,TESTBANK FOR Introduction to Public Health, 3rd
Edition Promises and Practices Goldsteen
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
,INTRODUCTION TO PUBLIC HEALTH, THIRD EDITION
Editors: Raymond L. Goldsteen, DrPH, Karen Goldsteen, PhD, MPH, Terry Dwelle, MD, MPHTM,
CPH
Chapter 1: What is Public Health?
1. Which of the following is an example of secondary prevention?
a. education about healthy eating
*b. regular mammograms to detect breast cancer
c. immunizations against infectious diseases
d. legislation to ban the use of hazardous products
Correct Answer b). Secondary prevention aims to reduce the impact of a disease or injury
that has already occurred. This is done by detecting and treating disease or injury to halt or
slow its process.
2. The cornerstone of public health is
*a. prevention
b. diagnosis
c. promotion
d. treatment
Correct Answer a.) Public health primarily focuses on primary prevention and aims to
promote health and influence the environment in which people live.
3. Which approach helps to conceptualize and organize the complexities of health by viewing
individuals as embedded within their environment?
a. biopsychosocial
b. medical
c. social
*d. ecological
Correct Answer d). The ecological approach is fundamental to public health practice
and views individuals as embedded within their environment, or context.
4. Which of the following determinants of health can be indicated by a combination of education,
occupation, and income?
*a. socioeconomic status
b. genetic inheritance
c. physical environment
d. psychosocial work environment
Correct Answer a.) In the United States and other Western countries, socioeconomic
status is often indicated by a combination of education, occupation, and income/wealth.
Individuals with lower status are at greater risk for health problems compared to higher
status individuals.
5. Disparities between majority and minority Americans have been found for which preventable
and treatable conditions?
a. heart disease
b. hypertension
c. asthma
*d. all of these
Correct Answer d.) The preventable and treatable conditions for which disparities
between majority and minority Americans include diabetes, hypertension, obesity, asthma,
heart disease, and others (CDC, 2011, 2021).
,6. Which of the following is true of genetic diseases?
a. an individual must inherit the genetic disease from a family member
b. changes to the whole DNA must occur for the disease to develop
*c. environmental exposures that damage the genome can cause genetic diseases
d. random occurrences of genetic diseases are not probable
Correct Answer c.) Research has shown that although genetic disorders can be inherited
from family members, some are random occurrences or caused by damage to the genome
from environmental exposures (National Human Genome Research Institute, 2018a). In
addition, disease processes tend to be determined both by environmental and genetic
factors.
7. Premature mortality in the 21st century is most significantly associated with health behaviors
related to
a. motor vehicle accidents
b. microbial agents
c. cancer
*d. substance abuse
Correct Answer d.) Studies of premature mortality have shown that it is significantly
associated with health behaviors related to substance abuse. Recent increases in accidental
deaths resulting from unintentional drug poisonings can be partially attributed to the
increase in opioid overdoses (Best et al., 2018).
8. What are the three components of the epidemiological triangle?
*a. host, agent, environment
b. knowledge, values, resources
c. disease, disability, premature mortality
d. treatment, diagnosis, prevention
Correct Answer a.) The epidemiological triangle was developed to better understand
infectious disease transmission. The three points of the triangle are the agent, host, and
environment.
9. The epidemiological triangle is most effective as a model for understanding
a. chronic health conditions
b. accidental injuries
c. genetic influences
*d. infectious diseases
Correct Answer d.) Because infectious diseases have a single agent, the epidemiological
triangle works well as a model for understanding the development of these diseases. It is
not as helpful for other kinds of diseases or health problems because of its emphasis on a
single agent, its isolation of the agent from the environment, and its conceptually
unspecified environment.
10. How does the Wheel of Causation differ from the epidemiological triangle?
a. the wheel includes the environment as a factor influencing disease transmission
b. the physical environment plays a more central role in the wheel
*c. the wheel contains a hub with the host at its center
d. the wheel places emphasis on changing the environment instead of changing attributes
of the host
Correct Answer c.) The Wheel of Causation contains the host at the center of the model.
