
-relapse tends to be the rule in behaviour change- "old habits die hard"
-can occur during contemplation, preparation, action, and maintenance (may go back to
contemplation or preparation)
What are some individual determinants of obesity (behavior)? - Answers Diet and physical activity
what is public health? - Answers the science and art of preventing disease, prolonging life and
promoting health through the organized efforts and informed choices of society, organizations, public
and private, communities and individuals
- emphasizes the promotion of health and populations as a whole
Miasma Theory - Answers belief that diseases such as cholera & Black Death were caused by noxious
clouds of "bad air"
describe the seven steps of assessment, planning, action, evaluation - Answers 1) Identify gaps that
prevent proper action through assesment
2) adapt to the local context
3) assess barriers to knowledge use
4)select, tailor, and implement interventions (use knowledge translation)
5) monitor knowledge use
6) evaluate outcomes
7)sustain knowledge use
Food and Drugs Act - Answers lays foundation for distributing food and drugs safely
health - Answers The combination of physical, mental/emotional, and social well-being (not just the
absence of disease)
1978 WHO definition of health - Answers level of health that permits people to lead socially and
economically productive lives
mortality based measures of health - Answers a binary measurement of health that is often easy to
attribute
what are two mortality based measures of health? - Answers infant mortality rates
life expectancy at birth
- lower socioeconomic status & lower education resulted in an increase chance of death
Disability Adjusted Life Year (DALY) - Answers A statistical measure combining in one number years
lost to premature mortality and years lived with disability. One DALY equals one lost year of healthy
life.
average life expectancy - Answers the number of years the average newborn in a particular
population group is likely to live
65 years in the US (11 yrs are lost to DALY)
biological risk factors - Answers genetic endowment, aging
environmental risk factors - Answers food, air, water, risk of infectious diseases
Psychosocial risk factors - Answers poverty, stress, personality and culture
absolute wealth - Answers Current market cash value of all of your assets
relative wealth - Answers your wealth compared to others
Gini Coefficient - Answers A measure of income inequality within a population, ranging from zero for
complete equality, to one if one person has all the income.
Epidemiology - Answers the study of distribution and determinants of disease in human populations
determinants of disease - Answers are answered using WHO, WHEN, and WHERE questions
how do epidemiologists study human populations? - Answers observational methods are used more
commonly than experimental methods (with the exception of intervention studies)
intervention studies - Answers studies the efficacy of a drug or vaccine (like in clinical trials)
has a placebo (control) group & experimental group
is done with randomized double-blind trials
randomized double-blind trials - Answers have participants randomly assigned to the group, neither
the patient nor investigator knows which group which patient is in
cohort studies - Answers exposing a normal (relatively healthy) population to a risk factor, and
studying them for many years to see if exposure has an association with disease
- has no intervention, is just observational
relative risk - Answers The Incidence Rate of a disease in a population exposed to a particular factor ÷
the Incidence Rate of those not exposed
needs iof a cohort study - Answers time, large population
,Case-control study - Answers A type of epidemiologic study where a group of individuals with the
diseases, referred to as cases, are compared to individuals without the disease, referred to as controls
- control for everything as much as possible except for the disease (ie age, gender etc)
are done RETROACTIVELY to determine their exposure to risk factor
odds ratio - Answers The likelihood of a disease among individuals exposed to a risk factor compared
to those who have not been exposed
part of CASE CONTROL STUDIES
sample size error - Answers The observed association may be due to chance.(one individual could
skew the data)
cause & effect may not be obvious
the timeframe between exposure + outcome might be long
confounding variable - Answers a factor other than the independent variable that might produce an
effect in an experiment
selection bias - Answers An error in which the sample is not representative of the population being
studied, so that some opinions are over- or underrepresented (ie those who are most satisfied/
disatisfied tend to answer)
most prevalent in case control studies
- can also be seen in cohort studies where there's a higher risk of participant drop out
recall bias - Answers Systematic error due to differences in accuracy or completeness of recall to the
memory of past events or experiences.
reporting bias - Answers A synonym for recall bias is very common in case-control studies where the
control and study group report differently even if their exposure to the risk factor is the same
disease prevalence - Answers It is the number of all cases of a disease (both old and new) identified in
a specific population at a given time.
disease rate - Answers expression of disease in a population in a given period of time
social determinants of health - Answers Aspects of society and the social environment that impact on
health, such as poverty, early life experiences, social networks and support.
Income and Social Status - Answers - Greatest DOH, influences others in terms of the overall diet, the
extent of physical activity, quality of life
- especially pronounced in places where healthcare, education, guaranteed basic income are not
guaranteed
what are some services not covered by the government in canada? - Answers prescription drugs,
dental care, eye care
-> these take a more significant portion of people's entire pay cheque when they are of lower SES
what are some causes of stress in the workplace? - Answers -not being able to use skills
-having a low decision-making capacity
-job uncertainty
- working pace, physical conditions, etc.
