MPH Master of Public Health: Public Health & U.S. Health Care 5 — Questions and Answers
Question 1: The 'social-ecological model' used in public health frames health behavior as influenced by:
- Only the individual's knowledge, attitudes, and beliefs
- Individual, interpersonal, community, organizational, and societal factors simultaneously (Correct answer)
- Genetic factors and individual willpower exclusively
- Health care system capacity and provider training only
Correct answer: Individual, interpersonal, community, organizational, and societal factors simultaneously
The social-ecological model recognizes that behavior is shaped by multiple interacting levels, from individual characteristics to broader social and policy environments.
Question 2: Under the ACA, 'community rating' rules prohibit health insurers in the individual market from:
- Charging different premiums based on health status or pre-existing conditions (Correct answer)
- Offering different plan tiers with different cost-sharing levels
- Selling plans across state lines
- Providing coverage for preventive services without cost-sharing
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 3: Which study design is most appropriate for estimating the prevalence of a health condition in a defined population at a specific point in time?
- Randomized controlled trial
- Cohort study
- Cross-sectional study (Correct answer)
- Case-control study
Correct answer: Cross-sectional study
Cross-sectional studies measure exposure and outcome simultaneously at one point in time, making them ideal for estimating disease prevalence.
Question 4: The primary goal of the U.S. Preventive Services Task Force (USPSTF) is to:
- Set Medicare reimbursement rates for preventive services
- Make evidence-based recommendations about clinical preventive services for primary care (Correct answer)
- License and accredit public health departments nationally
- Administer vaccination programs for children and adults
Correct answer: Make evidence-based recommendations about clinical preventive services for primary care
The USPSTF is an independent expert panel that reviews evidence and issues recommendations on preventive services such as screenings, counseling, and preventive medications.
Question 5: Which of the following scenarios best illustrates the concept of 'upstream' determinants of health?
- A physician prescribing blood pressure medication to a hypertensive patient
- A policy that increases the minimum wage, enabling low-income families to afford healthier food (Correct answer)
- A hospital implementing a patient discharge checklist to reduce readmissions
- A clinic offering free flu shots to walk-in patients
Correct answer: A policy that increases the minimum wage, enabling low-income families to afford healthier food
Upstream determinants are root social and economic causes; raising the minimum wage addresses poverty, which drives many downstream health risks.
Question 6: The concept of 'accountable care organizations' (ACOs) in the U.S. health system is primarily designed to:
- Replace fee-for-service billing with flat monthly premiums for all patients
- Coordinate care among providers who collectively share financial risk and accountability for quality (Correct answer)
- Provide care exclusively to Medicare Advantage enrollees
- Eliminate the role of private insurers in health care delivery
Correct answer: Coordinate care among providers who collectively share financial risk and accountability for quality
ACOs are groups of providers that voluntarily coordinate care and accept joint accountability for quality and costs, sharing in any savings generated.
Question 7: Which of the following public health interventions would be classified as 'tertiary prevention'?
- Administering HPV vaccine to adolescents before sexual debut
- Screening asymptomatic adults for colorectal cancer
- Providing cardiac rehabilitation to patients after a heart attack (Correct answer)
- Implementing smoke-free workplace policies to reduce tobacco use
Correct answer: Providing cardiac rehabilitation to patients after a heart attack
Tertiary prevention aims to reduce disability and improve functioning in people already diagnosed with disease, such as rehabilitation programs after acute events.
MPH Master of Public Health: Public Health & U.S. Health Care 5
The 'social-ecological model' used in public health frames health behavior as influenced by: