PUBH 401: QUIZ 1 SG UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
Question:
1. Refer to figure 1-2 from Lecture 1. List three reasons, other than the ones I named in the lecture, that
could explain why the top three causes of death have changed from infectious diseases (in 1900) to chronic
diseases (in
2014). (hint: Think of all that has changed in the United States over the 114 year period.)
Answer:
1) Medication
2) Diet
3) Sanitation
Question:
2. Many elementary schools (grades K - 6) provide education on the dangers of smoking cigarettes. They
are hoping that once students understand the dangers, they will never start smoking. Why type of
prevention campaign is this? Primary? Secondary? Tertiary?
Answer:
This is primary prevention because elementary schools are taking measures by educating children on the
dangers of smoking cigarettes. By using this type of prevention, they are trying to prevent the initial
development of a disease before the person has it. In this situation, educating children on the dangers of
smoking will convince them not to smoke.
Question:
3. Why did the Second Clinic have lower maternal mortality rates than First Clinic?
Answer:
The Second Clinic had lower maternal mortality rates than the First Clinic because the First Clinic had a
source of disease transmission. The doctors and students in the First Clinic would go from doing autopsies
to assisting other patients without washing their hands. The solution was implementing the policy of hand
washing.
Question:
4. Where did Dr. Snow get the evidence to establish the existence of a local epidemic (that is, what was his
source of death data)?
Answer:
Dr. Snow got the evidence to establish the existence of a local epidemic from the general registrar.
Question:
5. Does removal of the pump handle seem to be a reasonable and responsible action? Why or why not?
Answer:
The removal of the pump handle seems to be a reasonable and responsible action. Removing the pump
handle limits the rate of exposure of cholera for those drinking from the Broad Street pump. However,
Snow did not believe that removing the pump handle was reasonable and responsible because people just
moved away from the area of the pump
, Question:
6. Snow gives reasons to explain the six cholera cases who informants said had not drunk from the Broad
Street pump. Do you think these are reasonable explanations...or wishful thinking considering what was
known at that time about disease transmission? Explain.
Answer:
I think that these explanations were wishful thinking considering what was known at that time about
disease transmission. This is because these six cases were unrelated to the Broad Street pump but they
contracted cholera from other variables.
Question:
7. Snow focused on workers in the brewery because there were zero cholera deaths. Why did he find this
unusual? (hint: do these observations support or discredit the theory of miasm). What factor(s) "protected"
workers in the brewery from getting cholera?
Answer:
Snow found this unusual because the location of the brewery was close to the Broad Street pump. The
factors that "protected" the workers in the brewery from getting cholera was that they barely drank water at
all and there was a deep well in the brewery that provided the workers with water. The workers had no
reason to drink from the Broad Street pump because of these factors
Question:
8. Snow talks about the residents of the workhouse. Why did Snow focus on the workhouse? Explain the
concept of observed versus expected cholera deaths in the workhouse.
Answer:
Snow focused on the workhouse because out of 535 inmates, only 5 died from cholera. However, if the
mortality rate had been the same as that in the streets, upwards of 100 persons would have died. The
concept of observed versus expected cholera deaths in the workhouse is that the observed cholera deaths
was 5 and the expected number among inmates was 100.
The expected number was determined by dividing the number of cholera deaths in the area surrounding the
workhouse by the number of people living in the area surrounding the workhouse and multiplying it by the
number of inmates.
Question:
9. What did Snow determine as the onset date of the Broad Street epidemic? Why did he choose this date?
Answer:
Snow determined the onset date of the Broad Street epidemic as August 31, 1854. He chose this date
because nearly all of the 83 deaths had taken place in a short distance within the pump. The start of the
outbreak followed the mode for fatal attacks and mode for deaths
Question:
10. Snow had the Broad Street pump handle removed on Sept. 8th. Looking at the Epidemic Curve
(presented in slide 25), do you think removing the handle play a significant role in reducing the number of
people getting sick? Yes or No?
Answer:
Yes, I think that removing the handle played a significant role in reducing the number of people getting
sick. This is because there were no more than 5 attacks a day after the pump handle was removed on
September 8th. After this date, the attacks per day were becoming significantly less.
CORRECT ANSWERS
Question:
1. Refer to figure 1-2 from Lecture 1. List three reasons, other than the ones I named in the lecture, that
could explain why the top three causes of death have changed from infectious diseases (in 1900) to chronic
diseases (in
2014). (hint: Think of all that has changed in the United States over the 114 year period.)
Answer:
1) Medication
2) Diet
3) Sanitation
Question:
2. Many elementary schools (grades K - 6) provide education on the dangers of smoking cigarettes. They
are hoping that once students understand the dangers, they will never start smoking. Why type of
prevention campaign is this? Primary? Secondary? Tertiary?
Answer:
This is primary prevention because elementary schools are taking measures by educating children on the
dangers of smoking cigarettes. By using this type of prevention, they are trying to prevent the initial
development of a disease before the person has it. In this situation, educating children on the dangers of
smoking will convince them not to smoke.
Question:
3. Why did the Second Clinic have lower maternal mortality rates than First Clinic?
Answer:
The Second Clinic had lower maternal mortality rates than the First Clinic because the First Clinic had a
source of disease transmission. The doctors and students in the First Clinic would go from doing autopsies
to assisting other patients without washing their hands. The solution was implementing the policy of hand
washing.
Question:
4. Where did Dr. Snow get the evidence to establish the existence of a local epidemic (that is, what was his
source of death data)?
Answer:
Dr. Snow got the evidence to establish the existence of a local epidemic from the general registrar.
Question:
5. Does removal of the pump handle seem to be a reasonable and responsible action? Why or why not?
Answer:
The removal of the pump handle seems to be a reasonable and responsible action. Removing the pump
handle limits the rate of exposure of cholera for those drinking from the Broad Street pump. However,
Snow did not believe that removing the pump handle was reasonable and responsible because people just
moved away from the area of the pump
, Question:
6. Snow gives reasons to explain the six cholera cases who informants said had not drunk from the Broad
Street pump. Do you think these are reasonable explanations...or wishful thinking considering what was
known at that time about disease transmission? Explain.
Answer:
I think that these explanations were wishful thinking considering what was known at that time about
disease transmission. This is because these six cases were unrelated to the Broad Street pump but they
contracted cholera from other variables.
Question:
7. Snow focused on workers in the brewery because there were zero cholera deaths. Why did he find this
unusual? (hint: do these observations support or discredit the theory of miasm). What factor(s) "protected"
workers in the brewery from getting cholera?
Answer:
Snow found this unusual because the location of the brewery was close to the Broad Street pump. The
factors that "protected" the workers in the brewery from getting cholera was that they barely drank water at
all and there was a deep well in the brewery that provided the workers with water. The workers had no
reason to drink from the Broad Street pump because of these factors
Question:
8. Snow talks about the residents of the workhouse. Why did Snow focus on the workhouse? Explain the
concept of observed versus expected cholera deaths in the workhouse.
Answer:
Snow focused on the workhouse because out of 535 inmates, only 5 died from cholera. However, if the
mortality rate had been the same as that in the streets, upwards of 100 persons would have died. The
concept of observed versus expected cholera deaths in the workhouse is that the observed cholera deaths
was 5 and the expected number among inmates was 100.
The expected number was determined by dividing the number of cholera deaths in the area surrounding the
workhouse by the number of people living in the area surrounding the workhouse and multiplying it by the
number of inmates.
Question:
9. What did Snow determine as the onset date of the Broad Street epidemic? Why did he choose this date?
Answer:
Snow determined the onset date of the Broad Street epidemic as August 31, 1854. He chose this date
because nearly all of the 83 deaths had taken place in a short distance within the pump. The start of the
outbreak followed the mode for fatal attacks and mode for deaths
Question:
10. Snow had the Broad Street pump handle removed on Sept. 8th. Looking at the Epidemic Curve
(presented in slide 25), do you think removing the handle play a significant role in reducing the number of
people getting sick? Yes or No?
Answer:
Yes, I think that removing the handle played a significant role in reducing the number of people getting
sick. This is because there were no more than 5 attacks a day after the pump handle was removed on
September 8th. After this date, the attacks per day were becoming significantly less.