Since humans typically represent the host within the public health framework, this
configuration can better represent what is being evaluated in this sphere.
11. In the 1970s, the emphasis on health promotion within public health led to a greater emphasis
on public health initiatives at which level?
*a. individual
, b. environmental
c. cultural
d. biological
Correct Answer a.) According to Green (1999), 1974 was a turning point when health
promotion became a more significant component of health policy. The emphasis on health
promotion increasingly emphasized public health initiatives at the individual behavior
level (i.e., tobacco use, seat belt use), rather than the environmental level.
12. In the PRECEDE model, predisposing factors are the
a. objective aspects of the environment or system that block or promote safe or unsafe
behaviors
*b. characteristics of the individual, such as beliefs or attitudes, that provide the
motivation for safety-related behaviors
c. factors and the feedback the person receives from others following adoption of the
behavior
d. environmental, biological, and cultural characteristics that influences a person’s health
behaviors
Correct Answer b.) In the PRECEDE model, predisposing factors are the characteristics
of the individual (beliefs, attitudes, values, etc.) that provide the motivation for safety-
related behaviors.
13. The PRECEDE component of the PRECEDE-PROCEED model focuses on improving health
by changing individuals’ behavior through
a. increasing motivation to change
b. behavioral interventions
c. environmental changes
*d. education
Correct Answer d.) The acronym PRECEDE stands for Predisposing, Reinforcing, and
Enabling Constructs in the Educational Diagnosis and Evaluation. As the acronym
suggests, the model is oriented toward improving health by changing individuals’ behavior
through education, and not by intervening at the environmental level to change conditions
or structures.
14. What is one of the major criticisms of the health promotion movement?
a. individuals are unable to change their behavior without external assistance
b. providing education is not an effective strategy for improving health behaviors
c. changing the environment is more effective than influencing individuals to change their
behavior
*d. the individual’s behavior is viewed as the problem to be fixed, which places the
accountability for poor health on the individual
Correct Answer d.) Placing the accountability for poor health on the individual is one of
the major criticisms of the health promotion movement. An individual’s behavior is
typically caused by a combination of factors, including their environment, socioeconomic
status, and social influences.
15. In 1991, what was added to the PRECEDE-PROCEED model to place more emphasis on the
context of behavior?
a. genetic predisposition
*b. environment
c. lifestyle
d. social support
Correct Answer b.) In the 1980s, health promotion began to place more focus on
environmentally targeted interventions and the interaction between individuals and their
environment. In 1991, the model was updated to place more emphasis on the context of
behavior by adding environment to the model.
,16. In the 2022 version of the PRECEDE-PROCEED model, what occurs during the evaluation of
programs in phases 1 through 3?
a. health program and policy development
b. process evaluation
c. short-term, intermediate, and long-term evaluation
*d. educational, ecological, epidemiological, and social assessments
Correct Answer d.) In 2022, the PRECEDE-PROCEED model was revised with
improvements related to conceptualizing the evaluation of programs. Phases 1 through 3
focus on educational, ecological, epidemiological, and social assessments, and later phases
focus on policy development and evaluation.
17. The Whitehall study was one of the first studies to demonstrate which finding?
a. access to health care is the main predictor of the adoption of certain health behaviors
*b. people who are structurally disadvantaged are much more likely than advantaged
people to have poor health
c. health behaviors are “free-standing”, in that they are minimally influenced by social
context
d. environmental factors linked to genetic and immune dysfunction can lead to cancer and
other diseases
Correct Answer b.) The Whitehall study was one of the first to demonstrate what has
been a consistent finding in other studies. People who are structurally or environmentally
disadvantaged are more likely to have poor health when compared to those who are
advantaged.
