CHES Health Equity and Disparities 4 — Questions and Answers
Question 1: Which ethical principle is MOST directly violated when research excludes women and minorities without scientific justification?
- Autonomy
- Justice (Correct answer)
- Beneficence
- Non-maleficence
Correct answer: Justice
Justice requires fair distribution of research benefits and burdens; excluding groups denies them research benefits while narrowing generalizable knowledge.
Question 2: The 'inverse care law' states that:
- Preventive care reduces hospitalizations inversely
- Quality care is least available where health needs are greatest (Correct answer)
- Higher income populations use emergency rooms less
- Insurance coverage inversely correlates with hospital quality
Correct answer: Quality care is least available where health needs are greatest
Julian Tudor Hart's inverse care law observes that the availability of good medical care tends to vary inversely with the need for it in the population served.
Question 3: A health educator conducting a focus group with undocumented immigrants should FIRST address:
- Language preference for data collection
- Confidentiality and how data will be used and protected (Correct answer)
- Frequency of health care utilization
- Primary health concerns of the group
Correct answer: Confidentiality and how data will be used and protected
Confidentiality concerns are paramount for undocumented populations given fear of deportation, and must be addressed before any data collection.
Question 4: Redlining historically contributed to health disparities primarily by:
- Denying mortgages in minority neighborhoods, concentrating poverty (Correct answer)
- Restricting minority access to hospitals
- Limiting minority employment in health professions
- Mandating segregated waiting rooms in clinics
Correct answer: Denying mortgages in minority neighborhoods, concentrating poverty
Redlining denied home loans to residents of minority neighborhoods, preventing wealth accumulation and creating concentrated poverty with lasting health consequences.
Question 5: Which approach to eliminating health disparities focuses on improving outcomes for ALL groups while accelerating gains for disadvantaged groups?
- Targeted universalism (Correct answer)
- Race-neutral policy
- Individual behavior change
- Trickle-down health improvement
Correct answer: Targeted universalism
Targeted universalism sets universal goals but deploys differentiated strategies for different groups based on their specific barriers and needs.
Question 6: In evaluating a health disparity intervention, which outcome measure is MOST appropriate for assessing equity impact?
- Mean improvement across all participants
- Reduction in the gap between highest and lowest performing groups (Correct answer)
- Total number of participants served
- Cost per participant
Correct answer: Reduction in the gap between highest and lowest performing groups
Measuring reduction in the gap between groups directly assesses whether equity was achieved, not just average improvement across populations.
Question 7: The 'Hispanic paradox' refers to which finding in health disparities research?
- Hispanic Americans have higher cancer rates despite lower smoking rates
- Hispanic immigrants have better health outcomes than expected given socioeconomic status (Correct answer)
- Hispanic communities have paradoxically low health care utilization
- Hispanic Americans show higher cardiovascular risk despite healthier diets
Correct answer: Hispanic immigrants have better health outcomes than expected given socioeconomic status
The Hispanic paradox describes how recent Hispanic immigrants often have better health outcomes than expected given their low socioeconomic status, possibly due to healthy immigrant selection.
CHES Health Equity and Disparities 4
Which ethical principle is MOST directly violated when research excludes women and minorities without scientific justification?