# Community Health Psychology

Psychology I · Society and Health · https://tryals.app/learn/psychology-i/community-health-psychology

## Health Beyond the Individual

**Community health psychology** widens the lens beyond the individual patient to the community and societal conditions shaping health at a population level.

**Social-ecological model**: Arranges health influences into nested levels from micro to macro:

| Ecological level | Example influence |
|---|---|
| **Individual** | Personal health knowledge and skills |
| **Interpersonal** | Family, peers, and social networks |
| **Community** | Organizations, norms, and institutions |
| **Societal** | Policies, economic conditions, culture |

$$\text{Individual} \to \text{Interpersonal} \to \text{Community} \to \text{Societal}$$

**Common pitfall**: Treating community health problems as simply the sum of individual bad choices. Environment actively shapes choice.

## Partnerships and Disparities

**Community-based participatory research (CBPR)** treats community members as genuine partners in research, not just subjects. It recognizes that residents hold crucial local knowledge.

**Empowerment**: Interventions aiming to build a community's own capacity to address health needs, rather than delivering predetermined external programs.

Applied to health disparities, this framework explains persistence: disparities are produced across **multiple nested levels simultaneously**. Interventions focused solely on individual behavior change, ignoring community and societal drivers, have limited impact.

## Practice questions

7 of this lesson's 13 practice questions, with answers. The full set is in the app.

### 1. Lowering **everyone's** blood pressure by 2 mmHg prevents more heart attacks than treating the highest-risk 5% intensively, although no individual gains much. Why does the small shift win?

A. Because 2 mmHg is a larger reduction than intensive treatment achieves
B. Because population measures are cheaper, which is the whole of the advantage
C. Because high-risk individuals are already receiving treatment, so the comparison is unfair
D. Because most cases come from the majority at modest risk

**Answer:** D. Because most cases come from the majority at modest risk

**Why:** Rose's prevention paradox: risk is concentrated but cases are not, because the unremarkable middle is so much larger. It explains salt reduction and speed limits, measures that offer each person almost nothing and prevent more harm than any clinic, and are resented for exactly that reason.

Page: https://tryals.app/practice/psychology-i/community-health-psychology/lowering-everyones-blood-pressure-by-2-mmhg-prevents-more-heart

### 2. The same individual 'choice' can look very different depending on whether it is made inside a supportive environment or a constrained, unsupportive one.

**Answer:** True

**Why:** True. Community and societal conditions actively shape the options available, so the same nominal 'choice' is far easier in a supportive environment than a constrained one. This is precisely why the social-ecological model rejects treating outcomes as pure individual choice.

Page: https://tryals.app/practice/psychology-i/community-health-psychology/the-same-individual-choice-can-look-very-different-depending-on

### 3. A city runs a three-year programme teaching residents of a low-income neighbourhood how to cook healthy meals. Tested knowledge of nutrition improves substantially. What people actually eat does not change. On the social-ecological model, what is the most likely explanation?

A. Diet is individual, so the null result is a measurement artefact.
B. The residents cannot have absorbed the teaching after all.
C. Knowledge has no bearing on behaviour at all.
D. The programme moved the individual level and nothing above it.

**Answer:** D. The programme moved the individual level and nothing above it.

**Why:** Nested levels means the outer ones set the terms the inner one works under. The programme did its job, the knowledge is there, and a cookery class cannot reach the shops, the prices or the bus routes. An intervention aimed only at the individual is betting those were never the binding constraint.

Page: https://tryals.app/practice/psychology-i/community-health-psychology/a-city-runs-a-three-year-programme-teaching-residents-of-a-low-income

### 4. In community-based participatory research, residents are partners in designing the study rather than subjects of it. Beyond fairness, why does that arrangement tend to change the findings themselves?

A. Because it lets the researchers work with a larger sample.
B. Because it commits them to the community's preferred answer.
C. Because participation makes residents answer more truthfully.
D. Because the people who live the problem know things researchers do not.

**Answer:** D. Because the people who live the problem know things researchers do not.

**Why:** The decisive move happens before any data exists: which questions get asked, what counts as an outcome, which causes make the list at all. A team that has never taken two buses to a clinic may not think to measure the bus route, and a study can only find a cause it thought to look for. That is why CBPR is a claim about validity, not only about ethics.

Page: https://tryals.app/practice/psychology-i/community-health-psychology/in-community-based-participatory-research-residents-are-partners-in

### 5. Programmes delivered by trained **community health workers who live locally** often outperform the same programme delivered by visiting professionals, with less clinical training. What is the local worker supplying?

A. Lower cost, which allows the programme to reach more people for the same budget
B. Access and credibility the outsider cannot manufacture
C. Greater clinical skill, acquired through familiarity with the same conditions repeatedly
D. Nothing measurable, the advantage disappears once education level is controlled for

**Answer:** B. Access and credibility the outsider cannot manufacture

**Why:** Expertise is not the binding constraint, reach is. A neighbour is trusted, knows which shop actually stocks what, and has not left when the funding ends. It is the community level doing work no amount of individual-level clinical skill substitutes for.

Page: https://tryals.app/practice/psychology-i/community-health-psychology/programmes-delivered-by-trained-community-health-workers-who-live

### 6. Sort each intervention by whether it works only at the individual level or addresses wider conditions.

**Answer:**

- Individual-level only: Distributing a healthy-eating leaflet, Offering a personal fitness tracking app
- Multi-level (addresses community/societal conditions): Opening a supermarket in a food desert, Changing local food-advertising policy, Supporting a community-led health programme

**Why:** Leaflets and personal apps act only on individual knowledge and skills; opening a supermarket, changing advertising policy, and supporting community-led programmes change the conditions people act within. Individual-only efforts tend to have limited, short-lived impact against opposing community and societal forces.

Page: https://tryals.app/practice/psychology-i/community-health-psychology/sort-each-intervention-by-whether-it-works-only-at-the-individual

### 7. Select every statement that is TRUE about community health psychology.

A. Health disparities are produced purely at the individual level.
B. CBPR treats community members as partners rather than subjects.
C. Individual-only interventions often struggle against community and societal forces.
D. Where a person lives can constrain a choice more tightly than what they know about it.
E. A single leaflet reliably overcomes food deserts and advertising pressure.

**Answer:** B. CBPR treats community members as partners rather than subjects.; C. Individual-only interventions often struggle against community and societal forces.; D. Where a person lives can constrain a choice more tightly than what they know about it.

**Why:** Nested levels, the limits of individual-only interventions, and CBPR's partnership model are all true. Disparities are produced across multiple nested levels (not purely individually), and a leaflet cannot overcome food deserts and advertising - so those two are false.

Page: https://tryals.app/practice/psychology-i/community-health-psychology/select-every-statement-that-is-true-about-community-health-psychology