Social Determinants of Health Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Social Determinants of Health. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Social Determinants of Health Indian Medical PG Question 1: All are provisions of WHO mental health Gap Action Programme (mhGAP), except:
- A. Communication regarding care
- B. Human rights
- C. Screening family members (Correct Answer)
- D. Social support
Social Determinants of Health Explanation: ***Screening family members***
- The **WHO mhGAP** primarily focuses on scaling up care for **priority mental, neurological, and substance use disorders** in low- and middle-income countries. It does not explicitly include the provision of routine screening of family members of affected individuals.
- While family support is crucial, direct screening of asymptomatic family members for psychiatric disorders is not a core component of the program's defined interventions for service delivery.
*Communication regarding care*
- **Effective communication** is a fundamental aspect of the **WHO mhGAP** to ensure patients and their families understand their condition and treatment plan.
- It emphasizes **patient-centered care** and informed decision-making, which rely heavily on clear and empathetic communication from healthcare providers.
*Human rights*
- **Human rights** are a foundational principle of the **WHO mhGAP**, ensuring that individuals with mental disorders receive care without discrimination and with respect for their dignity and autonomy.
- The program advocates for policies and practices that protect the rights of people with mental health conditions. [1]
*Social support*
- **Social support** is a crucial component promoted by the **WHO mhGAP**, recognizing its role in recovery and well-being for individuals with mental health conditions.
- The program encourages interventions that strengthen social ties and community integration to reduce isolation and improve outcomes.
Social Determinants of Health Indian Medical PG Question 2: The Janani Suraksha Yojana (JSY) is a safe motherhood intervention primarily associated with which of the following programs?
- A. Reproductive and Child Health (RCH) (Correct Answer)
- B. Integrated Management of Childhood Illness (IMCI)
- C. National Rural Health Mission (NRHM)
- D. Integrated Child Development Services (ICDS)
Social Determinants of Health Explanation: ***Reproductive and Child Health (RCH)***
- The Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Rural Health Mission (NRHM).
- Its primary objective is to reduce **maternal and infant mortality** by promoting institutional delivery and improving access to RCH services.
*Integrated Management of Childhood Illness (IMCI)*
- IMCI is a strategy focused on improving the health and well-being of children under five, especially in managing common childhood illnesses.
- While JSY aims to reduce infant mortality, IMCI is a broader program addressing a range of **childhood diseases**, not just those related to birth.
*National Rural Health Mission (NRHM)*
- NRHM is a large-scale program launched to provide accessible, affordable, and accountable healthcare in rural areas.
- **JSY is an important component** of NRHM, specifically focusing on safe motherhood, but NRHM itself has a much broader scope.
*Integrated Child Development Services (ICDS)*
- ICDS is a comprehensive program designed to improve the nutritional and health status of children aged 0-6 years and pregnant/nursing mothers.
- While it addresses maternal and child health, its primary focus is on **nutrition, health, and early childhood education**, rather than solely promoting institutional deliveries and reducing maternal mortality as JSY does.
Social Determinants of Health Indian Medical PG Question 3: All are true regarding 'Positive health' in today's world except:-
- A. Involves adaptive behavioral changes for future challenges
- B. Body and mind at peace
- C. Influenced by social, economic and cultural factors
- D. Positive health is considered an illusion in changing environments (Correct Answer)
Social Determinants of Health Explanation: ***Positive health is considered an illusion in changing environments***
- This statement is incorrect because the concept of **positive health** emphasizes **resilience** and adaptability, suggesting that individuals can achieve and maintain well-being despite changing environments.
- Far from being an illusion, positive health frameworks aim to help individuals thrive by developing strategies to **cope with challenges** and changes.
*Involves adaptive behavioral changes for future challenges*
- **Positive health** encourages individuals to **proactively adapt** their behaviors and attitudes to better prepare for and manage future difficulties.
- This concept aligns with building **resilience**, promoting well-being, and fostering personal growth in the face of new challenges.
*Body and mind at peace*
- A key aspect of **positive health** is achieving a state of **harmony** and balance between one's physical and mental well-being.
- This involves practices and mindsets that promote a sense of **calmness**, contentment, and overall peace.
*Influenced by social, economic and cultural factors*
- **Positive health** is recognized as being multidimensional and deeply affected by various external elements, including **social support systems**, economic stability, and cultural norms.
- These factors can significantly impact an individual's ability to achieve and maintain optimal health and well-being.
Social Determinants of Health Indian Medical PG Question 4: The commonly used theory to predict individual's behaviour regarding preventive health care is:
- A. Salutogenic model
- B. Transtheoretical model
- C. Social cognitive theory
- D. Health belief model (Correct Answer)
Social Determinants of Health Explanation: ***Health belief model***
- This model is widely used for **predicting preventative health behaviors**, as it focuses on an individual's perceptions of threat and benefits.
