,CONTENT
Unit I – Foundations of Community and Public Health
Chapter 1: Community and Public Health: Yesterday, Today, and Tomorrow
Chapter 2: Organizations that Help Shape Community and Public Health
Chapter 3: Epidemiology: The Study of Disease, Injury, and Death in the Community
Chapter 4: Communicable and Noncommunicable Diseases: Prevention and Control
Chapter 5: Community Organizing/Building and Health Promotion
Chapter 6: The School Health Program: A Component of Community and Public Health
Unit II – The Nation’s Health
Chapter 7: Maternal, Infant, and Child Health
Chapter 8: Adolescents, Young Adults, and Adults
Chapter 9: Older Adults
Chapter 10: Disparate Populations and Community and Public Health
Chapter 11: Community Mental Health
Chapter 12: Alcohol, Tobacco, and Other Drugs: A Community Concern
Chapter 13: Health Care Delivery in the United States
Unit III – Environmental Health and Safety
Chapter 14: Community and Public Health and the Environment
Chapter 15: Injuries as a Community and Public Health Problem
Chapter 16: Safety and Health in the Workplace
,Chapter 1 — Community and Public Health: Yesterday,
Today, and Tomorrow
Theme: Origins and evolution of public health
Key Focus: Historical milestones, determinants of health, epidemiologic
transition, future trends
1. A mid-19th century cholera epidemic is often credited with launching
modern epidemiology. The Broad Street pump investigation by John Snow
is best known for which methodological contribution to public health?
A. Demonstrating that improved sanitation alone eliminates epidemics.
B. Using spatial mapping and comparative case analysis to infer a
waterborne source.
C. Proving miasma theory was correct.
D. Showing that quarantine is the most effective control measure.
Answer: B
Rationale: John Snow combined careful case finding, spot mapping of
cases, and comparison of exposures (pump users vs non-users) to
hypothesize and act on a waterborne transmission route. This empirical,
spatial/descriptive approach—linking geography to exposures—became a
foundation of outbreak investigation and modern epidemiologic methods.
It did not prove miasma theory (which it challenged), nor was the
intervention solely sanitation infrastructure or quarantine.
Key words: John Snow, Broad Street pump, outbreak investigation, spatial
mapping, waterborne transmission
2. The term “epidemiologic transition” most accurately refers to which
population health shift?
, A. From high chronic disease and low infection rates to high infectious
disease with development.
B. From predominantly infectious causes of death to predominantly
chronic, noncommunicable causes as societies develop.
C. From population growth to population decline due to urbanization.
D. From environmental causes to genetic causes of disease as technology
advances.
Answer: B
Rationale: The epidemiologic transition describes the historical pattern in
which societies moving through industrialization and socio-economic
development experience declines in infectious disease and rises in chronic
NCDs (cardiovascular disease, cancer, diabetes). This transition reflects
changes in demography, risk exposures, healthcare, and environment.
Key words: epidemiologic transition, infectious→chronic, demographic
shift, noncommunicable diseases
3. Which population measure is the most direct indicator of a vaccine
program’s success at preventing new cases of a disease?
A. Disease prevalence.
B. Incidence rate.
C. Case fatality rate.
D. Bed-occupancy rate in hospitals.
Answer: B
Rationale: Incidence measures new cases over a defined time and is the
most direct metric for assessing prevention of disease occurrence
following vaccination. Prevalence reflects existing cases (influenced by
duration), case fatality concerns severity once disease occurs, and bed-
occupancy is indirect and confounded by health system factors.
Key words: incidence, vaccine effectiveness, new cases, surveillance
,4. In a low-income urban settlement, which immediate mechanism explains
how installing communal latrines reduces under-five mortality?
A. It increases vaccine uptake by bringing health services closer.
B. It interrupts fecal-oral transmission pathways and lowers diarrheal
disease incidence.
C. It raises family income by creating jobs for latrine attendants.
D. It eliminates vector breeding sites for malaria.
Answer: B
Rationale: Communal latrines primarily interrupt fecal-oral transmission of
enteric pathogens, thereby reducing diarrheal disease—a major cause of
under-five morbidity and mortality. While latrines may have secondary
economic or vector impacts, the immediate causal pathway for reduced
child deaths is lowered diarrheal incidence and severity.
Key words: sanitation, fecal-oral transmission, diarrheal disease, child
mortality
5. A public health researcher investigating persistent low birth weights in a
neighborhood attributes the problem to interlocking factors: maternal
undernutrition, air pollution, limited prenatal care, and food deserts. This
explanation best illustrates which concept?
A. Genetic determinism.
B. Multifactorial social determinants of health interacting to produce
outcomes.
C. The primacy of individual lifestyle choice over structural factors.
D. A single etiologic agent causing most adverse birth outcomes.
Answer: B
Rationale: The scenario highlights how social, environmental, behavioral,
and healthcare access determinants interact—multicausal pathways that
, drive health outcomes. Public health frames such problems as arising from
multiple, often synergistic determinants rather than a single cause or pure
individual choice.
Key words: social determinants, multifactorial causation, prenatal care, air
pollution, nutrition
6. During an international infectious disease outbreak, which statement best
distinguishes the role of the World Health Organization (WHO) from that
of the U.S. Centers for Disease Control and Prevention (CDC)?
A. WHO enforces member-state public health laws; CDC funds
international health care systems.
B. WHO coordinates global guidance and cross-border response; CDC
provides technical expertise, surveillance support, and deployable teams to
augment national responses.
C. WHO focuses exclusively on noncommunicable diseases; CDC works
only domestically.
D. WHO manufactures vaccines; CDC certifies them.
Answer: B
Rationale: WHO’s mandate is international coordination, normative
guidance, and assisting countries with cross-border issues. The CDC is a
national public health agency with strong technical expertise that also
supports other countries through technical assistance, laboratory support,
and outbreak response teams. Neither organization unilaterally enforces
national laws or manufactures vaccines.
Key words: WHO, CDC, global coordination, technical assistance, outbreak
response
, 7. To reduce telemedicine-related disparities in rural regions, which single
policy is most likely to produce the largest equity gain?
A. Requiring all providers to receive training in telehealth platforms.
B. Mandating telehealth reimbursement parity for insurers.
C. Expanding affordable high-speed broadband access and subsidizing
devices for low-income households.
D. Creating national telehealth clinical practice guidelines.
Answer: C
Rationale: Access to infrastructure (broadband and devices) is typically the
largest barrier to telehealth equity. While provider training and
reimbursement are important, without connectivity and affordable devices
marginalized populations cannot use telemedicine services. Thus,
expanding broadband and subsidizing access addresses the root of the
digital divide.
Key words: telemedicine, digital divide, broadband, equity, infrastructure
8. Which health outcome is most plausibly and directly expected to increase
in temperate regions as a consequence of climate change?
A. Genetic mutations in the population.
B. Expansion of vector-borne diseases (e.g., dengue, chikungunya) to new
latitudes.
C. A sudden decrease in rates of heat-related illness.
D. A universal decline in noncommunicable disease prevalence.
Answer: B
Rationale: Climate change alters temperature and precipitation patterns,
enabling vectors (mosquitoes/ticks) and their pathogens to survive in
previously unsuitable regions—leading to geographic expansion of vector-
borne diseases. Genetic mutations and universal declines in NCDs are not
direct climate consequences; heat-related illness would increase, not
decrease.
Unit I – Foundations of Community and Public Health
Chapter 1: Community and Public Health: Yesterday, Today, and Tomorrow
Chapter 2: Organizations that Help Shape Community and Public Health
Chapter 3: Epidemiology: The Study of Disease, Injury, and Death in the Community
Chapter 4: Communicable and Noncommunicable Diseases: Prevention and Control
Chapter 5: Community Organizing/Building and Health Promotion
Chapter 6: The School Health Program: A Component of Community and Public Health
Unit II – The Nation’s Health
Chapter 7: Maternal, Infant, and Child Health
Chapter 8: Adolescents, Young Adults, and Adults
Chapter 9: Older Adults
Chapter 10: Disparate Populations and Community and Public Health
Chapter 11: Community Mental Health
Chapter 12: Alcohol, Tobacco, and Other Drugs: A Community Concern
Chapter 13: Health Care Delivery in the United States
Unit III – Environmental Health and Safety
Chapter 14: Community and Public Health and the Environment
Chapter 15: Injuries as a Community and Public Health Problem
Chapter 16: Safety and Health in the Workplace
,Chapter 1 — Community and Public Health: Yesterday,
Today, and Tomorrow
Theme: Origins and evolution of public health
Key Focus: Historical milestones, determinants of health, epidemiologic
transition, future trends
1. A mid-19th century cholera epidemic is often credited with launching
modern epidemiology. The Broad Street pump investigation by John Snow
is best known for which methodological contribution to public health?
A. Demonstrating that improved sanitation alone eliminates epidemics.
B. Using spatial mapping and comparative case analysis to infer a
waterborne source.
C. Proving miasma theory was correct.
D. Showing that quarantine is the most effective control measure.
Answer: B
Rationale: John Snow combined careful case finding, spot mapping of
cases, and comparison of exposures (pump users vs non-users) to
hypothesize and act on a waterborne transmission route. This empirical,
spatial/descriptive approach—linking geography to exposures—became a
foundation of outbreak investigation and modern epidemiologic methods.
It did not prove miasma theory (which it challenged), nor was the
intervention solely sanitation infrastructure or quarantine.
Key words: John Snow, Broad Street pump, outbreak investigation, spatial
mapping, waterborne transmission
2. The term “epidemiologic transition” most accurately refers to which
population health shift?
, A. From high chronic disease and low infection rates to high infectious
disease with development.
B. From predominantly infectious causes of death to predominantly
chronic, noncommunicable causes as societies develop.