18. According to the President’s Cancer Panel report in 2010, interventions and programs should
focus on which factor(s) to reduce the burden and prevalence of cancer?
a. early screening and diagnosis
*b. environmental exposures
c. affordable and accessible treatment
d. immune and endocrine dysfunction
Correct Answer b.) The President’s Cancer Panel report (2010) titled, Reducing
Environmental Cancer Risk: What We Can Do Now, states that the actual burden of
environmentally induced cancers has been underestimated. The report argues that the
current regulatory approach is reactionary rather than precautionary, and that more
emphasis should be placed on environmental exposures and their impact on cancer risk.
19. The Health Impact Pyramid suggests that interventions with the greatest population impact and
the least required individual effort are those that address
a. long-lasting protective interventions
b. the context of decision making
*c. socioeconomic factors
d. counseling and education
Correct Answer c.) The base of the Health Impact Pyramid has the greatest potential for
population impact and lowest level of individual effort needed. At the base of this pyramid
are efforts to address the socioeconomic determinants of health.
,INTRODUCTION TO PUBLIC HEALTH, Third Edition
Editors: Raymond L. Goldsteen, DrPH, Karen Goldsteen, PhD, MPH, Terry Dwelle, MD, MPHTM,
CPH
Chapter 2: Origins of Public Health
1. Which of the following is a noninfectious disease?
a. cholera
b. human immunodeficiency virus (HIV)
*c. hemophilia
d. tuberculosis
Correct Answer c.) Noninfectious diseases are those that are not caused by a pathogenic
microbe, but by factors that are not communicable or contagious, such as environmental
exposures to toxins, health behaviors, and autoimmune conditions.
2. The most common unintentional injuries result from
*a. motor vehicle crashes
b. drownings
c. suicide
d. poisonings
Correct Answer a.) Unintentional or accidental injuries can be self-inflicted or inflicted
by others and result in mortality or morbidity. The most common unintentional injuries
result from motor vehicle crashes.
3. The history of modern public health in the United States and elsewhere has its roots in the
*a. Industrial Revolution
b. Machine Age
c. Early Modern Period
d. Age of Exploration
Correct Answer a.) The history of modern public health in the United States and
elsewhere has its roots in the Industrial Revolution. During industrialization, many
growing cities had poor living conditions that resulted in the spread and development of
different diseases.
4. What method was used to address the problem of infectious diseases in Britain and other
industrializing countries during the 1800s?
a. vaccines
b. food safety regulations
c. sanitation laws
*d. environmental engineering
Correct Answer d.) In the 1800s, the method used to address the problem of infectious
diseases in Britain and other industrializing countries was environmental engineering.
This method is one of the first primary prevention strategies which modified the
environment for all persons at risk.
5. What is one of epidemiology’s first and most essential tools that provides data for scientific
studies of disease causation, treatment, and prevention?
a. Centers for Disease Control and Prevention (CDC)
*b. International Classification of Diseases (ICD)
c. World Health Organization (WHO)
d. National Center for Health Statistics
Correct Answer b.) Epidemiology fulfilled the need for evidence to evaluate methods and
demonstrate the success of methods to improve health. The International Classification of
, Diseases (ICD) was one of epidemiology’s first and most essential tools by providing the
data for scientific studies of disease causation, treatment, and prevention.
6. What is the main purpose of epidemiology?
*a. shape policy decisions and support evidence-based practice by identifying risk
factors for disease and targets for intervention
b. reduce health disparities and increase health equity among vulnerable populations
c. classify, diagnose, and treat infectious and noninfectious diseases to prevent their
spread
d. prevent intentional and unintentional injuries through education and environmental
engineering strategies
Correct Answer a.) Generally considered an integral or foundational component of public
health practice, epidemiology aims to shape policy decisions and support evidence-based
practice by identifying risk factors for disease and targets for intervention (Department of
Epidemiology, 2020; Public Health Science and Surveillance, 2012).
7. Who is often referred to as the founder of epidemiology?
*a. Dr. John Snow
b. Florence Nightingale
c. John Graunt
d. William Farr
Correct Answer a.) Dr. John Snow (1813-1858) is often referred to as the father or
epidemiology. Dr. Snow’s epidemiologic investigation of a cholera epidemic in London
linked the outbreak to the Broad Street Pump.
