Test Questions & Answers Ch.21 Development And Health Haslam

Chapter 21

Development and Health

Multiple Choice Questions

1. Which of the following is true about social determinants of health?
   1. They demonstrate how the conditions under which people live and work affect their opportunities to lead healthy lives.
   2. They show us that differences in health status are not only among but within countries.
   3. They are only relevant in low-income countries.
   4. Both A and B
   5. All of the above
2. The “double burden of disease” contrasts which of the following?
   1. The reinforcing mechanism of poverty and institutional power arrangements
   2. The continued prevalence of diseases of poverty coexists with diseases of affluence
   3. The contradiction between enough resources to meet human need and the prevalence of poverty
   4. The impact of communicable disease on communities of great poverty
   5. The mismatch between prevalence of disease and resources to combat them
3. What mediates the relationship between economic growth and human health and welfare?
   1. Wealth
   2. Institutions
   3. Civil society
   4. Entrepreneurs
   5. Politics
4. According to Simon Szreter, what was the result of the Industrial Revolution in Britain?
   1. It caused life expectancy rates to plummet in “provincial” cities for several decades.
   2. It caused life expectancy rates to plummet in rural areas for several decades.
   3. It greatly improved health outcomes for individuals living in “provincial” cities immediately but did not affect those living in rural areas for several decades.
   4. It is evidence of the link between economic growth and lower mortality rates.
   5. It had no impact on the health of workers.
5. According to Simon Szreter, which of the following characterizes the relationship between economic growth and human health and welfare?
   1. Statistically positive
   2. Critically mediated by politics
   3. Influenced by social factors
   4. Statistically insignificant
   5. Politically neutral
6. According to Sir Michael Marmot, which of the following is an important factor in how stress is experienced?
   1. Availability of traditional means of addressing health
   2. Presence of NGOs in health provision
   3. Access to economic resources and position within a social hierarchy
   4. Access to public transportation
   5. National levels of unemployment and underemployment
7. What did the Agreement on Trade Related Aspects of Intellectual Property Rights do?
   1. It increased the affordability of medicine in developing countries.
   2. It was vehemently opposed by US pharmaceutical companies.
   3. It led to the liberalization of patent-protection laws.
   4. It reduced the 10/90 gap.
   5. It created barriers to the affordability of medicine in developing countries.
8. What is the 10/90 gap?
   1. 10 out of every 90 people in developing countries suffer from communicable diseases.
   2. 10 out of every 90 people in developing countries suffer from non-communicable diseases.
   3. 10 per cent of global health research spending is directed towards conditions that cause 90 per cent of disease.
   4. 90 per cent of the world’s poor suffer from the 10 deadliest diseases.
   5. 90 per cent of the world’s population suffers from 10 percent of the deadliest diseases.
9. What has been found to have a strong correlation with increased levels of foreign investment in LMICs?
   1. Greater exposure to unhealthy food
   2. Increased equity
   3. Lower indicators of structural poverty
   4. Higher rates of communicable diseases
   5. More robust protection for at risk groups
10. Which of the following is true about the World Health Organization?
    1. It is controlled by the World Trade Organization.
    2. It is a UN agency.
    3. It was created by members of the G8.
    4. It is controlled by the International Monetary Fund.
    5. It is financially supported by the “global fund.”
11. The World Health Organization operates offices in approximately how many countries?
    1. 63
    2. 79
    3. 67
    4. 147
    5. 236
12. The World Bank has strongly promoted which of the following?
    1. Nationalized healthcare
    2. Market-oriented healthcare
    3. Universal healthcare
    4. Two-tier healthcare
    5. Private healthcare
13. At what conference did the WHO call attention to the goal of Comprehensive Primary Health Care?
    1. Lima Conference 1976
    2. Alma-Ata Conference 1978
    3. Alexandria Conference 1980
    4. Shanghai Conference 1982
    5. Porto Alegre Conference 1984
14. The IMF demands for limiting increased public expenditures on health have resulted in which of the following?
    1. Deteriorating health system performance
    2. Elimination of the over-supply of health workers
    3. A more efficient and reliable healthcare industry
    4. Improved healthcare outcomes among impoverished populations
    5. Increased ability for governments to pay their health professionals and teachers competitive wages
15. The Global Fund was established as which of the following?
    1. A multilateral agreement between several developed and developing country governments
