Patient health and wellness: What’s zip code got to do with it?

3. Reliable transportation

Ask your patient if they have access to reliable transportation. If they do not this will likely prevent them from making healthy lifestyle decisions. Savoy et al. (2019, p. 3) lists the research findings that a lack of transportation causes such as preventing individuals from accessing goods and services to include healthy foods, medication, education, employment, and initial or follow up health care visits.

4. Utilities

Has the utility company has threatened to turn off services in the last year? Find out if they currently have running water, heat and/or AC, and electricity. Utility shut-offs lead to dangerous living environments, including unhygienic conditions, temperature extremes and injuries (Savoy et al., 2019).

5. Employment and financial situation

Is your patient employed? Steady source of income will better a client’s overall health by enabling clients to live in safer neighborhoods, afford access to better health care, provide education or childcare for their children, and buy nutritious food. (Savoy et al., 2019).

6. Access to reliable childcare

Is childcare an ongoing issue? Childcare not only affects the child but the adult as well. Access to adequate childcare and early childhood education are associated with improved cognitive and emotional development, academic achievement and reduces teen pregnancy and crime rates. Lack of consistent access to childcare impacts parents as they may forgo their own health needs and can prevent educational and employment opportunities for parents (Savoy et al., 2019).

7. Education

Ask your patient if they have a high school diploma or GED. Low education levels are correlated with lower income which are associated with higher incidence of smoking and hospitalizations and a shorter life expectancy. They are less likely to comply with medical care and/or take responsibility of their own health (Savoy et al., 2019).

8. Personal safety

Last, but certainly not least, is personal safety. Research shows that “exposure to violence, whether interpersonal or community violence, has lasting effects on an individual’s physical and emotional health. Utilize the screening tools to provide early intervention. Tools that incorporate the HITS (Hurt, Insult, Threaten, Scream) instrument is best, this tool has been recently modified, to “anyone, including family” instead of only “your partner.” This change broadens the scope beyond intimate partner violence” (Savoy et al., 2019 p. 4).

It’s necessary to understand these SDoH conditions to get the full picture of a client’s health and potential future risks. These questions should occur at admission, discharge, and as many times as necessary to get the answers needed to prevent a readmission, exacerbation, unintentional injury or death of a client.

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