🧭 SDOH in Action: What’s Driving Health?
A city reports that adults in one neighborhood have much higher rates of asthma than adults in other parts of the city. The neighborhood is located near major highways and industrial facilities.
Which social determinant of health is MOST directly shaping asthma risk here?
A. Individual health behaviors
B. Access to healthcare
C. Neighborhood conditions
D. Educational attainment
C. Neighborhood conditions
Question:
A report shows that rates of Type 2 diabetes are higher among adults living in one ZIP code compared to adults living in another ZIP code in the same city.
From a CHS perspective, what is the first analytic question you should ask?
A. What individual behaviors explain diabetes in this ZIP code?
B. Is this difference patterned by social conditions?
C. What intervention would reduce diabetes rates?
D. Is diabetes genetic in this population?
B. Is this difference patterned by social conditions?
Question:
Residents of a low-income neighborhood experience higher rates of hypertension. The primary social determinant shaping this pattern is economic insecurity.
Which of the following is the most plausible key influencing factor linking economic insecurity to hypertension?
A. Genetic predisposition
B. Chronic stress exposure
C. Individual motivation
D. Health literacy
B. Chronic stress exposure
Question:
A pathway links economic insecurity → chronic stress exposure → hypertension.
Which theory from class is MOST directly useful for explaining this pathway?
A. Health Belief Model
B. Life Course Theory
C. Stress Process Model
D. Diffusion of Innovations
C. Stress Process Model
Question:
A pathway links housing instability → chronic stress → poor mental health.
Which intervention point MOST directly targets the social determinant in this pathway?
A. Stress management workshops
B. Individual therapy
C. Affordable housing policy
D. Mindfulness apps
C. Affordable housing policy
A student writes:
“The main social determinant of health affecting this community is race.”
From a CHS perspective, what is the main problem with this statement?
A. Race is not a social determinant of health
B. Race should be replaced with socioeconomic status
C. Race must be specified in terms of how it operates
D. Race only matters at the individual level
C. Race must be specified in terms of how it operates
Question:
Two groups have different rates of a health outcome. Which additional piece of information would MOST strongly suggest this represents a health disparity rather than a simple difference?
A. The outcome affects many people
B. The difference persists across time and contexts
C. The difference is linked to social disadvantage
D. The outcome is costly to treat
C. The difference is linked to social disadvantage
Question:
A researcher identifies housing discrimination as a key social determinant shaping poor mental health outcomes.
Which key influencing factor best completes the pathway?
A. Poor decision-making
B. Lack of resilience
C. Chronic exposure to stress and threat
D. Biological vulnerability
C. Chronic exposure to stress and threat
Question:
Why is theory important when explaining a pathway linking a social determinant of health to a health outcome?
A. Theory replaces the need for evidence
B. Theory helps explain how and why the pathway operates
C. Theory identifies the correct intervention
D. Theory makes pathways more complex
B. Theory helps explain how and why the pathway operates
Question:
A pathway highlights neighborhood disinvestment → limited food access → poor diet quality.
Which action BEST aligns with this pathway?
A. Nutrition education classes
B. Food delivery apps
C. Zoning and incentives for grocery stores
D. Individual counseling on healthy eating
C. Zoning and incentives for grocery stores
Question:
In a county health report, low-income older adults experience higher rates of untreated chronic pain than higher-income older adults living in the same area.
Which indicator of socioeconomic position is most directly shaping this inequity?
A. Educational attainment
B. Income and wealth
C. Employment sector
D. Social support
B. Income and wealth
Question:
Which of the following problem statements is MOST aligned with CHS principles?
A. “Obesity is a growing problem in the United States.”
B. “Many adults struggle to maintain a healthy weight.”
C. “Obesity rates are higher among low-income adults in South Los Angeles.”
D. “Poor diet causes obesity.”
C. “Obesity rates are higher among low-income adults in South Los Angeles.”
Question:
Undocumented immigrants are less likely to access preventive healthcare services. The social determinant shaping this pattern is immigration policy and legal status.
