HCMG EXAM QUESTIONS AND ANSWERS LATEST
EDITION ALREADY GRADED A+
See slide 3/44 on "Health and the Environment" lecture. Why are there geographic differences in life
expectancy??
Many southern states (southern belt) did not undergo Medicaid expansion - their populations are facing
the consequences
What can a geographic life expectancy map tell you?
socioeconomics, food access, healthcare access, weather patterns (# of cold/hot days) in a given
state/city
What can't a geographic life expectancy map tell you?
Would we expect the populations that are in a low life expectancy grouping at birth to increase life
expectancy if moved to a higher life expectancy group (so moving from one state to a different state
basically).
The affect of place on health and longevity mechanisms (there are 2)
1. Non-random sorting (geographic differences just reflect characteristics of the population)
2. Causal effect of the "place" on health (what would happen if you moved someone from one
geographic location to another?)
Thought experiment: a hypothetic health effect exists of moving someone from one location to another.
list some of the broad, interrelated mechanisms that could be generating observed place health
effects and the individual components of each
1. Local environment (pollution, weather, temperature)
2. Socioeconomics
3. Peer effects (peers in area have certain shared behaviors - smoking)
4. Health care delivery
5. Public policy (medicaid expansion)
What are examples of pollutants we talked about in class when thinking about environment and
health
air pollutants (particulate matter), water pollutants (ex. Flint Michigan crisis), other toxins (industrial
waste sites)
How did Obama and Trump base their car emission regulations?
on a meta study from 2010 that concluded:
(1) evidence of impacts on mortality is suggestive but not sufficient
, (2) the evidence linking car pollution to birth outcomes (mortality, birth weight) is inadequate and
insufficient
(3)***the evidence is deemed sufficient to conclude a causal relationship only in the case of the
exacerbation of asthma
#3 is the only one that is relevant for the regulations!
What is measuring the health effects of pollution a difficult problem??
1. There is no control group! At this point, everyone has already been exposed to pollution
2. Some people have air purifiers in their house, so even if located in the same area, there are always
caveats
3. Proximity does NOT = exposure --> some people spend less time outside (various levels of exposure,
and measuring exposure very $$)
4. Effects may be non-linear or interactive --> could be interactions between behaviors and pollution
(like smoking and air pollution)
5. May take a while to manifest
6.**If you are healthier, pollution won't affect you as much as someone who is compromised
True or False: Many people who live in areas w/ higher levels of pollutants are worse off in other ways
that may affect health?
True (lower income, worse health care access, worse nutrition)
true or false?:
more polluted areas are typically cheaper to live
true
How to measure pollution on health
Step 1: find effect of pollutant on health outcomes overall (ex: PM2.5 on health)
Step 2: zoom in on the effect of pollution from a particular source (ex: PM2.5 from cars on health)
What populations should we focus on when looking at effect of pollution on health? Why?
infants or the elderly
infants because their exposure period is relatively well defined
both have well defined health outcomes that are common enough to measure (birth weight, mortality)
*there is also widely available population-level data from statistics and Medicare
How did researchers measure population on health in the elderly?
- used medicare data, looked at mortality
- observed how changes in wind directions would affect health (clean air on one side, dirty air on the
other)
EDITION ALREADY GRADED A+
See slide 3/44 on "Health and the Environment" lecture. Why are there geographic differences in life
expectancy??
Many southern states (southern belt) did not undergo Medicaid expansion - their populations are facing
the consequences
What can a geographic life expectancy map tell you?
socioeconomics, food access, healthcare access, weather patterns (# of cold/hot days) in a given
state/city
What can't a geographic life expectancy map tell you?
Would we expect the populations that are in a low life expectancy grouping at birth to increase life
expectancy if moved to a higher life expectancy group (so moving from one state to a different state
basically).
The affect of place on health and longevity mechanisms (there are 2)
1. Non-random sorting (geographic differences just reflect characteristics of the population)
2. Causal effect of the "place" on health (what would happen if you moved someone from one
geographic location to another?)
Thought experiment: a hypothetic health effect exists of moving someone from one location to another.
list some of the broad, interrelated mechanisms that could be generating observed place health
effects and the individual components of each
1. Local environment (pollution, weather, temperature)
2. Socioeconomics
3. Peer effects (peers in area have certain shared behaviors - smoking)
4. Health care delivery
5. Public policy (medicaid expansion)
What are examples of pollutants we talked about in class when thinking about environment and
health
air pollutants (particulate matter), water pollutants (ex. Flint Michigan crisis), other toxins (industrial
waste sites)
How did Obama and Trump base their car emission regulations?
on a meta study from 2010 that concluded:
(1) evidence of impacts on mortality is suggestive but not sufficient
, (2) the evidence linking car pollution to birth outcomes (mortality, birth weight) is inadequate and
insufficient
(3)***the evidence is deemed sufficient to conclude a causal relationship only in the case of the
exacerbation of asthma
#3 is the only one that is relevant for the regulations!
What is measuring the health effects of pollution a difficult problem??
1. There is no control group! At this point, everyone has already been exposed to pollution
2. Some people have air purifiers in their house, so even if located in the same area, there are always
caveats
3. Proximity does NOT = exposure --> some people spend less time outside (various levels of exposure,
and measuring exposure very $$)
4. Effects may be non-linear or interactive --> could be interactions between behaviors and pollution
(like smoking and air pollution)
5. May take a while to manifest
6.**If you are healthier, pollution won't affect you as much as someone who is compromised
True or False: Many people who live in areas w/ higher levels of pollutants are worse off in other ways
that may affect health?
True (lower income, worse health care access, worse nutrition)
true or false?:
more polluted areas are typically cheaper to live
true
How to measure pollution on health
Step 1: find effect of pollutant on health outcomes overall (ex: PM2.5 on health)
Step 2: zoom in on the effect of pollution from a particular source (ex: PM2.5 from cars on health)
What populations should we focus on when looking at effect of pollution on health? Why?
infants or the elderly
infants because their exposure period is relatively well defined
both have well defined health outcomes that are common enough to measure (birth weight, mortality)
*there is also widely available population-level data from statistics and Medicare
How did researchers measure population on health in the elderly?
- used medicare data, looked at mortality
- observed how changes in wind directions would affect health (clean air on one side, dirty air on the
other)