8. Which of the following infectious diseases were among the 10 leading causes of death in 2006?
a. tuberculosis, diarrhea, enteritis
b. diphtheria, cholera, respiratory syncytial virus
c. HIV/AIDS, E. coli, giardiasis
*d. influenza, pneumonia, septicemia
Correct Answer d.) The only infectious diseases among the 10 leading causes of death
in 2006 were influenza, pneumonia, and septicemia. These infectious diseases only
accounted for 4 percent of deaths.
9. Life expectancy is defined as the
*a. average number of years of life that could be expected if current death rates
remain constant
b. effectiveness of measures to control infectious diseases and infections within a
population
c. number of years of life gained from health promotion, prevention, and other public
health measures
d. inverse of the death rate attributable to infectious and non-infectious diseases in a
population
Correct Answer a.) As a summary measure of mortality, life expectancy represents the
average number of years of life that could be expected if current death rates were to remain
constant.
10. In 2006, what was the leading cause of death in the United States?
a. pneumonia
*b. heart disease
c. cancer
d. cerebrovascular diseases
Correct Answer b.) In 2006, diseases of the heart accounted for 26.03 percent of all
deaths in the United States.
,11. What was the major cause of increased life expectancy in the first half of the 20th century?
*a. control of infectious diseases
b. seat belts in motor vehicles
c. improved working conditions
d. cancer screening
Correct Answer a.) The control of infectious diseases, which included sanitary and
housing improvements in the 1800s and microbial treatments and vaccines, was a major
cause of increased life expectancy in the first half of the 20th century.
12. Between 1900 and 2006, most of the overall increase in life expectancies for children at birth
and at the age of 1 occurred prior to
a. 1810
b. 1915
c. 1932
*d. 1951
Correct Answer d.) Between 1900 and 2006, children at birth and at the age of 1 year
experienced a 58% and 40% increase in life expectancy. About 65% and 62%,
respectively, of the overall increase for these ages came prior to 1951.
13. What was the third leading cause of death in 2021?
*a. COVID-19
b. heart disease
c. cancer
d. pneumonia
Correct Answer a.) The COVID-19 pandemic, which emerged late in 2019, is the most
recent and deadly infectious disease. It was the third leading cause of death in 2021 with
416,893 deaths, exceeded only by heart disease and cancer.
14. Since 1900, infant mortality has decreased
a. 65%
b. 83%
*c. 90%
d. 99%
Correct Answer c.) Since 1900, infant mortality has decreased 90%, and maternal
mortality has decreased 99%.
15. Which of the following was a finding of the National Health and Nutrition Examination
Surveys related to lead poisoning in children?
*a. there was a steep decline in the percentage of children aged 1 to 5 years with
elevated blood lead levels
b. the risks for elevated blood lead levels based on socioeconomic status and race were
increased slightly
c. children between the ages of 1 and 2 were most at risk for elevated blood lead levels
d. there was a 28% decrease in the percentage of children aged 1 to 5 years with elevated
blood levels
Correct Answer a.) From 1976-1980 to 2003-2008, findings from the National Health
and Nutrition Examination Surveys found a steep decline, from 88.2% to 0.9%, in the
percentage of children aged 1 to 5 years with blood lead levels greater than or equal to 10
mcg/dL.
16. According to the CDC, which of the following is not one of the 10 greatest achievements of
public health from 1900 to 1999?
*a. reform of the health care system
b. motor vehicle safety
c. safer and healthier foods
, d. control of infectious diseases
Correct answer a.) While public health participates in health care reform initiatives, it is
not the major actor. Public health’s major achievements concern primary prevention of
disease, injury, and premature mortality.
17. The CDC attributes 25 years of the gain in average life span in the United States since 1900 to
a. improved dietary behaviors
b. technology
c. genetic changes
*d. public health measures
Correct Answer d.) The average life span has increased by more than 30 years in the
United States since 1900. The CDC attributes 25 years of this gain to public health
measures.