Which key influencing factor most plausibly explains this relationship?
A. Low health knowledge
B. Fear of surveillance and deportation
C. Aging-related health decline
D. Cultural preferences
B. Fear of surveillance and deportation
Question:
A pathway links neighborhood disinvestment → reduced access to safe spaces → lower physical activity.
Which theory is MOST appropriate for explaining this pathway?
A. Social Cognitive Theory
B. Health Belief Model
C. Socioecological Model
D. Rational Choice Theory
C. Socioecological Model
Question:
Using a socioecological perspective, which intervention approach is MOST appropriate?
A. Focus only on individual knowledge
B. Target multiple levels shaping health outcomes
C. Prioritize clinical treatment
D. Emphasize personal responsibility
B. Target multiple levels shaping health outcomes
Question:
You identify structural racism in housing as a key social determinant shaping hypertension among Black adults.
Which factor is the most plausible way this determinant influences hypertension risk?
A. Genetic predisposition
B. Individual motivation
C. Chronic stress exposure
D. Health literacy
C. Chronic stress exposure
Question:
Why is it important, from a CHS perspective, to clearly define the population affected by a health issue?
A. To ensure the sample size is large enough
B. To identify which theories apply
C. To understand how inequities are produced and maintained
D. To determine the correct clinical treatment
C. To understand how inequities are produced and maintained
Question:
A student proposes the following pathway:
Neighborhood disinvestment → lack of access → poor health
From a CHS perspective, what is the main limitation of this pathway?
A. Neighborhoods do not affect health
B. “Lack of access” is too vague to explain how health is shaped
C. Access only matters for healthcare
D. Poor health is not an outcome
B. “Lack of access” is too vague to explain how health is shaped
Question:
A student explains a pathway using only individual motivation and personal responsibility.
From a CHS perspective, what is the main limitation of this theoretical framing?
A. Motivation is not related to health
B. It ignores how social and structural conditions shape choices
C. It cannot be tested empirically
D. It applies only to certain populations
B. It ignores how social and structural conditions shape choices
Question:
Which mistake most often weakens intervention proposals in community health?
A. Using theory
B. Targeting only one population
C. Ignoring the pathway that explains the health issue
D. Focusing on equity
C. Ignoring the pathway that explains the health issue
Question:
A policymaker asks why a public health team is prioritizing housing instability instead of individual diet choices when addressing diabetes disparities.
Which explanation best reflects a CHS approach?
A. Diet is unrelated to diabetes
B. Housing instability shapes stress, food access, and healthcare use
C. Individual behavior change programs never work
D. Structural factors are easier to change
B. Housing instability shapes stress, food access, and healthcare use
Question:
A brief describes a health issue but includes extensive detail on biology, genetics, and individual behaviors, with little mention of social context.
From a CHS standpoint, what is the main limitation of this framing?
A. It ignores treatment options
B. It overlooks how social conditions shape health patterns
C. It uses too much technical language
D. It focuses too much on outcomes
B. It overlooks how social conditions shape health patterns
Question:
Which pathway is MOST aligned with CHS principles?
A. Race → genetics → hypertension
B. Poverty → unhealthy choices → diabetes
C. Structural racism → chronic stress exposure → hypertension
D. Education → intelligence → health
C. Structural racism → chronic stress exposure → hypertension
Question:
Which statement BEST reflects how theory should be used in CHS pathway explanations?
A. Theory identifies the best intervention strategy
B. Theory explains relationships and highlights levels for action
C. Theory replaces the need for pathway models
D. Theory applies only to individual behavior
B. Theory explains relationships and highlights levels for action
Question:
A student identifies economic insecurity → stress → hypertension and proposes an intervention.
Which proposal BEST reflects strong CHS reasoning?
A. Encourage individuals to exercise more
B. Provide stress management apps
C. Improve labor protections and wage stability
D. Increase blood pressure screenings
C. Improve labor protections and wage stability