Certified in Public Health (CPH) — Questions and Answers

Question 1: The concept of 'medical home' in primary care emphasizes which of the following?

Specialist-led acute care coordination
Comprehensive, continuous, coordinated patient-centered care (Correct answer)
Fee-for-service reimbursement structures
Hospital-based outpatient services only

Correct answer: Comprehensive, continuous, coordinated patient-centered care

The patient-centered medical home model focuses on ongoing, coordinated, team-based primary care with a personal physician.

Question 2: Which study design is considered the gold standard for establishing causality?

Cohort study
Cross-sectional study
Case-control study
Randomized controlled trial (Correct answer)

Correct answer: Randomized controlled trial

Randomized controlled trials are considered the gold standard because randomization minimizes confounding and allows causal inference.

Question 3: The concept of 'health equity' in public health primarily refers to:

The absence of avoidable, unfair, or remediable differences in health outcomes (Correct answer)
Universal access to the same health care providers
Equal insurance premiums for all citizens regardless of income
Equal distribution of health care facilities across states

Correct answer: The absence of avoidable, unfair, or remediable differences in health outcomes

Health equity means that everyone has a fair and just opportunity to be as healthy as possible, eliminating preventable disparities.

Question 4: Which statistical test is appropriate for comparing means between two independent groups?

Independent samples t-test (Correct answer)
Chi-square test
Paired t-test
ANOVA

Correct answer: Independent samples t-test

The independent samples t-test compares means from two unrelated groups to determine if they differ significantly.

Question 5: A hotel notices a cluster of guests reporting gastrointestinal illness after dining at the on-site restaurant. What is the FIRST public health action?

Conduct a staff meeting
Notify the local health department (Correct answer)
Offer refunds to affected guests
Shut down the restaurant immediately

Correct answer: Notify the local health department

Reporting to the local health department triggers an official outbreak investigation and ensures coordinated public health response.

Question 6: Which of the following best describes a community asset map?

A database of disease prevalence and incidence rates
A ranked list of community health problems
A geographic map showing hospital and clinic locations
A catalog of community strengths, resources, and capacities (Correct answer)

Correct answer: A catalog of community strengths, resources, and capacities

Asset mapping identifies existing community resources, strengths, and capacities that can be mobilized to address health issues.

Question 7: Relative risk (RR) of 1.0 indicates:

The study was underpowered
A strong positive association
A strong negative association
No association between exposure and outcome (Correct answer)

Correct answer: No association between exposure and outcome

An RR of 1.0 means the risk in the exposed group equals the risk in the unexposed group, indicating no association.

Question 8: In program evaluation, 'formative evaluation' is conducted:

Before any funding decisions are finalized
After a program concludes to measure long-term population impact
At the exact midpoint of a program to assess intermediate outcomes
During program development or implementation to improve the program while it is ongoing (Correct answer)

Correct answer: During program development or implementation to improve the program while it is ongoing

Formative evaluation is conducted during development and implementation phases to provide feedback that improves the program design before it is finalized.

Question 9: Which data source is most commonly used for state and county-level community health status assessment?

Behavioral Risk Factor Surveillance System (BRFSS) (Correct answer)
National Health Interview Survey (NHIS)
Medical Expenditure Panel Survey (MEPS)
Medicare claims data

Correct answer: Behavioral Risk Factor Surveillance System (BRFSS)

BRFSS is the nation's premier telephone-based surveillance system for collecting state and local data on health risk behaviors, chronic conditions, and preventive service use.

Question 10: A public health inspector identifies that a resort's swimming pool has a free chlorine level of 0.5 ppm. This is significant because:

It exceeds the safe limit and poses chemical exposure risk
Chlorine levels are irrelevant to public health in pools
It is within acceptable range for all pool types
It is below the CDC-recommended minimum of 1 ppm for pools (Correct answer)

Correct answer: It is below the CDC-recommended minimum of 1 ppm for pools

CDC recommends free chlorine of at least 1 ppm in pools to effectively inactivate pathogens like Cryptosporidium and E. coli.

Question 11: The term 'social determinants of health' refers to:

Conditions in the environments where people are born, live, work, and age that shape health outcomes (Correct answer)
Genetic factors that influence individual disease susceptibility
Healthcare utilization patterns observed across populations
Personal lifestyle choices that directly impact individual wellbeing

Correct answer: Conditions in the environments where people are born, live, work, and age that shape health outcomes

Social determinants of health are the non-medical conditions in social and physical environments — such as income, education, and housing — that profoundly influence health.