    2. A branch of the UN devoted to healthcare development
    3. A means of supporting integrated primary healthcare
    4. A specialized division of the World Bank
    5. A multilateral partnership by the G8 countries
16. Since 2006-7, WHO has operated on an annual budget of _______________.
    1. approximately US$1 billion
    2. approximately US$5 billion
    3. approximately US$10 billion
    4. approximately US$4 billion
    5. approximately US$50 billion
17. What is the most prevalent motivation for donors to allocate resources to improve health outside their state?
    1. Colonial legacies
    2. Altruistic norms surrounding human well being
    3. Economic motivations
    4. Research and development opportunities
    5. Danger of communicable diseased
18. What is instructive about the response to the 2014 Ebola outbreak?
    1. The ability of the developed world to eradicate disease when motivated
    2. The paradox of high resource commitment and low threat assessment
    3. The robust response of the WHO to deal with threats of pandemics
    4. The danger communicable diseases pose to developed states
    5. The ability of high-income governments to react appropriately to threats of disease
19. Which of the following is an obstacle to even well-intentioned health strategies?
    1. Rising inequality
    2. Growing poverty
    3. Collapsing health systems
    4. Both A and B
    5. All of the above
20. What is an important driver of the nutrition transition?
    1. The transformation of food systems
    2. The transformation of the liberation systems
    3. The consolidation of the food systems
    4. Liberation of trade
    5. None of the above
21. What does the term “global health governance” reflect?
    1. The expanding role of agencies of national governments
    2. The expanding role of multilateral agencies
    3. The lack of a supranational authority in terms of health
    4. The expanding role of organizations that go against conventions
    5. A supranational authority in terms of health
22. What is the WHO’s mission?
    1. To oversee its 34-member nations
    2. To set economic policies
    3. To focus on health protection and authorize international health work
    4. To finance the development of vaccines
    5. None of the above
23. How is WHO constrained?
    1. By contributions made by member states
    2. By the donor-driven nature of its priorities
    3. By its intergovernmental nature
    4. By its lack of any source of authority apart from the cooperation and commitment of member states
    5. All of the above
24. Comprehensive primary health care (CPHC) a strategy for ________________ endorsed at the Alma-Ata Conference, 1978.
    1. assessing the social determinants of health
    2. securing international authority for WHO
    3. achieving universal health care for developed countries, particularly those in the European Union
    4. integrating prevention and treatment at the core of the goal of achieving “Health for All in the Year 2000”
    5. None of the above
25. What does DAH stand for?
    1. 25.4% of the health spending in low-income countries
    2. 1% of total global spending on health
    3. Development assistance for health
    4. Economic development for health
    5. Development assistance for health and wealth
26. How did COVID-19 interact with socioeconomic inequality?
    1. It made informal and day-to-day work more dangerous
    2. People with underlying health conditions were at greater risk
    3. In some places it was impossible to social distance
    4. Pre-existing conditions are not distributed equally throughout the world, and therefore certain places and certain socioeconomic groups were more adversely affected
    5. All of the above
27. How was the Ebola outbreak in 2018 better controlled than the outbreak in 2014?
    1. The availability of effective vaccines
    2. WHO was quicker to declare a public health emergency
    3. The outbreak happened in a politically stable area of the Democratic Republic of Congo
    4. Both A and B
    5. All of the above
28. COVID-19 death toll projections for 2021 were ________________.
    1. dependent on whether protective measures were more widely adopted or relaxed
    2. overestimated based on vaccine rollout plans
    3. underestimated based on a lack of knowledge about new variants
    4. All of the above
    5. None of the above
29. How has COVID-19 death toll projections underestimated the overall death toll that should be anticipated?
    1. They do not include deaths related to reduced access to treatment or prevention for other conditions among people not infected with the virus.
    2. They do not include health consequences from the economic depression that followed lockdowns of major segments of economies and societies.
    3. They were underestimated due to political pressure to minimize the severity of COVID-19
    4. Both A and B
    5. All of the above
30. Comprehensive primary health care (CPHC) failed ___________.
    1. because of criticism from governments
    2. because of criticism from medical communities
    3. because it depended on donors
    4. because of its small budget
    5. None of the above

