CHES Health Equity and Disparities 5 — Questions and Answers
Question 1: A health educator wants to ensure a diabetes program is appropriate for a Southeast Asian refugee community. The BEST first step is:
- Translate existing materials into Hmong
- Conduct a community needs and assets assessment with community members (Correct answer)
- Adopt a program proven effective with Latino populations
- Partner with the local hospital's diabetes clinic
Correct answer: Conduct a community needs and assets assessment with community members
Community needs and assets assessment with community members ensures the program is grounded in the specific cultural, linguistic, and contextual realities of that community.
Question 2: Which of the following represents a PRIMARY prevention strategy targeting health equity at the policy level?
- Free mammography screening for uninsured women
- Legislation requiring paid sick leave for all workers (Correct answer)
- Community health worker home visits
- Translation services at health clinics
Correct answer: Legislation requiring paid sick leave for all workers
Paid sick leave policy addresses a social determinant of health (economic stability) before illness occurs, representing upstream primary prevention.
Question 3: Which data source would BEST help a health educator identify census-tract level health disparities?
- National Health Interview Survey
- CDC PLACES (formerly 500 Cities) (Correct answer)
- BRFSS state-level data
- National Vital Statistics Reports
Correct answer: CDC PLACES (formerly 500 Cities)
CDC PLACES provides model-based estimates of health measures at census tract, county, and city levels, enabling local health disparity analysis.
Question 4: Intersectionality as a framework in health disparities recognizes that:
- Race is the primary determinant of all health disparities
- Multiple social identities interact to create unique health experiences (Correct answer)
- Health disparities exist at the intersection of primary and secondary prevention
- Class disparities override racial disparities in health outcomes
Correct answer: Multiple social identities interact to create unique health experiences
Intersectionality, coined by Kimberlé Crenshaw, recognizes that race, gender, class, and other identities overlap to create compounded, unique experiences of oppression and health disadvantage.
Question 5: A health educator discovers that a community program has great reach among English-speakers but misses monolingual Spanish-speakers. This gap is BEST described as:
- Selection bias in program enrollment
- A disparity in program access by language (Correct answer)
- Cultural insensitivity of staff
- An administrative inefficiency
Correct answer: A disparity in program access by language
Differential program access by language represents a health disparity where a group is systematically excluded from program benefits.
Question 6: Which of the following BEST exemplifies community-based participatory research (CBPR) principles?
- Researchers inform community members of study findings after publication
- Community members are co-investigators who share decision-making throughout the research (Correct answer)
- A university IRB approves a study targeting an underserved community
- Researchers hire community members as paid subjects
Correct answer: Community members are co-investigators who share decision-making throughout the research
CBPR requires genuine partnership where community members share power and decision-making in all phases of research, not just as subjects or recipients.
Question 7: The leading cause of the Black-White infant mortality gap in the United States is:
- Differences in prenatal care initiation rates
- Differential rates of low birthweight, largely driven by racial stress (Correct answer)
- Higher rates of congenital anomalies in Black infants
- Disparities in NICU availability by race
Correct answer: Differential rates of low birthweight, largely driven by racial stress
Low birthweight, strongly associated with chronic stress from racial discrimination and structural racism, is the primary driver of the persistent Black-White infant mortality disparity.
CHES Health Equity and Disparities 5
A health educator wants to ensure a diabetes program is appropriate for a Southeast Asian refugee community.
The BEST first step is: