PUBH 302 EXAM 2 QUESTIONS AND ANSWERS 2026
Social Determinants of Health - Answers -The circumstances in which people are born,
grow up, live, work and age, and the systems put in place to deal with illness.
The Tuskegee Study - Answers -- 600 black men involved (399 with syphilis, 201
without)
- told they were being treated for "bad blood"
- did not receive proper care/treatment to cure their illness
- Study was suppose to last 6 months; lasted 40 years
- no informed consent
National Research Act - Answers -- 1974
- requires voluntary informed consent
- required establishment of Institutional Review Boards (IRBs)
Institutional Review Boards (IRBs) - Answers -- review and decide whether studies
meet ethical standards
Adverse Childhood Experiences - Answers -- Abuse: physical, emotional, sexual
- Neglect: physical, emotional
- Household dysfunction: mental illness, incarcerated relative, mother treated violently,
substance abuse, divorce
Potential determinants of disparities - Answers -- patient level: knowledge and
attitudes, mistrust, behavior intentions
provider level: training and skills, knowledge and attitudes, bias and stereo typing
system level: access to healthcare
What did the Whitehall study reveal about the connection between health and wealth?
What is the wealth-health gradient? - Answers -The wealthier you are, the healthier you
are. The poorer you are, the sicker you are. The lower the grade of employment the
higher the risk of disease. The wealth-health gradient is like a ladder, the higher up the
more wealth and health.
Dr. David Williams says: "Stress helps motivate us. In our society today everybody
experiences stress. The person who has no stress is a person who is dead."
a) How is chronic stress different from the normal fight/flight response?
b) How might chronic stress increase the risk of illness and disease? - Answers -a)
Chronic stress can be activated for an extended period of time. Chronic stress tends to
produce too much cortisol.
b) The overproduction of cortisol can:
- Inhibit memory
- Shrink parts of the brain
- Impair immune function
, How do the lives of Jim Taylor, Tondra Young, Corey Anderson and Mary Turner
exemplify concepts like the wealth-health gradient and the importance of power and
control? - Answers -The wealthier had more opportunities to manage stress, eat
healthier foods, and have time to relax. The people who were more poor were under
more stress. People higher in gradient had more opportunity to exercise, more control of
their lives.
Professor Leonard Syme defines control of destiny as the "ability to influence the events
that impinge on your life." Why is this ability an important factor for health? - Answers -
The ability is important because if someone has the ability than they will have less
stress in their life.
What stories from Corey Anderson's life exemplify a high demand / low control job and
stressful home situation? - Answers -He works a low-level job as a janitor and lives in
an unsafe neighborhood
What stories from Jim Taylor's life illustrate how wealth and status translate into better
health? - Answers -He has a high control job and his wealth allows him to escape from
the stress.
4 major people in the video 'Unnatural Causes' - Answers -Jim Taylor (CEO of
hospital); safe neighborhood to exercise, money to buy better foods, financial security,
control of his life, time, family.
Tundra Yang (Lab Supervisor); Middle-class, still in school, just bought a house, less
likely to get a cold if you own your own home or your parents own their home, in debt
due to education, a little less control, recently engaged (establishing family), good
neighborhood (safety)
Mary Taylor (Unemployed Women); felt like she could not get a job because then they
would take away her disability/benefits, volunteers, unsafe neighborhood, decreases
her meals so she can feed her kids
Corey Anderson (Janitor) & Angelic; hypertension problems at age 34, mom had
hypertension, mom lost her job then became ill, they did not feel safe in their
neighborhood, not much control in job, can not save money
Article- CDC: Childhood Trauma is A Public Health Issue And We Can Do More To
Prevent It
important information: - Answers -- Childhood trauma causes health repercussions
throughout life
- Experiencing traumatic things as a child puts you at risk for lifelong health effects
- One in six people across the United States has experienced four or more kinds of
adverse childhood experiences
- Women, American Indian and Alaskan Natives, and African Americans have a higher
risk of experiencing four or more types of childhood traumas.