C. From population growth to population decline due to urbanization.
D. From environmental causes to genetic causes of disease as technology
advances.
Answer: B
Rationale: The epidemiologic transition describes the historical pattern in
which societies moving through industrialization and socio-economic
development experience declines in infectious disease and rises in chronic
NCDs (cardiovascular disease, cancer, diabetes). This transition reflects
changes in demography, risk exposures, healthcare, and environment.
Key words: epidemiologic transition, infectious→chronic, demographic
shift, noncommunicable diseases
3. Which population measure is the most direct indicator of a vaccine
program’s success at preventing new cases of a disease?
A. Disease prevalence.
B. Incidence rate.
C. Case fatality rate.
D. Bed-occupancy rate in hospitals.
Answer: B
Rationale: Incidence measures new cases over a defined time and is the
most direct metric for assessing prevention of disease occurrence
following vaccination. Prevalence reflects existing cases (influenced by
duration), case fatality concerns severity once disease occurs, and bed-
occupancy is indirect and confounded by health system factors.
Key words: incidence, vaccine effectiveness, new cases, surveillance
,4. In a low-income urban settlement, which immediate mechanism explains
how installing communal latrines reduces under-five mortality?
A. It increases vaccine uptake by bringing health services closer.
B. It interrupts fecal-oral transmission pathways and lowers diarrheal
disease incidence.
C. It raises family income by creating jobs for latrine attendants.
D. It eliminates vector breeding sites for malaria.
Answer: B
Rationale: Communal latrines primarily interrupt fecal-oral transmission of
enteric pathogens, thereby reducing diarrheal disease—a major cause of
under-five morbidity and mortality. While latrines may have secondary
economic or vector impacts, the immediate causal pathway for reduced
child deaths is lowered diarrheal incidence and severity.
Key words: sanitation, fecal-oral transmission, diarrheal disease, child
mortality
5. A public health researcher investigating persistent low birth weights in a
neighborhood attributes the problem to interlocking factors: maternal
undernutrition, air pollution, limited prenatal care, and food deserts. This
explanation best illustrates which concept?
A. Genetic determinism.
B. Multifactorial social determinants of health interacting to produce
outcomes.
C. The primacy of individual lifestyle choice over structural factors.
D. A single etiologic agent causing most adverse birth outcomes.
Answer: B
Rationale: The scenario highlights how social, environmental, behavioral,
and healthcare access determinants interact—multicausal pathways that
, drive health outcomes. Public health frames such problems as arising from
multiple, often synergistic determinants rather than a single cause or pure
individual choice.
Key words: social determinants, multifactorial causation, prenatal care, air
pollution, nutrition
6. During an international infectious disease outbreak, which statement best
distinguishes the role of the World Health Organization (WHO) from that
of the U.S. Centers for Disease Control and Prevention (CDC)?
A. WHO enforces member-state public health laws; CDC funds
international health care systems.
B. WHO coordinates global guidance and cross-border response; CDC
provides technical expertise, surveillance support, and deployable teams to
augment national responses.
C. WHO focuses exclusively on noncommunicable diseases; CDC works
only domestically.
D. WHO manufactures vaccines; CDC certifies them.
Answer: B
Rationale: WHO’s mandate is international coordination, normative
guidance, and assisting countries with cross-border issues. The CDC is a
national public health agency with strong technical expertise that also
supports other countries through technical assistance, laboratory support,
and outbreak response teams. Neither organization unilaterally enforces
national laws or manufactures vaccines.
Key words: WHO, CDC, global coordination, technical assistance, outbreak
response
, 7. To reduce telemedicine-related disparities in rural regions, which single
policy is most likely to produce the largest equity gain?
A. Requiring all providers to receive training in telehealth platforms.
B. Mandating telehealth reimbursement parity for insurers.
C. Expanding affordable high-speed broadband access and subsidizing
devices for low-income households.
D. Creating national telehealth clinical practice guidelines.
Answer: C
Rationale: Access to infrastructure (broadband and devices) is typically the
largest barrier to telehealth equity. While provider training and
reimbursement are important, without connectivity and affordable devices
marginalized populations cannot use telemedicine services. Thus,
expanding broadband and subsidizing access addresses the root of the
digital divide.
Key words: telemedicine, digital divide, broadband, equity, infrastructure
8. Which health outcome is most plausibly and directly expected to increase
in temperate regions as a consequence of climate change?
A. Genetic mutations in the population.
B. Expansion of vector-borne diseases (e.g., dengue, chikungunya) to new
latitudes.
C. A sudden decrease in rates of heat-related illness.
D. A universal decline in noncommunicable disease prevalence.
Answer: B
Rationale: Climate change alters temperature and precipitation patterns,
enabling vectors (mosquitoes/ticks) and their pathogens to survive in
previously unsuitable regions—leading to geographic expansion of vector-
borne diseases. Genetic mutations and universal declines in NCDs are not
direct climate consequences; heat-related illness would increase, not
decrease.
