Here is research showing the importance of knowing where your patient lives and what resources they have.
Lang IA, Hubbard RE, Andrew MK, Llewellyn DJ, Melzer D, Rockwood K. Neighborhood Deprivation, Individual Socioeconomic Status, and Frailty in Older Adults. Journal of the American Geriatrics Society 2009; 57: 1776 – 1780.
OBJECTIVES: To assess how individual socioeconomic status and neighborhood deprivation affect frailty.
DESIGN: Nationally representative population-based study, the English Longitudinal Study of Aging (ELSA), analyzed cross-sectionally.
PARTICIPANTS: Four thousand eight hundred eighteen individuals aged 65 and older.
MEASUREMENTS: Outcome was a frailty index (FI), based on 58 potential deficits, with a theoretical range from 0 to 1; exposures were individual wealth and neighborhood deprivation (lack of local resources, financial and otherwise), based on a set of standard indicators.
RESULTS: The FI score varied independently according to wealth and neighborhood deprivation. The mean FI score for an individual in the highest 20% of wealth and least deprived 20% of neighborhoods was 0.09 (95% confidence interval (CI)=0.09–0.09) and for an individual in the lowest 20% of wealth and most deprived 20% of neighborhoods was 0.17 (95% CI=0.16–0.17).
CONCLUSION: Frailty in older adults is independently associated with individual and neighborhood socioeconomic factors. Older adults who are poor and live in deprived neighborhoods are most vulnerable. Policies and interventions intended to prevent or reduce frailty must take into account individual circumstances and the broader social settings in which individuals are located.
DIGITAL OBJECT IDENTIFIER (DOI) 10.1111/j.1532-5415.2009.02480.x