Social Determinants of Health - Answers -The circumstances in which people are born,
grow up, live, work and age, and the systems put in place to deal with illness.
The Tuskegee Study - Answers -- 600 black men involved (399 with syphilis, 201
without)
- told they were being treated for "bad blood"
- did not receive proper care/treatment to cure their illness
- Study was suppose to last 6 months; lasted 40 years
- no informed consent
National Research Act - Answers -- 1974
- requires voluntary informed consent
- required establishment of Institutional Review Boards (IRBs)
Institutional Review Boards (IRBs) - Answers -- review and decide whether studies
meet ethical standards
Adverse Childhood Experiences - Answers -- Abuse: physical, emotional, sexual
- Neglect: physical, emotional
- Household dysfunction: mental illness, incarcerated relative, mother treated violently,
substance abuse, divorce
Potential determinants of disparities - Answers -- patient level: knowledge and
attitudes, mistrust, behavior intentions
provider level: training and skills, knowledge and attitudes, bias and stereo typing
system level: access to healthcare
What did the Whitehall study reveal about the connection between health and wealth?
What is the wealth-health gradient? - Answers -The wealthier you are, the healthier you
are. The poorer you are, the sicker you are. The lower the grade of employment the
higher the risk of disease. The wealth-health gradient is like a ladder, the higher up the
more wealth and health.
Dr. David Williams says: "Stress helps motivate us. In our society today everybody
experiences stress. The person who has no stress is a person who is dead."
a) How is chronic stress different from the normal fight/flight response?
b) How might chronic stress increase the risk of illness and disease? - Answers -a)
Chronic stress can be activated for an extended period of time. Chronic stress tends to
produce too much cortisol.
b) The overproduction of cortisol can:
- Inhibit memory
- Shrink parts of the brain
- Impair immune function
, How do the lives of Jim Taylor, Tondra Young, Corey Anderson and Mary Turner
exemplify concepts like the wealth-health gradient and the importance of power and
control? - Answers -The wealthier had more opportunities to manage stress, eat
healthier foods, and have time to relax. The people who were more poor were under
more stress. People higher in gradient had more opportunity to exercise, more control of
their lives.
Professor Leonard Syme defines control of destiny as the "ability to influence the events
that impinge on your life." Why is this ability an important factor for health? - Answers -
The ability is important because if someone has the ability than they will have less
stress in their life.
What stories from Corey Anderson's life exemplify a high demand / low control job and
stressful home situation? - Answers -He works a low-level job as a janitor and lives in
an unsafe neighborhood
What stories from Jim Taylor's life illustrate how wealth and status translate into better
health? - Answers -He has a high control job and his wealth allows him to escape from
the stress.
4 major people in the video 'Unnatural Causes' - Answers -Jim Taylor (CEO of
hospital); safe neighborhood to exercise, money to buy better foods, financial security,
control of his life, time, family.
Tundra Yang (Lab Supervisor); Middle-class, still in school, just bought a house, less
likely to get a cold if you own your own home or your parents own their home, in debt
due to education, a little less control, recently engaged (establishing family), good
neighborhood (safety)
Mary Taylor (Unemployed Women); felt like she could not get a job because then they
would take away her disability/benefits, volunteers, unsafe neighborhood, decreases
her meals so she can feed her kids
Corey Anderson (Janitor) & Angelic; hypertension problems at age 34, mom had
hypertension, mom lost her job then became ill, they did not feel safe in their
neighborhood, not much control in job, can not save money
Article- CDC: Childhood Trauma is A Public Health Issue And We Can Do More To
Prevent It
important information: - Answers -- Childhood trauma causes health repercussions
throughout life
- Experiencing traumatic things as a child puts you at risk for lifelong health effects
- One in six people across the United States has experienced four or more kinds of
adverse childhood experiences
- Women, American Indian and Alaskan Natives, and African Americans have a higher
risk of experiencing four or more types of childhood traumas.
