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Major eras in the history of the American public health system were characterized by all of the following EXCEPT: a. Intermittent epidemics throughout the 18th and 19th centuries. b. Edwin Chadwick's epidemiological investigations of cholera. c. The development of state and local public health systems into the mid-20th century. d. The movement into the provision of medical care services after about 1950. 2. Which of the following statements characterizes an important difference between public health and most other professions? a. Education and training beyond the undergraduate (college) level is not available for public health b. Large professional organizations are not available for public health. c. Public health professionals work only in the public sector. d. Although they come from many professions and disciplines, their common bond is not one of a shared body of knowledge or academic preparation, but a commitment to the goals of the improved population health. 3. Which of these important public health figures from the 19th century advanced the argument that the factors contributing to fatal diseases should be identified as the official causes of death? a. Edwin Chadwick b. Lemuel Shattuck c. William Farr d. John Snow 4. Based on your examination of Internet web sites, which of these organizations is most closely affiliated with local public health agencies across the U.S.? a. NACCHO b. ASTHO c. APHA d. CDC 5. Based on your examination of Internet web sites, which of these federal health agencies places the greatest emphasis on prevention? a. Food and Drug Administration b. Health Resources and Services Administration c. American Public Health Association d. Centers for Disease Control

6. In which form of justice are collective actions leading to the assumption of additional burdens often necessary in order to assure the fair distribution of societal benefits? a. Market justice b. Judicial justice c. Social justice d. Individual justice 7. The Public Health Code of Ethics is an exhaustive set of health principles that should be held by people in the public health discipline a. True b. False 8. The Cholera epidemic of the 1854 afflicted poverty stricken individuals more than affluent individuals. a. True b. False 9. In 1900, the leading cause of death in the United States was which of the following conditions? a. Tuberculosis b. Diphtheria c. typhoid fever d. pneumonia and influenza 10. Public health was characterized as fulfilling society's interest in assuring conditions in which people could be healthy by: a. US Centers for Disease Control and Prevention (CDC) in Healthy People 2000 b. Institute of Medicine in The Future of Public Health c. C.E.A. Winslow d. Sir Geoffrey Vickers 11. Which of the following does not represent an important achievement of public health in twentieth century America? a. fluoridation of drinking water to prevent dental caries b. control of infectious diseases c. prevention of bio-terrorism threats d. decline in deaths from heart disease and stroke 12. The Report on the Sanitary Commission of Massachusetts---perhaps the most outstanding treatise in the history of American public health---was written by: a. John Snow b. Edwin Chadwick

c. Lemuel Shattuck d. W.H. Frost 13. Which term best describes individuals whose health insurance coverage has limitations that restrict access to needed services? 14. Introduction of smallpox vaccination is credited to which of these individuals? a. Virchow b. Pasteur c. Lister d. Jenner 15. What major public health intervention strategy has the purpose of eliminating or reducing exposure to harmful factors by modifying human behavior? a. health promotion b. disease prevention c. health monitoring d. environmental scanning 16. Early detection of disease and interventions to reverse, halt, or at least slow the progression of a condition, often performed when disease is not yet symptomatic, is a description of: a. primary prevention b. secondary prevention c. tertiary prevention d. none of the above 17. Immunizations fall into what category of disease prevention? a. primary prevention b. secondary prevention c. tertiary prevention d. none of the above 18. The major strategy used by the federal government in the U.S. after about 1935 to influence the health policies and services of states and local governments was: a. appointment of state and local health commissioners b. development of unified national policy through federal legislation c. establishment of direct federal health service systems d. grants-in-aid 19. The approximate percentage of all health and medical care expenditures in the United States spent on clinical preventive and public health services is: a. 25-30 percent

b. 15-20 percent c. 5-10 percent d. less than 5 percent 20. Health care expenditures in the United States have increased from $12.7 billion in 1950 to $1.5 trillion in 2003. About what proportion of the gross national product was spent on health care in 2003? a. 2 percent b. 6 percent c. 10 percent d. 14 percent e. 20 percent 21. The total level of health expenditures for health and medical care services in the United States for 2006 is likely to be closest to which of these figures? a. 500 million dollars b. 50 billion dollars c. 2 trillion dollars d. 100 trillion dollars 22. As a society, we endorse the delegation of executive, legislative, and judicial authority to administrative agencies for many reasons, EXCEPT which of these? a. Because the complexity of modern society calls for more regulatory bodies to fulfill government's expanded regulatory roles b. Because of the need to rely upon the technical and professional expertise of agency personnel to carry out the public policy behind the legislation c. Because of the need to lessen the burden on the civil court system d. Because it is not always possible or even wise to include extensive detailed and technical information in a statute 23. More than three-fourths of all US local health departments are organized at this level of government a. County b. City c. Township d. State 24. Food and Drug Administration (FDA) is responsible for: a. Overseeing the science of preventive services b. Conducting research into the treatment of major categories of disease c. Providing services to indigenous populations

