美国国家公共电台 NPR Your ZIP Code Might Be As Important To Health As Your Genetic Code

 

AUDIE CORNISH, HOST:

When a receptionist gives you a form to fill out in a doctor's office, the questions are usually about medical issues - family history of illness, allergies¹ or the last time you got vaccines². Some doctors are now asking more general questions about jobs and where patients live. It's as if your ZIP code is as important as your genetic³ code. Kristian Foden-Vencil of Oregon Public Broadcasting reports.

KRISTIAN FODEN-VENCIL, BYLINE⁴: Shannon McGrath was given a life situation form this spring when she turned up for her first OB-GYN appointment 36 weeks pregnant.

SHANNON MCGRATH: When I got pregnant, I was homeless. I didn't have a lot of structure. And so it was hard to make an appointment. I had struggles with child care for my other kids, transportation.

FODEN-VENCIL: The mother of four sits next to her new baby, Rayder. That's him snoring in the background. The form asked questions like, are you worried about your housing? Is it safe? Can you pay the rent? It asked about food, transportation and child care. On the strength of McGrath's answers, her doctor, who's part of Kaiser Permanente, assigned her a patient navigator.

MCGRATH: She automatically set up my next few appointments and then set up the rides for them because that was my No. 1 struggle. She assured me that the child care wouldn't be an issue and that it would be OK if they came. So I brought the kids, and everything was easy just like she said it would be.

FODEN-VENCIL: McGrath is on Oregon's version of Medicaid. Her navigator connected her with local nonprofits who helped her with rent and a phone. The hope is that making her life easier might keep her and her children healthier and lower Oregon's Medicaid costs. McGrath says her patient navigator was a bureaucratic⁵ ninja, slicing through all the paperwork. She says for a pregnant mother with three children and tenuous⁶ housing, it was just too daunting⁷.

Patient navigators have been around for a while. What's new is the life situation form and, more importantly, having that information coded into a patient's permanent electronic medical record. Sarah Lambert is McGrath's gynecologist. She really appreciates seeing a patient's housing situation, debt or even their history of domestic abuse in the file.

SARAH LAMBERT: I find it incredibly helpful because it can be very hard to find out. And 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.

FODEN-VENCIL: Nicole Friedman with Kaiser Permanente agrees, and she goes a step further. She hopes these changes push health care away from more high-priced treatments and toward providing the basics.

NICOLE FRIEDMAN: My personal belief is that putting more money into health care is a moral sin and that we need to take money out of health care (laughter) and put it into other social inputs⁸ like housing and food and transportation.

FODEN-VENCIL: Back with baby Rayder, I asked Shannon McGrath whether she was surprised her doctor's office helped her with things like rent and transportation.

MCGRATH: A hundred percent - I was skeptical⁹. I didn't want someone to see my situation and have it raise alarms.

FODEN-VENCIL: But she says she was pleased she opened up, as it made her more likely to seek help in the future.

MCGRATH: I'm able to look at life and not feel overwhelmed or burdened or like I've got the whole world on my shoulders.

FODEN-VENCIL: Of course the idea has raised concerns. Patients may worry about privacy. And providing transportation or even a home doesn't necessarily cure a person's ailment¹⁰. For NPR News, I'm Kristian Foden-Vencil in Portland.

(SOUNDBITE OF TEEBS' "WHY LIKE THIS?")

CORNISH: This story's part of a reporting partnership¹¹ with NPR, Oregon Public Broadcasting and Kaiser Health News.

(SOUNDBITE OF TEEBS' "WHY LIKE THIS?")

1 allergies   

n.[医]过敏症；[口]厌恶，反感；（对食物、花粉、虫咬等的）过敏症( allergy的名词复数 )；变态反应，变应性

参考例句：

• Food allergies can result in an enormous variety of different symptoms. 食物过敏会引发很多不同的症状。 来自辞典例句
• Let us, however, examine one of the most common allergies; hayfever. 现在让我们来看看最常见的变态反应的一种--枯草热。 来自辞典例句

2 vaccines   

疫苗，痘苗( vaccine的名词复数 )

参考例句：

• His team are at the forefront of scientific research into vaccines. 他的小组处于疫苗科研的最前沿。
• The vaccines were kept cool in refrigerators. 疫苗放在冰箱中冷藏。

3 genetic   

adj.遗传的，遗传学的

参考例句：

• It's very difficult to treat genetic diseases.遗传性疾病治疗起来很困难。
• Each daughter cell can receive a full complement of the genetic information.每个子细胞可以收到遗传信息的一个完全补偿物。

4 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

5 bureaucratic   

adj.官僚的，繁文缛节的

参考例句：

• The sweat of labour washed away his bureaucratic airs.劳动的汗水冲掉了他身上的官气。
• In this company you have to go through complex bureaucratic procedures just to get a new pencil.在这个公司里即使是领一支新铅笔，也必须通过繁琐的手续。

6 tenuous   

adj.细薄的，稀薄的，空洞的

参考例句：

• He has a rather tenuous grasp of reality.他对现实认识很肤浅。
• The air ten miles above the earth is very tenuous.距离地面十公里的空气十分稀薄。

7 daunting   

adj.使人畏缩的

参考例句：

• They were faced with the daunting task of restoring the house.他们面临着修复房子的艰巨任务。
• Starting a new job can be a daunting prospect.开始一项新工作有时会让人望而却步。

8 inputs   

n.输入( input的名词复数 )；投入；输入端；输入的数据v.把…输入电脑( input的第三人称单数 )

参考例句：

• Uncheck the inputs checked for optimization in the previous stage. 不测试那些已经测试过的优化了的以前步骤的inputs.（变量参数）。 来自互联网
• Just in case, save in a file the inputs obtained at the previous stage. 以防万一，保存以前步骤获得的inputs（变量参数值）到一个文件中去。 来自互联网

9 skeptical   

adj.怀疑的，多疑的

参考例句：

• Others here are more skeptical about the chances for justice being done.这里的其他人更为怀疑正义能否得到伸张。
• Her look was skeptical and resigned.她的表情是将信将疑而又无可奈何。

10 ailment   

n.疾病，小病

参考例句：

• I don't have even the slightest ailment.我什么毛病也没有。
• He got timely treatment for his ailment.他的病得到了及时治疗。

11 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。