True or False Questions

In sub-Saharan Africa, a person’s risk of dying from complications of pregnancy or childbirth is 1 in 36, while in Canada it is 1 in 8800.

Health care has more influence on an individual’s health than social determinants of health.

Social determinants of health are conditions under which people live and work that affect their opportunities to lead healthy lives.

The social or socio-economic gradient demonstrates within-country health discrepancies.

As of 2017, 2.3 billion people lack access to basic sanitation.

The “double burden of disease” refers to women who are suffering from a disease while continuing to care for their families.

Health improvements have been shown to follow rapidly and automatically from economic growth.

England’s Industrial Revolution decreased the life expectancy of some of the population.

According to Simon Szreter, the British Industrial Revolution had an immediately positive impact on the health of British citizens.

Contemporary trade and investment agreements limit government’s policy space.

The Declaration on the TRIPS Agreement and Public Health can allow health concerns to trump intellectual property protections.

The 10/90 Gap refers to the 10 per cent of pharmaceutical drugs that make it through to the market.

There is a strong correlation between foreign investment in LMICs and exposure to unhealthy food.

The globalization of food production and processing supports the argument that “globalization is good for your health.”

The use of the term “governance” in “global health governance” reflects the lack of supranational authority.

The Alma-Ata vision is concerned with promoting comprehensive primary healthcare.

Development assistance for health (DAH) has roughly quintupled between 1990 and 2018, indicating that health is now firmly established as an element of the foreign policy agenda of high-income countries.

Worldwide, governments spend more on health research compared to the amount that private, for-profit firms spend.

The Bill and Melinda Gates Foundation annually spends more money on health initiatives compared to the amount that the World Health Organization spends.

Donations to health programs outside the donor’s state tend to be motivated more by risk than by altruism.

While the WHO was unprepared for the 2014 Ebola crisis, the frontline states were well prepared.

The vision articulated at Alma-Ata included not only comprehensive access to health care but also many elements that would now be described in terms of social determinants of health.

WHO has overshadowed the richer World Bank and International Monetary Fund (IMF) as a decisive player in development policy in relation to health.

The World Bank’s importance as a player in the development of health policies derives both from its role as a channel of development finance and from its formidable research budget for gathering and analyzing data.

The strongest indication that health has NOT been firmly established as an element of the foreign policy agenda of countries is the increasing value of development assistance for health (dah).

NGOs are the dominant sources of DAH.

Middle-income countries like the BRICS (Brazil, Russia, India, China, and South Africa) are not significant sources of development assistance, though not necessarily for health.

National governments disburse funds for, among other programs, the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria.

Concerns about the spread of communicable diseases such as influenza and SARS motivate donors to allocate resources to improving health outside their borders.

The success in translating the political salience of health security into meaningful domestic policies has been exemplified by the covid-19 pandemic of 2020.

The covid-19 pandemic of 2020 has shown a disjuncture between what governments say about global health, internationally and for domestic consumption, and what they are actually competent or willing to do about mobilizing in response to threats.

Short Answer Questions

1. What is a social determinant of health? Provide at least two examples.
2. What is the estimated cost of providing a bare minimum of essential health services for all the residents of a low-income country? How much are low-income countries actually spending on healthcare? How does this compare to high-income countries’ spending?
3. What evidence is there to judge the glass of health and development as either half empty or half full?
4. What is the double burden of disease in low- and middle-income countries?
5. What does Simon Szreter argue about the relationship between economic growth and human health?
6. What is the 10/90 gap and what explains it?
7. Why are socio-economic gradients important to understanding development and health?
8. How do contemporary trade treaties differ from the past? What are the implications for health and development policy?
9. Discuss the effects of the Agreement on Trade Related Aspects of Intellectual Property Rights.
10. What is one of the strongest indications that health is now firmly established as an element of the foreign policy agenda of high-income countries?
11. What are the sources of development assistance for health (DAH) and how is it distributed?
12. Why did the IMF limit public expenditures on health and education?
13. What is the Global Fund and what are the concerns about it?
14. How has the Bill and Melinda Gates Foundation been criticized?
15. What is the Health 8?
16. What motivates donors to allocate resources to improving health outside their borders?
17. Why is the 2014 Ebola crisis an interesting case for examining donor motivations?
18. What are the oft unspoken structural elements of the 2014 Ebola Crisis?
19. Explain the shift toward universal health coverage (UHC) as a priority for development and health policy. What are the concerns about UHC?
20. What is the inconvenience of presenting health data solely in national averages?
21. What has research that deals with the relation between globalization and health show?
22. What are two reasons that COVID-19 death toll estimations are understatements of the overall death toll that should be anticipated?

Essay Questions

1. Discuss the claim that “globalization is good for your health.”
2. What is the WHO? How does it operate? What is its significance in health and development?
3. There seems to be a shift towards universal health coverage as a priority for development and health policy. Discuss this statement.
4. Describe the evolution of global health governance in the twenty-first century.
5. Explain the impact of development assistance for health (DAH).