- It considers factors like **perceived susceptibility, perceived severity, perceived benefits, perceived barriers**, cues to action, and self-efficacy in motivating health actions.
*Salutogenic model*
- The salutogenic model emphasizes factors that **promote health and well-being**, rather than focusing on disease or risk factors.
- It centers around an individual's **sense of coherence**, which is their capacity to comprehend, manage, and find meaning in life's challenges.
*Transtheoretical model*
- This model describes **stages of change** that individuals go through when modifying a health behavior, such as precontemplation, contemplation, preparation, action, and maintenance.
- While useful for understanding behavior change, it is more about the **process of change** rather than predicting initial engagement in preventative care.
*Social cognitive theory*
- Social cognitive theory emphasizes the role of **observational learning, social experiences, and self-efficacy** in the development of personality and health behaviors.
- While it explains how individuals learn and perform health actions, it is not as directly focused on the **cognitive factors influencing preventative care decisions** as the Health Belief Model.
Social Determinants of Health Indian Medical PG Question 5: In Ayushman Bharat under School Health Services, which of the following is not included?
- A. Health check-up/screening
- B. Albendazole provision
- C. Monthly Iron Folic Acid Supplementation
- D. Providing free spectacles (Correct Answer)
Social Determinants of Health Explanation: ***Providing free spectacles***
- Under Ayushman Bharat School Health Services and RBSK (Rashtriya Bal Swasthya Karyakram), while **vision screening** is universally implemented, the provision of **free spectacles** is not uniformly guaranteed across all states and depends on fund availability and state-level implementation.
- The primary focus remains on **screening and referral**, with spectacle provision being supplementary rather than a core mandated service compared to the other interventions listed.
- Unlike the other three services which are universally delivered, free spectacles provision shows **geographic and implementation variability**.
*Health check-up/screening*
- **Comprehensive health check-ups** and screenings are a mandatory core component of the Ayushman Bharat School Health Program implemented uniformly across all states.
- This includes screening for common conditions like **vision problems**, **hearing impairments**, **dental issues**, and growth monitoring.
*Albendazole provision*
- The administration of **Albendazole** for biannual deworming is a standard, universally implemented practice under the National Deworming Day initiative integrated with School Health Programs.
- This is part of a broader strategy to improve the **nutritional status** and overall health of school-going children.
*Monthly Iron Folic Acid Supplementation*
- **Iron Folic Acid (IFA) supplementation** through the Weekly Iron Folic Acid Supplementation (WIFS) program is a key mandated intervention to combat **anemia** among adolescents (10-19 years).
- This is universally implemented through School Health Services and directly contributes to improving **cognitive function** and physical health of students.
Social Determinants of Health Indian Medical PG Question 6: Most important component of level of living is
- A. Education
- B. Housing
- C. Health
- D. Occupation (Correct Answer)
Social Determinants of Health Explanation: ***Occupation***
- **Occupation** is the most important component of the level of living as it is the primary determinant of **income**, which forms the economic foundation of the level of living.
- In Community Medicine, "level of living" is an **objective economic indicator** primarily measured by income and consumption patterns, distinguishing it from the broader concept of "quality of life."
- A stable and remunerative occupation ensures regular income, which directly enables individuals to afford basic necessities (food, clothing, shelter) and access other essential resources like healthcare and education.
- Occupation also confers social status and determines the standard of living that an individual or family can maintain.
*Education*
- While **education** is crucial for human development and enhances future opportunities, it serves as a means to achieve better employment rather than being a direct component of the level of living itself.
- Education's impact on living standards is realized primarily through its influence on occupational opportunities and earning potential.
*Housing*
- **Housing** is an important indicator of living standards and reflects the level of living, but the quality and affordability of housing are dependent on income derived from occupation.
- It is more of an outcome of the level of living rather than its primary determinant.
*Health*
- **Health** is essential for well-being and productivity, but in the context of "level of living" as an economic measure, it is often a consequence of adequate income and access to resources (which stem from occupation) rather than the primary component.
- Good health enables productivity, but health status alone does not define the economic level of living without associated income security.
Social Determinants of Health Indian Medical PG Question 7: Provision of the Mental Health Act 2017, based on WHO guidelines, includes all, except:
- A. Social support
- B. Screening family members (Correct Answer)
- C. Human rights
- D. Communication regarding care and treatment
Social Determinants of Health Explanation: ***Screening family members***
- The Mental Health Act 2017 focuses on the **rights, treatment, and support of individuals with mental illness**, not routine screening of their family members.
- The Act does not contain provisions mandating **screening of asymptomatic family members**, though family history may be relevant for clinical assessment.
- This is **not a provision** outlined in the Act based on WHO guidelines.
*Human rights*
- The Act is explicitly grounded in the **protection and promotion of human rights** for persons with mental illness (Chapter I).
- Ensures care with **dignity, respect, and freedom from discrimination** as core principles.
- Aligns with WHO's mental health action plan and human rights framework.
