Exam 3

Question 1

What is the burden of noncommunicable diseases in the U.S. and worldwide?

Answer 1

Leading cause of death and disability worldwide.
Nationally 70% of all deaths and 90% of healthcare spending.
Globally 70% of deaths; majority in low- and middle-income countries.

Question 2

What features distinguish most noncommunicable diseases?

Answer 2

Long-lasting, progress over time, and are associated with lifestyle factors
(e.g., smoking, poor diet, lack of physical activity) and genetic predisposition
Not transmitted from person to person.

Question 3

Epidemiological transition

Answer 3

The shift in the patterns of health and disease in a population. A move from infectious diseases being the leading cause of death to NCDs becoming more prevalent; often accompanied by improvements in sanitation, healthcare, and nutrition.

Question 4

What are Hill’s criteria for establishing causation involving noncommunicable diseases?

Answer 4

Strength
Consistency
Specificity
Temporality
Biological Gradient
Plausibility
Coherence
Experiment
Analogy

Question 5

Primary prevention

Answer 5

Ams to prevent the disease before it occurs (e.g., vaccination, health
education)

Question 6

Secondary prevention

Answer 6

Seeks to detect and address the disease early (e.g., screening for
cancer)

Question 7

Tertiary prevention

Answer 7

Focuses on reducing the impact of the disease once it has occurred
(e.g., rehabilitation, disease management).

Question 8

What is the most plausible strategy to prevent/reduce the burden of noncommunicable
disease in society?

Answer 8

Promoting healthier lifestyles, improving access to healthcare for early detection, and implementing policies that address social determinants of health

Question 9

What reason(s) can you give for concluding that it’s appropriate to screen for a noncommunicable disease?

Answer 9

Screening is appropriate when:
- The disease has a significant burden on public health.
- Early detection can reduce morbidity and mortality.
- There is an effective treatment or intervention available.
- The screening test is accurate and reliable.
- The benefits of screening outweigh the potential harms (e.g., over-diagnosis, false positives).

Question 10

Sensitivity

Answer 10

The ability of a test to correctly identify those with the disease (true
positives)

Question 11

Specificity

Answer 11

The ability of a test to correctly identify those without the disease (true
negatives)

Question 12

Predictive value

Answer 12

The likelihood that a positive or negative test result accurately reflects
the true disease status, considering both the sensitivity and specificity of the test.

Question 13

What is lead-time bias and how does it affect our evaluation of the effectiveness of screening
tests?

Answer 13

When early detection of a disease does not actually improve outcomes but only extends the time from diagnosis to death; Can make it appear that screened patients live longer, even if the screening had no effect on their overall survival.

Question 14

False positives

Answer 14

When a test incorrectly indicates the presence of a disease, leading
to unnecessary treatments, anxiety, and further testing.

Question 15

False negatives

Answer 15

When a test fails to detect the disease, leading to missed opportunities for early intervention and potentially worse health outcomes.

Question 16

What is the relative burden of communicable diseases in the U.S. and worldwide?

Answer 16

Major burden globally, especially in low- and middle-income
countries, where they are a leading cause of death. Lower in U.S, , but outbreaks of diseases like influenza, tuberculosis, and COVID-19 can still cause significant public health challenges.

Question 17

Epidemic

Answer 17

A sudden increase in the number of cases of a disease in a specific geographic
area above what is normally expected.

Question 18

Endemic

Answer 18

A disease that is consistently present in a population or geographic area over
time.

Question 19

Pandemic

Answer 19

An epidemic that has spread over multiple countries or continents, affecting
a large number of people.

Question 20

What features distinguish most communicable diseases?

Answer 20

Infectious agents and transmissible between individuals, either directly or indirectly. Cause acute or chronic
illnesses and are often preventable through vaccines, hygiene, and sanitation measures.

Question 21

What is Koch’s postulates and how do they help establish causation involving communicable
diseases?

Answer 21

Koch’s postulates are a set of criteria used to establish that a specific microorganism causes a
particular disease:
1. The microorganism must be found in all cases of the disease.
2. The microorganism must be isolated and grown in pure culture.
3. The cultured microorganism must cause the disease when introduced into a healthy
organism.
4. The microorganism must be re-isolated from the infected organism.

Question 22

Direct transmission

Answer 22

Through person-to-person contact (e.g., touching, sexual contact).

Question 23

Indirect transmission

Answer 23

Via contaminated objects (fomites), water, or air (e.g., respiratory
droplets, vectors like mosquitoes).

Question 24

Vertical transmission

Answer 24

From mother to child (e.g., during childbirth or breastfeeding).

Question 25

Infectivity

Answer 25

The ability of a pathogen to establish an infection in a host, measured by
the number of individuals who become infected after exposure.

Question 26

What is the most plausible strategy to prevent/reduce the burden of communicable disease in
society?

Answer 26

Vaccination
Promoting hygiene and sanitation, improving access to
healthcare for early detection and treatment
Educating the public on preventive measures

Question 27

Passive immunity

Answer 27

When an individual receives antibodies from another person or animal, either through maternal transfer or an
antibody-containing blood product.

Question 28

Herd immunity

Answer 28

When a large percentage of a population becomes immune to a disease,
either through vaccination or previous infection, reducing the spread of the disease; Protects individuals who are not immune by limiting transmission.

Question 29

Why are some communicable diseases likely to be eliminated/controlled while others are not?

Answer 29

Depends on factors like the
availability of effective vaccines or treatments, the pathogen’s mutation rate, the ability to implement public health measures, and the economic and logistical
feasibility of controlling transmission in populations

Question 30

Environment

Answer 30

The surroundings or conditions in which a person, animal, or plant lives or operates, both natural and man-made

Question 31

Natural environment

Answer 31

The physical world unaffected by human activity (e.g., forests, oceans, mountains)

Question 32

Altered environment

Answer 32

Environments that have been modified by human activity (e.g., agricultural lands, urban areas).

Question 32

Built environment

Answer 32

Human-made surroundings designed for living, working, and recreation (e.g., buildings, transportation systems, parks).

Question 33

What is the relative burden of environmental diseases in the U.S. and worldwide?

Answer 33

Pollution and exposure to toxins are a
major health burden worldwide; Lower burden in U.S but still significant, especially in areas with high levels of air and water
pollution

Question 34

What are the pathways ways by which individuals are exposed to environmental hazards?

Answer 34

Inhalation, ingestion

Question 35

Public Health Assessment

Answer 35

Focuses on evaluating the risks posed by environmental exposures to human health.

Question 36

Ecological Risk Assessment

Answer 36

Focuses on evaluating the potential effects of environmental hazards on ecosystems, including wildlife, plant species, and entire habitat

Question 37

Explain how social justice and health equity important considerations are in assessing and
controlling environmental risk.

Answer 37

Ensures that the distribution of environmental risks and
benefits is fair and does not disproportionately impact disadvantaged or marginalized populations; equal access to protections and resources that promote a healthy environment

Question 38

Hazard identification

Answer 38

Determining whether a substance or environmental factor can
cause harm.

Question 39

Dose-response assessment

Answer 39

Understanding the relationship between the level of
exposure and the severity of the effect.

Question 40

Exposure assessment

Answer 40

Estimating the extent of human exposure to the hazard,
considering factors like duration and intensity

Question 41

Risk characterization

Answer 41

Combining hazard identification, dose-response, and exposure
data to estimate the risk of harm to human health.