PUBH 6012 EVALUATION TEST QUESTIONS AND
ANSWERS SET A+
✔✔4 governance classifications for state/local health departments - ✔✔1.
Decentralized/Local (local govts lead)
2. Centralized/State (LHDs are state units)
3. Mixed (no dominant pattern)
4. Shared (co-governed by state and local)
✔✔What % of local public health agencies are at the county level? - ✔✔~75%
✔✔Definition of federalism - ✔✔Shared sovereignty among levels of government
(usually federal and state), intergovernmental relations are key to outcomes
✔✔What does the 10th Amendment do? - ✔✔Reserves all powers not given to the
federal government (or prohibited by the Constitution) to the STATES or INDIVIDUALS
✔✔Which level of government has primary constitutional responsibility for public health?
- ✔✔STATES - under the 10th Amendment, the feds have limited, enumerated powers
only
✔✔What are police powers? - ✔✔State power to act to promote health, safety, morals,
and general welfare. Includes the power to restrict individual liberty and economic
interests
✔✔4 Key Federal Powers (relevant to health policy) - ✔✔1. TAX - raise revenue,
influence behavior
2. SPEND - with conditions attached
3. REGULATE INTERSTATE COMMERCE
4. PREEMPT state law (supremacy clause)
, ✔✔What is federal preemption? - ✔✔Federal law overrides state law when the federal
action is within constitutional powers (via the Supremacy Clause)
✔✔What is the biggest federal lever for influencing state health policy? - ✔✔SPENDING
POWER - attaching conditions to receipt of federal funds. Feds rarely command
directly; they incentivize with money
✔✔Can states spend like the federal government? - ✔✔No, states have BALANCED
BUDGET REQUIREMENTS - explains why emergency/preparedness funding is
overwhelmingly federal
✔✔3 arguments FOR federal primacy in health - ✔✔1. Health requires a national
perspective
2. State autonomy leads to a 'race to the bottom'
3. Feds have the necessary resources ($$$)
✔✔3 arguments FOR state primacy in health - ✔✔1. 'Laboratories for democracy'
2. Some programs work better decentralized
3. One size doesn't fit all
✔✔Correspondence principle in federalism - ✔✔Costs and benefits should align to the
appropriate level of government - whoever benefits should bear the costs
✔✔Federal PH role - 5 things feds CAN do - ✔✔1. Act when threats span states
2. Act when solutions exceed state jurisdiction
3. Assist states lacking capacity (emergency, bioterrorism, emerging disease)
4. Ensure capabilities across levels (but limited authority to require)
5. Facilitate goal-setting
✔✔Key Powers of the Executive Branch - ✔✔1. Veto
2. Executive orders/presidential directives
3. Budget process
4. Interact with legislative process
5. Agenda setting
✔✔What do administrative agencies do? - ✔✔Part of the executive branch; implements
laws by issuing REGULATIONS (rules)
Must follow the Administrative Procedures Act (notice-and-comment rulemaking);
decisions can't be arbitrary and capricious
✔✔Statute vs. Regulation - ✔✔Statute = law passed by Congress, signed by the
President, codified in the U.S. Code
Regulation (rule) = issued by an agency via notice-and-comment under the APA
ANSWERS SET A+
✔✔4 governance classifications for state/local health departments - ✔✔1.
Decentralized/Local (local govts lead)
2. Centralized/State (LHDs are state units)
3. Mixed (no dominant pattern)
4. Shared (co-governed by state and local)
✔✔What % of local public health agencies are at the county level? - ✔✔~75%
✔✔Definition of federalism - ✔✔Shared sovereignty among levels of government
(usually federal and state), intergovernmental relations are key to outcomes
✔✔What does the 10th Amendment do? - ✔✔Reserves all powers not given to the
federal government (or prohibited by the Constitution) to the STATES or INDIVIDUALS
✔✔Which level of government has primary constitutional responsibility for public health?
- ✔✔STATES - under the 10th Amendment, the feds have limited, enumerated powers
only
✔✔What are police powers? - ✔✔State power to act to promote health, safety, morals,
and general welfare. Includes the power to restrict individual liberty and economic
interests
✔✔4 Key Federal Powers (relevant to health policy) - ✔✔1. TAX - raise revenue,
influence behavior
2. SPEND - with conditions attached
3. REGULATE INTERSTATE COMMERCE
4. PREEMPT state law (supremacy clause)
, ✔✔What is federal preemption? - ✔✔Federal law overrides state law when the federal
action is within constitutional powers (via the Supremacy Clause)
✔✔What is the biggest federal lever for influencing state health policy? - ✔✔SPENDING
POWER - attaching conditions to receipt of federal funds. Feds rarely command
directly; they incentivize with money
✔✔Can states spend like the federal government? - ✔✔No, states have BALANCED
BUDGET REQUIREMENTS - explains why emergency/preparedness funding is
overwhelmingly federal
✔✔3 arguments FOR federal primacy in health - ✔✔1. Health requires a national
perspective
2. State autonomy leads to a 'race to the bottom'
3. Feds have the necessary resources ($$$)
✔✔3 arguments FOR state primacy in health - ✔✔1. 'Laboratories for democracy'
2. Some programs work better decentralized
3. One size doesn't fit all
✔✔Correspondence principle in federalism - ✔✔Costs and benefits should align to the
appropriate level of government - whoever benefits should bear the costs
✔✔Federal PH role - 5 things feds CAN do - ✔✔1. Act when threats span states
2. Act when solutions exceed state jurisdiction
3. Assist states lacking capacity (emergency, bioterrorism, emerging disease)
4. Ensure capabilities across levels (but limited authority to require)
5. Facilitate goal-setting
✔✔Key Powers of the Executive Branch - ✔✔1. Veto
2. Executive orders/presidential directives
3. Budget process
4. Interact with legislative process
5. Agenda setting
✔✔What do administrative agencies do? - ✔✔Part of the executive branch; implements
laws by issuing REGULATIONS (rules)
Must follow the Administrative Procedures Act (notice-and-comment rulemaking);
decisions can't be arbitrary and capricious
✔✔Statute vs. Regulation - ✔✔Statute = law passed by Congress, signed by the
President, codified in the U.S. Code
Regulation (rule) = issued by an agency via notice-and-comment under the APA