d. Evaluating the safety of food and drugs 25. The Centers for Disease Control (CDC) does which of the following? a. Oversees the science of preventive medicine through basic science and applied research b. Conducts research into the treatment of major categories of disease c. Provides funds for the clinical services for the poor, aged, and totally disabled d. Provides services to indigenous populations e. Evaluates the safety of food and drugs 26. The National Institutes of Health does which of the following? a. Oversees the science of preventive medicine through basic science and applied research b. Conducts research into the treatment of major categories of disease c. Provides funds for the clinical services for the poor, aged, and totally disabled d. Provides services to indigenous populations e. Evaluates the safety of food and drugs 27. Government can influence the health of its citizens by: a. Altering social factors that influence health b. Assuring equity and equality through public programs c. Providing access to services d. All the above 28. The agency that was first created as a Marine Hospital Service in 1789 is: a. National Tuberculosis Association b. UNICEF c. World Health Organization d. United States Public Health Service e. National Institutes of Health 29. Which of these characteristics applies to the greatest number of official state health departments in the United States? a. Lead environmental agency for the state b. Free standing agencies rather than components of larger multi-purpose human services agencies c. Operates state institutions d. Operates the state's Medicaid Program 30. Which of these is a core function of public health a. Assessment (diagnosis) i. Asses community health needs

ii. Investigate health hazards and effects iii. Analyze health factors b. Policy Development (formation of treatment plan) i. Advocate for community needs and issues ii. Prioritize health needs iii. Plan and develop policies c. Assurance (treatment) i. Manage resources ii. Implement programs iii. Inform the public 31. What does the COBRA Act of 1985 do? a. Pay for the coverage 18months after leaving employment (apples to firms with 20 or more employees) 32. Which statements accurately describe findings about woman access to health care? a. Woman 25% more likely than men to report not getting needed care b. Communication c. Stereotypes d. Less likely to receive major procedures e. Prescribed tranquilizers 2.5 times as often as men 33. Which of the following parts recently introduced Medicare parts coverage of prescription drugs? a. Part D 34. Ways of Paying for health care a. Out of pocket b. Individual private insurance c. Employment based group private insurance d. Government financing 35. Does community rating weaken the principle of insurance, which is to distribute health more in accordance with human needs rather than exclusively on ability to pay? a. Experience rating less distributive than community rating. b. No community rating does not weaken the principle of insurance 36. Which model describes the idea of requiring people to make a contribution in order to receive benefits a. Social insurance model 37. Which are the two major components of the definition of access to healthcare? a. Ability to pay

b. Ability of personnel and facilities 38. A study followed mortality rates between 1971 and 1987 found that lack of insurance alone increased the risk of dying by what %? a. 25% 39. The health insurance portability and accountability act of 1996 did what with respect to coverage of pre existing illness? a. Placed limits on the amount of time insurance companies can delay coverage for pre existing illnesses, but did not eliminate pre existing illness exclusions. 40. Identifying high risk individuals and offer them individual protection, often by counseling on topics such as smoking or diet fall under what model a. Medical model 41. IS prevention better served by concentrating intensive medical interventions on the smaller number of high risk persons in a population than by broad public health efforts to reduce risk among the majority of people at moderate risks? a. May be better served to reduce risk among the majority of people at moderate risk 42. What influences infectious disease mortality rate more than any other factors? a. Access to health care b. Ability to pay 43. Which best describes the basis for the federal government involvement in health care a. Protecting the health of all Americans and provide essential human serviced especially for those who are least able to help themselves 44. A public health agency located within a large umbrella organization that also includes other related or unrelated serviced or programs is referred to as a. Super agency structure 45. The prescription donut hoe refers to what? a. Under the Medicare prescription drug plan beneficiaries pay premiums that average about $32 per month b. How plan works i. Patient pays the first $250 as deductable ii. Patient pays 25% of prescription costs from $251-$2,250 iii. Patient pays 100% of prescriptions from $2,251-5,100 iv. Patient pays 5% of prescriptions above $5,100 46. Characteristics of a regional model a. Eg. British NHS b. Types of personnel and facilities assigned to different tiers

c. Three levels of care i. Primary ii. Secondary iii. Tertiary iv. A sense of a planned system v. Some responsibility for population outcomes vi. Distinct gate keeping 47. Characteristics of dispersed model a. Eg. USA b. Limited assignment of personnel and facilities to different tiers c. Less clearly defined boundaries between professional roles d. Also less clearly defined boundaries among hospitals. 48. The process of matching patient needs and preferences with judicious use of medical services a. Gate keeping 49. Gate keeping is important to health care because a. Each patient gets the right service at the right time at the right place 50. Four key tasks of primary care a. First contact care b. Longitudinal i. Continuity of care ii. Personal health records c. Comprehensiveness i. Ability to manage a wide range of health care needs 51. Coordination a. Referral and follow up b. Integrate services delivered by other care givers 52. The supreme court has struck down state laws on regulating abortion in the first trimester on a. Privacy grounds 53. When it comes to healthcare what is the highest legal authority a. Constitution and federal laws unless state laws are more strict 54. Which term best describes individuals whose health insurance coverage has limitations that restrict access to needed serviced a. Underinsurance

55. Which two features distinguish Medicare prescription coverage from other Medicare coverage a. New monthly premium and deductable