Edition Promises and Practices Goldsteen
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
,INTRODUCTION TO PUBLIC HEALTH, THIRD EDITION
Editors: Raymond L. Goldsteen, DrPH, Karen Goldsteen, PhD, MPH, Terry Dwelle, MD, MPHTM,
CPH
Chapter 1: What is Public Health?
1. Which of the following is an example of secondary prevention?
a. education about healthy eating
*b. regular mammograms to detect breast cancer
c. immunizations against infectious diseases
d. legislation to ban the use of hazardous products
Correct Answer b). Secondary prevention aims to reduce the impact of a disease or injury
that has already occurred. This is done by detecting and treating disease or injury to halt or
slow its process.
2. The cornerstone of public health is
*a. prevention
b. diagnosis
c. promotion
d. treatment
Correct Answer a.) Public health primarily focuses on primary prevention and aims to
promote health and influence the environment in which people live.
3. Which approach helps to conceptualize and organize the complexities of health by viewing
individuals as embedded within their environment?
a. biopsychosocial
b. medical
c. social
*d. ecological
Correct Answer d). The ecological approach is fundamental to public health practice
and views individuals as embedded within their environment, or context.
4. Which of the following determinants of health can be indicated by a combination of education,
occupation, and income?
*a. socioeconomic status
b. genetic inheritance
c. physical environment
d. psychosocial work environment
Correct Answer a.) In the United States and other Western countries, socioeconomic
status is often indicated by a combination of education, occupation, and income/wealth.
Individuals with lower status are at greater risk for health problems compared to higher
status individuals.
5. Disparities between majority and minority Americans have been found for which preventable
and treatable conditions?
a. heart disease
b. hypertension
c. asthma
*d. all of these
Correct Answer d.) The preventable and treatable conditions for which disparities
between majority and minority Americans include diabetes, hypertension, obesity, asthma,
heart disease, and others (CDC, 2011, 2021).
,6. Which of the following is true of genetic diseases?
a. an individual must inherit the genetic disease from a family member
b. changes to the whole DNA must occur for the disease to develop
*c. environmental exposures that damage the genome can cause genetic diseases
d. random occurrences of genetic diseases are not probable
Correct Answer c.) Research has shown that although genetic disorders can be inherited
from family members, some are random occurrences or caused by damage to the genome
from environmental exposures (National Human Genome Research Institute, 2018a). In
addition, disease processes tend to be determined both by environmental and genetic
factors.
7. Premature mortality in the 21st century is most significantly associated with health behaviors
related to
a. motor vehicle accidents
b. microbial agents
c. cancer
*d. substance abuse
Correct Answer d.) Studies of premature mortality have shown that it is significantly
associated with health behaviors related to substance abuse. Recent increases in accidental
deaths resulting from unintentional drug poisonings can be partially attributed to the
increase in opioid overdoses (Best et al., 2018).
8. What are the three components of the epidemiological triangle?
*a. host, agent, environment
b. knowledge, values, resources
c. disease, disability, premature mortality
d. treatment, diagnosis, prevention
Correct Answer a.) The epidemiological triangle was developed to better understand
infectious disease transmission. The three points of the triangle are the agent, host, and
environment.
9. The epidemiological triangle is most effective as a model for understanding
a. chronic health conditions
b. accidental injuries
c. genetic influences
*d. infectious diseases
Correct Answer d.) Because infectious diseases have a single agent, the epidemiological
triangle works well as a model for understanding the development of these diseases. It is
not as helpful for other kinds of diseases or health problems because of its emphasis on a
single agent, its isolation of the agent from the environment, and its conceptually
unspecified environment.
10. How does the Wheel of Causation differ from the epidemiological triangle?
a. the wheel includes the environment as a factor influencing disease transmission
b. the physical environment plays a more central role in the wheel
*c. the wheel contains a hub with the host at its center
d. the wheel places emphasis on changing the environment instead of changing attributes
of the host
Correct Answer c.) The Wheel of Causation contains the host at the center of the model.