job stress is linked to heart disease incidence
benefits of higher education - Answers better job security & upward motility
- more likely to promote their own health through individual action
single-payer system - Answers health care system in which the government collects all health care
fees via taxes and pays out all health care costs
aka universal healthcare, like in Canada
public policy - Answers the course of action the government takes/ doesn't take in response to an
issue or problem
health policy - Answers decisions, plans, and actions that are undertaken to achieve specific health
care goals within a society
,economic lens of health policy - Answers determines the allocation of health resources
public health lens of health policy - Answers influences the DOH to improve population health
health care lens of health policy - Answers influences the health services available for individuals
including wait times, drugs, etc
health policy triangle - Answers context (political, economic, etc.) factors about where the policy is
being acted on
content (what is the policy)
process(how is the policy being implemented)
actors: individuals who make or enact policy (individuals, groups, organizations)
agency - Answers the capacity of an actor to act independently and influence policy development
situational factors that affect policy - Answers transient conditions or events that can influence policy
(ie war, pandemic)
*unpredictable
structural factors that affect policy - Answers unchanging elements of society including
the politcal system and demographic features
What is the Lalond framework and why is it significant? - Answers A framework that considers health
as encompassing of human biology, health care organizations, lifestyle, and environment. It makes up
the "new" public health that was used from the 1970s and onwards
What was "A New Perspective on the Health of Canadians" significant? - Answers Recognized that
growing life expectancy is associated with changes in living conditions and sanitation, more so than
medical advances. Recognized the importance of public health
What is the definition of health promotion as defined in the Ottawa Charter For Health Promotion? -
Answers The process of enabling people to increase control over, and to improve, their health.
How did the Ottawa Charter for Health Promotion view and define health as a more positive concept?
What was the view of the health sector's role in health? - Answers Health was seen as a resource for
everyday life, not the objective of living. It is not just the responsibility of the health sector, but goes
beyond healthy lifestyles to wellbeing.
What are the perquisites for health according to the Ottawa Charter for Health Promotion? How can
they be addressed? - Answers Peace, shelter, education, food, income, a stable eco-system,
sustainable resources, social justice and equity. Must advocate, enable, and mediate to address these
prerequisites.
What are the Ottawa Charter Action Strategies? - Answers 1. Building Healthy Public Policy
2. Create Supportive Environments
3. Strengthen Community Action
4. Develop Personal Skills
5. Reorient Health Services
What is the ecological model of health promotion? - Answers Recognizes that individual skills,
knowledge, and attitudes are not enough to have good health. Interpersonal (family, friends, social
networks), organizational (organizations, social institutions) community (relationships among
organizations), and public policy (national, state, and local laws) factors all work together to
contribute to the health of an individual.
Why do we use theories of behavioural change in health promotion and what are some frequently
used theories? - Answers -interventions to change health behaviour are more effective if based on
theory
-someone may be well motivated and has the resources, but doesn't have the skills or knowledge to
make a change to health behavior, so we use theories to help them develop these skills
-most frequently used theories: social-psychological, motivational, stage-based
What specific things can theory-based interventions help us achieve in helping people develop
personal skills in terms of their health? - Answers -theories can provide a framework from which
interventions can be developed
-can help us determine what to target and why
-can help us ensure all components of an intervention are in place
What are some types of motivational theories in health promotion? - Answers -social cognitive theory
-theory of planned behavior/ reasoned action
, -protection motivation theory
What is the most commonly used model for behavioral change in health promotion? What kind of
model is it? - Answers -the transtheoretical model
-is a multi stage model with stages of change
What are the components of the transtheoretical model - Answers -has stages of change
-recognizes that there needs to be a decisional balance (weighing the pros and cons, if more pros, are
more likely to make the behavioral change)
-self efficacy (belief that you can carry through on an intention that you indicate that you want to do
eg: belief you can quit smoking)
-change goes through processes
Explain all the stages of change in the transtheoretical model of health promotion - Answers 1. Pre-
contemplation: you are not thinking about making a change at this stage
2. Contemplation: are thinking that it may be a good idea to make a change sometime in the next 6
months eg: quitting drinking as a new year resolution
3. Preparation: intend to change in the next 30 days. You are planning and taking steps to change
4. Action: actively going through the process of changing but have been doing it for less than 6
months. eg: directly after the new year you stop drinking
5. Maintenance: have been successfully doing the new action for more than 6 months
Explain why the stages of change in the transtheoretical model are not depicted as a linear diagram? -
Answers Because people may regress as they move through the stages eg: often times people will be
very good about keeping their resolutions after the new years, but then it will die off
What is a precontentemplation approach to promote health? - Answers -oftentimes health
promotion programs are not designed for or matched to the needs of people in this stage
-increase awareness and importance of the recommended behaviour
-listen and try to understand (oftentimes people have. more important priorities that do not allow
them to make a change)
What is a contemplation approach to health promotion? - Answers -also not ready for traditional
action oriented HP programs so:
-focus on benefits if change and identify barriers
-make a decisional balance list; build and focus on "pros" (focus on building up pros)
-start bolstering self-confidence
What is a preparation approach to health promotion? - Answers -ideal stage for recruitment into
action-oriented HP programs eg: weight loss, more physical activity
-encourage goal setting
provide specific alternative
-help set a change date (date change starts)
-establish a reward system
-evaluate progress to date
-provide helpful resources
What is the action approach for health promotion? - Answers -a mentally challenging time; risk for
relapse (need for support) is greatest
-reassure person on goal setting
-coach on useful skills to reinforce correct behaviour
-support person to fight temptations/lapse
-promote social support
What is the maintenance approach to health promotion? - Answers -less tempted to relapse;
increasingly more confident that they can continue their change
-review "goals"
-discuss slips; plan strategies in case of relapse
-refine/ add variety to the program
What is the regression/ relapse profile? What is it, and at what stages can it occur? - Answers -occurs
when an individual reverts to an earlier stage of change (dynamic, non-linear process)
-relapse tends to be the rule in behaviour change- "old habits die hard"
-can occur during contemplation, preparation, action, and maintenance (may go back to
contemplation or preparation)
What are some individual determinants of obesity (behavior)? - Answers Diet and physical activity