Question 12: Maternal mortality ratio (MMR) is defined as:

Maternal deaths per 100,000 live births in a given time period (Correct answer)
The proportion of women dying from obstetric complications
Maternal deaths per 1,000 live births per year
Infant deaths attributable to maternal illness per year

Correct answer: Maternal deaths per 100,000 live births in a given time period

MMR is expressed as the number of maternal deaths per 100,000 live births, used to assess obstetric care quality and women's health in populations.

Question 13: Which industry DOES NOT include the entertainment industry?

Casinos
Nightclubs
Amusement parks
Resorts (Correct answer)

Correct answer: Resorts

The entertainment industry primarily encompasses activities and businesses focused on amusement, leisure, and diversion, such as nightclubs, amusement parks, and casinos. Resorts, while often offering entertainment options, are fundamentally part of the hospitality and tourism industry, providing accommodation, food, and a range of services. Their core business model is broader than just entertainment.

Question 14: The PRECEDE-PROCEED model is primarily used in public health for:

Conducting epidemiological outbreak investigations
Health facility accreditation and licensing
Clinical diagnosis and individualized treatment planning
Planning, implementing, and evaluating health promotion and disease prevention programs (Correct answer)

Correct answer: Planning, implementing, and evaluating health promotion and disease prevention programs

PRECEDE-PROCEED is a comprehensive, evidence-based planning model that guides practitioners through educational diagnosis, program design, implementation, and evaluation.

Question 15: Which metric best reflects health inequities within a country?

Life expectancy disaggregated by income quintile or race/ethnicity (Correct answer)
Infant mortality rate at the national level
Total health expenditure as a percentage of GDP
National average life expectancy

Correct answer: Life expectancy disaggregated by income quintile or race/ethnicity

Disaggregating health indicators by socioeconomic status or race/ethnicity reveals disparities that national averages mask, enabling targeted equity-focused interventions.

Question 16: The process of creating strategic partnerships in the healthcare industry is dynamic and starts with .

The desire to capture all the healthcare business in the region
An awareness of more providers in the region
An awareness of crisis which calls for change (Correct answer)
Need for more patients in the healthcare system

Correct answer: An awareness of crisis which calls for change

Strategic partnerships in healthcare typically emerge from a recognized need or challenge that existing structures cannot adequately address. This 'awareness of crisis,' whether it's financial pressure, poor patient outcomes, or market shifts, serves as the catalyst for organizations to seek collaborative solutions. It highlights the urgency and necessity for change that drives the formation of new alliances.

Question 17: The 'hierarchy of controls' in occupational health, from most to least effective, begins with:

Personal protective equipment
Administrative controls
Elimination of the hazard (Correct answer)
Engineering controls

Correct answer: Elimination of the hazard

Elimination — physically removing the hazard — is the most effective control because it prevents exposure entirely rather than managing it.

Question 18: Under the ACA, 'community rating' rules prohibit health insurers in the individual market from:

Providing coverage for preventive services without cost-sharing
Charging different premiums based on health status or pre-existing conditions (Correct answer)
Selling plans across state lines
Offering different plan tiers with different cost-sharing levels

Correct answer: Charging different premiums based on health status or pre-existing conditions

ACA community rating rules prevent insurers from varying premiums based on health status, medical history, or gender, protecting consumers with pre-existing conditions.

Question 19: Which approach is an example of a 'downstream' health intervention?

Subsidizing healthy food in low-income neighborhoods
Training community health workers to promote cancer screening
Providing treatment for a patient with lung cancer (Correct answer)
Passing smoke-free workplace legislation

Correct answer: Providing treatment for a patient with lung cancer

Downstream interventions target individuals after disease has occurred, such as treating existing illness, rather than addressing upstream social or environmental causes.

Question 20: The Theory of Planned Behavior proposes that behavior is most directly predicted by:

Perceived susceptibility and perceived severity
Reinforcement and punishment contingencies
Behavioral intention, which is shaped by attitudes, subjective norms, and perceived behavioral control (Correct answer)
Environmental cues and automatic triggers

Correct answer: Behavioral intention, which is shaped by attitudes, subjective norms, and perceived behavioral control

Ajzen's Theory of Planned Behavior holds that intention — determined by attitudes toward the behavior, subjective norms, and perceived behavioral control — is the strongest proximal predictor of behavior.

Question 21: Which federal agency in the U.S. is primarily responsible for regulating workplace safety and health standards?

OSHA (Correct answer)
EPA
CDC
NIOSH

Correct answer: OSHA

The Occupational Safety and Health Administration (OSHA) sets and enforces workplace safety standards under the Department of Labor.

Question 22: What is the purpose of stratified analysis in epidemiology?

