Most people are used to filling out forms at doctors’ offices detailing the medical history of close family members as well as their own. This makes sense: We’re genetically predisposed to many health issues and conditions. Now some health organizations are including additional questions in the intake process — specifically, ones aimed at determining an individual’s socioeconomic status.
Questions about your safety at home, ability to pay bills and whether you have enough to eat can tell your doctor a lot about your health. In fact, your ZIP code may actually have more to do with your health than your genetics, and medical professionals are finally wising up to this factor when dealing with patients.
According to a 2017 study published in JAMA Internal Medicine, people who live in certain counties in the United States may live for as much as 20 years longer than those who live in others.
“[T]his study found that socioeconomic and race/ethnicity factors alone explained 60 percent of the variation in life expectancy,” said researchers. A recent NPR segment examined the subject firsthand, using the example of Shannon McGrath, a woman who walked into her first OB-GYN appointment at Kaiser Permanente in Portland, Oregon, when she was already 36 weeks pregnant. (Most pregnant women see their doctor during the first trimester, usually around the eight-week mark).
McGrath was asked to fill out a “life situation form” that asked questions about her rent, debts, child care situation and other social factors — and that included her ZIP code.
“When I got pregnant, I was homeless. I didn’t have a lot of structure. And so it was hard to make an appointment,” McGrath told NPR. “I had struggles with child care for my other kids, transportation, financial struggles.” As a result of her answers to the life situation form, Kaiser Permanente assigned a “patient navigator” to help Shannon during her pregnancy.
“She automatically set up my next few appointments and then set up the rides for them, because that was my number-one struggle,” she continued. The patient navigator also told McGrath to bring her kids along to her appointments instead of struggling to arrange child care and helped remove many of the bureaucratic paperwork obstacles.
In addition to aiding her on the medical front, the patient navigator also connected McGrath with local nonprofits that could help her with everything from rent to getting essential things for the baby. The goal of this assistance was to give McGrath the best chance of having a healthy pregnancy as well as to keep the hospital’s medical costs lower and have a positive effect on the health care system as a whole.
While “patient navigators” aren’t anything new, using the type of form that McGrath filled out about her socioeconomic status, and utilizing that information to connect patients like her with the help they need, is a more recent practice. It’s also beneficial for the doctors who treat patients who wouldn’t otherwise disclose such specific information as homelessness and inability to pay bills.
“Your ZIP code is a better predictor of your health than your genetic code,” Melody Goodman, an assistant professor at Washington University in St. Louis, told the crowd at a Harvard School of Public Health address about the link between segregation and poor health in 2014.
And doctors agree. “I find it incredibly helpful because it can be very hard to find out,” says Sarah Lambert, McGrath’s OB-GYN. “Having it coded right there — we have this problem list that jumps up — really can give you a much better understanding as to what the patient is going through.”
Bottom line: Helping individuals in less fortunate ZIP codes will likely benefit the health care industry as a whole, and even those at the very top will be better off.
What Do YOU Think?
Is your ZIP code as important as your genetic code when it comes to your health? Do you think asking individuals questions about their socioeconomic status will help the health care industry? What other things can be done to help improve the situation?