Since humans typically represent the host within the public health framework, this
configuration can better represent what is being evaluated in this sphere.
11. In the 1970s, the emphasis on health promotion within public health led to a greater emphasis
on public health initiatives at which level?
*a. individual
, b. environmental
c. cultural
d. biological
Correct Answer a.) According to Green (1999), 1974 was a turning point when health
promotion became a more significant component of health policy. The emphasis on health
promotion increasingly emphasized public health initiatives at the individual behavior
level (i.e., tobacco use, seat belt use), rather than the environmental level.
12. In the PRECEDE model, predisposing factors are the
a. objective aspects of the environment or system that block or promote safe or unsafe
behaviors
*b. characteristics of the individual, such as beliefs or attitudes, that provide the
motivation for safety-related behaviors
c. factors and the feedback the person receives from others following adoption of the
behavior
d. environmental, biological, and cultural characteristics that influences a person’s health
behaviors
Correct Answer b.) In the PRECEDE model, predisposing factors are the characteristics
of the individual (beliefs, attitudes, values, etc.) that provide the motivation for safety-
related behaviors.
13. The PRECEDE component of the PRECEDE-PROCEED model focuses on improving health
by changing individuals’ behavior through
a. increasing motivation to change
b. behavioral interventions
c. environmental changes
*d. education
Correct Answer d.) The acronym PRECEDE stands for Predisposing, Reinforcing, and
Enabling Constructs in the Educational Diagnosis and Evaluation. As the acronym
suggests, the model is oriented toward improving health by changing individuals’ behavior
through education, and not by intervening at the environmental level to change conditions
or structures.
14. What is one of the major criticisms of the health promotion movement?
a. individuals are unable to change their behavior without external assistance
b. providing education is not an effective strategy for improving health behaviors
c. changing the environment is more effective than influencing individuals to change their
behavior
*d. the individual’s behavior is viewed as the problem to be fixed, which places the
accountability for poor health on the individual
Correct Answer d.) Placing the accountability for poor health on the individual is one of
the major criticisms of the health promotion movement. An individual’s behavior is
typically caused by a combination of factors, including their environment, socioeconomic
status, and social influences.
15. In 1991, what was added to the PRECEDE-PROCEED model to place more emphasis on the
context of behavior?
a. genetic predisposition
*b. environment
c. lifestyle
d. social support
Correct Answer b.) In the 1980s, health promotion began to place more focus on
environmentally targeted interventions and the interaction between individuals and their
environment. In 1991, the model was updated to place more emphasis on the context of
behavior by adding environment to the model.
,16. In the 2022 version of the PRECEDE-PROCEED model, what occurs during the evaluation of
programs in phases 1 through 3?
a. health program and policy development
b. process evaluation
c. short-term, intermediate, and long-term evaluation
*d. educational, ecological, epidemiological, and social assessments
Correct Answer d.) In 2022, the PRECEDE-PROCEED model was revised with
improvements related to conceptualizing the evaluation of programs. Phases 1 through 3
focus on educational, ecological, epidemiological, and social assessments, and later phases
focus on policy development and evaluation.
17. The Whitehall study was one of the first studies to demonstrate which finding?
a. access to health care is the main predictor of the adoption of certain health behaviors
*b. people who are structurally disadvantaged are much more likely than advantaged
people to have poor health
c. health behaviors are “free-standing”, in that they are minimally influenced by social
context
d. environmental factors linked to genetic and immune dysfunction can lead to cancer and
other diseases
Correct Answer b.) The Whitehall study was one of the first to demonstrate what has
been a consistent finding in other studies. People who are structurally or environmentally
disadvantaged are more likely to have poor health when compared to those who are
advantaged.
