High Quality Health Care Depends on Knowing a Community’s ‘Vital Signs’

FOR IMMEDIATE RELEASE: Thursday, June 2, 2016

Leslie Champlin
Senior Public Relations Strategist
(800) 274-2237, Ext. 5224

WASHINGTON, DC — Patients’ neighborhoods directly affect their health, and information about those neighborhoods should be a part of each patient’s electronic health record. That’s the call from Robert Graham Center policy analysts Lauren Hughes, MD, MPH, and Andrew Bazemore, MD, MPH.

Writing in “Community Vital Signs: Taking the pulse of the community while caring for patients(www.jabfm.org)” in the May-June issue of the Journal of the American Board of Family Medicine, Hughes and Bazemore say a neighborhood’s poverty rate, education level, availability of social services, even grocery store locations determine whether a patient has access to care or the amenities that make a healthy lifestyle possible. Physicians should have such information as readily available as their patients’ blood pressure, temperature and other physiological vital signs.

“While patients’ vital signs provide a glimpse into their physical wellness, we lack analogous information about the neighborhoods in which they live, learn, work, and play – patients’ community vital signs,” write Hughes and Bazemore. “Community vital signs could be independent social determinants of health, such as poverty level, education attained, or employment status, or they could be indices of these factors. Either way, community vitals convey contextual social deprivation and associated risks based on where patients live -- important information that could influence point-of-care decisions similar to physiologic vital signs.”

Incorporating such information into electronic health records is possible, they say. Community vital signs can be generated by already available population health data down to the zip code level, census tract or city block. That information can be linked to patient address data from EHRs.

“These linked data, once imported into EHRs, would help primary care practices understand the context in which their patients reside, increase awareness of resultant health risks, and tailor clinical interventions based on neighborhood and local public health factors,” Hughes and Bazemore write.

They point to Community Rx, a patient-centered community services initiative in which each patient’s electronic health record generates a customized map of local health and social resources that is individual tailored to the patient’s address and diagnosis.

“Instead of simply recommending that patients eat better and exercise more, primary care clinicians are able to help patients connect to local resources they can use on a regular basis in their daily lives,” they write. “…We have long known that place matters to personal and population health. Neighborhood-level social determinants of health have begun to shape local public health and policy interventions, but it is now time for primary care clinicians to harness the power of community vital signs to improve the health of our patients and our communities.”


About the Robert Graham Center

The Robert Graham Center for Policy Studies in Family Medicine and Primary Care works to improve individual and population health by enhancing the delivery of primary care. The Center staff generates and analyzes evidence that brings a family medicine and primary care perspective to health policy deliberations at local, state, and national levels.

Founded in 1999, the Robert Graham Center is an independent research unit affiliated with the American Academy of Family Physicians (AAFP). The information and opinions contained in research from the Center do not necessarily reflect the views or policy of the AAFP.