Crash Cart Emergency Medicine

In Your Patient’s Neighborhood

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Where you live is a significant social determinant of health that impacts health and emergency care. In this episode, Dr. Kim Bambach (Assistant Professor of EM) interviews Dr. Amogh Krishnagiri (PGY-3 Chief Resident) about how built spaces and the connections they create ultimately influence health. From transportation access and food availability to education, housing stability, and local resources, a patient’s built environment directly affects their ability to follow up, fill prescriptions, and heal.

Key Learning Points:

  1. A neighborhood is more than a built location
    • It reflects the social connections, infrastructure, and resources that shape health outcomes.
    • Social determinants of health impact emergency care
      • Transportation, food access, housing stability, income, and education all directly affect whether patients can follow through on ED discharge plans.
      • Consider what’s in your patient’s neighborhood
        • Not all neighborhoods offer equal access to pharmacies, clinics, grocery stores, or safe transit. Expecting identical follow-up success across different environments is unrealistic.
        • Transportation is often overlooked
          • If patients cannot physically get to appointments, pharmacies, or community resources, the plan fails.
          • Take the time to make a safe discharge
            • Safe discharge planning requires feasibility, not just medical accuracy. A brief conversation about barriers can prevent bounce backs and unnecessary admissions.
            • Connect to your community resources
              • Emergency physicians are uniquely positioned to connect patients to community resources.
              • Get to know the resources in your community and your ED social worker.

                • Bottom Line:
                Understanding your patient’s neighborhood — especially their access to transportation and community resources — is essential to creating discharge plans that are safe, realistic, and truly effective.

                Resources:

                1. Close.City
                2. Columbus Street Card
                3. Central Ohio Area Agency on Aging
                4. Columbus Metropolitan Library
                5. Ohio Domestic Violence Network
                6. Columbus Food Pantries
                  7. ...more
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                  Crash Cart Emergency MedicineBy The Ohio State University
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