*Communication regarding care and treatment*
- **Section 4** emphasizes the right to information and **informed consent** for all treatment decisions.
- Patients must receive clear communication about their **diagnosis, treatment options, and care plans**.
- Includes provisions for **advance directives** and involvement in treatment decisions.
*Social support*
- **Chapter V** addresses rehabilitation and community-based services, emphasizing the role of **social support systems**.
- Promotes **community integration** and access to social resources for recovery.
- Recognizes family and community support as essential for long-term mental health management.
Social Determinants of Health Indian Medical PG Question 8: Which of the following was NOT an actual goal of the WHO 'Health for All by 2000' strategy?
- A. All people will be healthy by 2000 A.D (Correct Answer)
- B. Equal health status for people and countries
- C. All will have socially and economically productive life
- D. All people have access to health care services
Social Determinants of Health Explanation: ***All people will be healthy by 2000 A.D***
- This statement represents an **absolute and unrealistic outcome** that was not a practical goal of the WHO's "Health for All by 2000" strategy.
- The strategy aimed for a **significant improvement in health status** and equity, not the complete eradication of all illness.
*Equal health status for people and countries*
- This was a core aspiration of the "Health for All by 2000" strategy, focusing on **reducing health disparities** between different populations and nations.
- The aim was to achieve a more **equitable distribution of health resources** and outcomes globally.
*All will have socially and economically productive life*
- This goal emphasized the importance of health as a prerequisite for **social and economic development**, allowing individuals to participate fully in society.
- It highlights the concept that health is not merely the absence of disease but a state that enables a **productive and fulfilling life**.
*All people are accessible to health care services*
- **Universal access** to essential health care services was a fundamental pillar of the "Health for All by 2000" strategy.
- This meant ensuring that **primary healthcare** was available and affordable to everyone, regardless of their location or socioeconomic status.
Social Determinants of Health Indian Medical PG Question 9: Negative symptoms of schizophrenia are all except:-
- A. Apathy
- B. Anhedonia
- C. Over activity (Correct Answer)
- D. Alogia
Social Determinants of Health Explanation: ***Over activity***
- **Overactivity** is a manifestation of disorganized or positive symptoms in schizophrenia, such as **agitation** or purposeless movements, rather than a deficiency.
- While it can occur in schizophrenia, it represents an excess or distortion of normal function, distinguishing it from **negative symptoms** which reflect a reduction or absence of typical behaviors.
*Apathy*
- **Apathy**, or avolition, is a core negative symptom characterized by a **lack of motivation** and an inability to initiate or persist in goal-directed activities.
- Patients with apathy often show diminished interest in daily activities and personal care.
*Anhedonia*
- **Anhedonia** is a negative symptom defined by the **inability to experience pleasure** from activities that are usually enjoyable.
- This can include a loss of interest in social interactions, hobbies, and other rewarding experiences.
*Alogia*
- **Alogia**, or poverty of speech, is a negative symptom characterized by a **reduction in the quantity and fluency of speech**.
- Individuals with alogia may provide brief, empty responses and exhibit long pauses during conversation.
Social Determinants of Health Indian Medical PG Question 10: Loss of an anatomical structure or a physiological function is called:
- A. Disability
- B. Impairment (Correct Answer)
- C. Handicap
- D. Paralysis
Social Determinants of Health Explanation: ### Explanation
The question refers to the **WHO classification of the consequences of disease**, which follows a specific linear sequence: **Disease → Impairment → Disability → Handicap.**
**1. Why Impairment is Correct:**
**Impairment** is defined as any loss or abnormality of psychological, physiological, or anatomical structure or function. It represents a disturbance at the **organ level**. In this case, the loss of an anatomical structure (e.g., loss of a limb) or a physiological function (e.g., loss of vision) fits the definition of impairment perfectly.
**2. Why Other Options are Incorrect:**
* **Disability:** This is any restriction or lack of ability to perform an activity in a manner considered normal for a human being. It represents a disturbance at the **personal level** (e.g., inability to walk due to the loss of a leg).
* **Handicap:** This is a disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents the fulfillment of a role that is normal for that individual. It represents a disturbance at the **societal level** (e.g., inability to gain employment due to the inability to walk).
* **Paralysis:** This is a specific clinical condition (loss of muscle function) which is an *example* of an impairment, but it does not define the broad concept of anatomical or physiological loss.
**High-Yield Clinical Pearls for NEET-PG:**
* **Sequence:** Disease (Etiology) → Impairment (Organ level) → Disability (Personal level) → Handicap (Social level).
* **ICIDH:** This framework is part of the International Classification of Impairments, Disabilities, and Handicaps.
* **Example for Memory:**
* *Accident* → **Disease**
* *Loss of foot* → **Impairment**
* *Cannot walk* → **Disability**
* *Unemployed* → **Handicap**
* **Rehabilitation** aims to reduce the transition from impairment to disability and from disability to handicap.
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