18. According to the President’s Cancer Panel report in 2010, interventions and programs should
focus on which factor(s) to reduce the burden and prevalence of cancer?
a. early screening and diagnosis
*b. environmental exposures
c. affordable and accessible treatment
d. immune and endocrine dysfunction
Correct Answer b.) The President’s Cancer Panel report (2010) titled, Reducing
Environmental Cancer Risk: What We Can Do Now, states that the actual burden of
environmentally induced cancers has been underestimated. The report argues that the
current regulatory approach is reactionary rather than precautionary, and that more
emphasis should be placed on environmental exposures and their impact on cancer risk.
19. The Health Impact Pyramid suggests that interventions with the greatest population impact and
the least required individual effort are those that address
a. long-lasting protective interventions
b. the context of decision making
*c. socioeconomic factors
d. counseling and education
Correct Answer c.) The base of the Health Impact Pyramid has the greatest potential for
population impact and lowest level of individual effort needed. At the base of this pyramid
are efforts to address the socioeconomic determinants of health.
,INTRODUCTION TO PUBLIC HEALTH, Third Edition
Editors: Raymond L. Goldsteen, DrPH, Karen Goldsteen, PhD, MPH, Terry Dwelle, MD, MPHTM,
CPH
Chapter 2: Origins of Public Health
1. Which of the following is a noninfectious disease?
a. cholera
b. human immunodeficiency virus (HIV)
*c. hemophilia
d. tuberculosis
Correct Answer c.) Noninfectious diseases are those that are not caused by a pathogenic
microbe, but by factors that are not communicable or contagious, such as environmental
exposures to toxins, health behaviors, and autoimmune conditions.
2. The most common unintentional injuries result from
*a. motor vehicle crashes
b. drownings
c. suicide
d. poisonings
Correct Answer a.) Unintentional or accidental injuries can be self-inflicted or inflicted
by others and result in mortality or morbidity. The most common unintentional injuries
result from motor vehicle crashes.
3. The history of modern public health in the United States and elsewhere has its roots in the
*a. Industrial Revolution
b. Machine Age
c. Early Modern Period
d. Age of Exploration
Correct Answer a.) The history of modern public health in the United States and
elsewhere has its roots in the Industrial Revolution. During industrialization, many
growing cities had poor living conditions that resulted in the spread and development of
different diseases.
4. What method was used to address the problem of infectious diseases in Britain and other
industrializing countries during the 1800s?
a. vaccines
b. food safety regulations
c. sanitation laws
*d. environmental engineering
Correct Answer d.) In the 1800s, the method used to address the problem of infectious
diseases in Britain and other industrializing countries was environmental engineering.
This method is one of the first primary prevention strategies which modified the
environment for all persons at risk.
5. What is one of epidemiology’s first and most essential tools that provides data for scientific
studies of disease causation, treatment, and prevention?
a. Centers for Disease Control and Prevention (CDC)
*b. International Classification of Diseases (ICD)
c. World Health Organization (WHO)
d. National Center for Health Statistics
Correct Answer b.) Epidemiology fulfilled the need for evidence to evaluate methods and
demonstrate the success of methods to improve health. The International Classification of
, Diseases (ICD) was one of epidemiology’s first and most essential tools by providing the
data for scientific studies of disease causation, treatment, and prevention.
6. What is the main purpose of epidemiology?
*a. shape policy decisions and support evidence-based practice by identifying risk
factors for disease and targets for intervention
b. reduce health disparities and increase health equity among vulnerable populations
c. classify, diagnose, and treat infectious and noninfectious diseases to prevent their
spread
d. prevent intentional and unintentional injuries through education and environmental
engineering strategies
Correct Answer a.) Generally considered an integral or foundational component of public
health practice, epidemiology aims to shape policy decisions and support evidence-based
practice by identifying risk factors for disease and targets for intervention (Department of
Epidemiology, 2020; Public Health Science and Surveillance, 2012).
7. Who is often referred to as the founder of epidemiology?
*a. Dr. John Snow
b. Florence Nightingale
c. John Graunt
d. William Farr
Correct Answer a.) Dr. John Snow (1813-1858) is often referred to as the father or
epidemiology. Dr. Snow’s epidemiologic investigation of a cholera epidemic in London
linked the outbreak to the Broad Street Pump.