To increase sample size
To calculate incidence rates from prevalence data
To examine associations within subgroups and control for confounding (Correct answer)
To randomize participants into groups

Correct answer: To examine associations within subgroups and control for confounding

Stratified analysis divides data into subgroups to evaluate whether a third variable modifies or confounds the exposure-outcome relationship.

Question 23: Social Cognitive Theory, developed by Albert Bandura, identifies which concepts as central to behavior change?

Community norms and social capital
Perceived barriers and cues to action
Self-efficacy, observational learning, and reciprocal determinism (Correct answer)
Stages of readiness and decisional balance

Correct answer: Self-efficacy, observational learning, and reciprocal determinism

Bandura's Social Cognitive Theory centers on self-efficacy (confidence in one's ability), observational learning, and reciprocal determinism (the interplay between person, behavior, and environment).

Question 24: In community health practice, 'cultural competence' is best defined as:

Translating all health materials into multiple languages
The capacity of programs and providers to effectively serve populations with diverse cultural backgrounds and needs (Correct answer)
Exclusively hiring healthcare workers from underrepresented communities
Removing all cultural content from health education materials to avoid bias

Correct answer: The capacity of programs and providers to effectively serve populations with diverse cultural backgrounds and needs

Cultural competence encompasses the awareness, knowledge, attitudes, and skills needed to deliver effective services that are responsive to the cultural and social needs of diverse populations.

Question 25: Under the Americans with Disabilities Act (ADA), hospitality venues must provide:

Dedicated parking for all hotel guests
Accessible accommodations and services for guests with disabilities (Correct answer)
Free upgrades for disabled guests
On-site medical staff at all times

Correct answer: Accessible accommodations and services for guests with disabilities

The ADA requires that hotels and restaurants offer equal access, reasonable accommodations, and barrier-free facilities to guests with disabilities.

Question 26: The Hill-Burton Act of 1946 primarily aimed to:

Regulate hospital merger and acquisition activity
Establish Medicare and Medicaid funding formulas
Fund hospital construction in underserved areas (Correct answer)
Create the Veterans Health Administration

Correct answer: Fund hospital construction in underserved areas

The Hill-Burton Act provided federal grants for hospital construction and modernization in exchange for obligations to provide free or reduced-cost care to those unable to pay.

Question 27: Which of the following is a primary air pollutant regulated under the U.S. Clean Air Act?

Acid rain
Particulate matter (PM2.5) (Correct answer)
Ground-level ozone
Smog

Correct answer: Particulate matter (PM2.5)

PM2.5 is one of the six criteria air pollutants directly regulated under the Clean Air Act's National Ambient Air Quality Standards.

Question 28: Healthy People 2030 is best described as:

A grant program exclusively for community health centers
A set of science-based national health objectives to improve the health of all Americans (Correct answer)
A federal insurance program for low-income populations
A clinical guideline for preventive care services

Correct answer: A set of science-based national health objectives to improve the health of all Americans

Healthy People 2030 establishes science-based objectives and targets with the overarching goal of improving health and well-being across the decade.

Question 29: Which of the following organizations is not for profit? CDC and American Cancer Society are listed first and second, respectively (CDC) National Institutes of Health, third (NIH)

II and III only
I only (Correct answer)
III only
II only

Correct answer: I only

The CDC (Centers for Disease Control and Prevention) is a federal government agency. As such, its primary mission is public health, not generating financial profit. Therefore, it functions as a 'not for profit' entity in the sense that it does not seek to make money for shareholders or owners. While other organizations listed also operate without a profit motive, the question's structure and provided answer suggest a focus on the CDC as fitting the 'not for profit' description among the choices.

Question 30: Effect modification (interaction) in epidemiology means:

A confounding variable masks the true association
Two exposures cause the same outcome through different pathways
The effect of an exposure on an outcome differs across strata of a third variable (Correct answer)
Random measurement error inflates the association

Correct answer: The effect of an exposure on an outcome differs across strata of a third variable

Effect modification occurs when the magnitude or direction of an association varies across levels of another variable, indicating a true biological or social interaction.

Certified in Public Health (CPH)

The CPH exam, administered by the National Board of Public Health Examiners (NBPHE), certifies public health professionals across 10 core domains including epidemiology, program planning, policy, law, leadership, and health equity.

Questions

35 min

Time Limit

70%

To Pass

Checking for saved progress...

Exam Rules

You can skip questions and return to them later
Flag questions for review before submitting
No feedback shown until you submit the entire exam
Unanswered questions count as wrong — answer everything
10 pretest questions are mixed in and don't affect your score
Timer auto-submits when time runs out
Your progress is auto-saved every 30 seconds