8. Which of the following infectious diseases were among the 10 leading causes of death in 2006?
a. tuberculosis, diarrhea, enteritis
b. diphtheria, cholera, respiratory syncytial virus
c. HIV/AIDS, E. coli, giardiasis
*d. influenza, pneumonia, septicemia
Correct Answer d.) The only infectious diseases among the 10 leading causes of death
in 2006 were influenza, pneumonia, and septicemia. These infectious diseases only
accounted for 4 percent of deaths.
9. Life expectancy is defined as the
*a. average number of years of life that could be expected if current death rates
remain constant
b. effectiveness of measures to control infectious diseases and infections within a
population
c. number of years of life gained from health promotion, prevention, and other public
health measures
d. inverse of the death rate attributable to infectious and non-infectious diseases in a
population
Correct Answer a.) As a summary measure of mortality, life expectancy represents the
average number of years of life that could be expected if current death rates were to remain
constant.
10. In 2006, what was the leading cause of death in the United States?
a. pneumonia
*b. heart disease
c. cancer
d. cerebrovascular diseases
Correct Answer b.) In 2006, diseases of the heart accounted for 26.03 percent of all
deaths in the United States.
,11. What was the major cause of increased life expectancy in the first half of the 20th century?
*a. control of infectious diseases
b. seat belts in motor vehicles
c. improved working conditions
d. cancer screening
Correct Answer a.) The control of infectious diseases, which included sanitary and
housing improvements in the 1800s and microbial treatments and vaccines, was a major
cause of increased life expectancy in the first half of the 20th century.
12. Between 1900 and 2006, most of the overall increase in life expectancies for children at birth
and at the age of 1 occurred prior to
a. 1810
b. 1915
c. 1932
*d. 1951
Correct Answer d.) Between 1900 and 2006, children at birth and at the age of 1 year
experienced a 58% and 40% increase in life expectancy. About 65% and 62%,
respectively, of the overall increase for these ages came prior to 1951.
13. What was the third leading cause of death in 2021?
*a. COVID-19
b. heart disease
c. cancer
d. pneumonia
Correct Answer a.) The COVID-19 pandemic, which emerged late in 2019, is the most
recent and deadly infectious disease. It was the third leading cause of death in 2021 with
416,893 deaths, exceeded only by heart disease and cancer.
14. Since 1900, infant mortality has decreased
a. 65%
b. 83%
*c. 90%
d. 99%
Correct Answer c.) Since 1900, infant mortality has decreased 90%, and maternal
mortality has decreased 99%.
15. Which of the following was a finding of the National Health and Nutrition Examination
Surveys related to lead poisoning in children?
*a. there was a steep decline in the percentage of children aged 1 to 5 years with
elevated blood lead levels
b. the risks for elevated blood lead levels based on socioeconomic status and race were
increased slightly
c. children between the ages of 1 and 2 were most at risk for elevated blood lead levels
d. there was a 28% decrease in the percentage of children aged 1 to 5 years with elevated
blood levels
Correct Answer a.) From 1976-1980 to 2003-2008, findings from the National Health
and Nutrition Examination Surveys found a steep decline, from 88.2% to 0.9%, in the
percentage of children aged 1 to 5 years with blood lead levels greater than or equal to 10
mcg/dL.
16. According to the CDC, which of the following is not one of the 10 greatest achievements of
public health from 1900 to 1999?
*a. reform of the health care system
b. motor vehicle safety
c. safer and healthier foods
, d. control of infectious diseases
Correct answer a.) While public health participates in health care reform initiatives, it is
not the major actor. Public health’s major achievements concern primary prevention of
disease, injury, and premature mortality.
17. The CDC attributes 25 years of the gain in average life span in the United States since 1900 to
a. improved dietary behaviors
b. technology
c. genetic changes
*d. public health measures
Correct Answer d.) The average life span has increased by more than 30 years in the
United States since 1900. The CDC attributes 25 years of this gain to public health
measures.
