Social Determinants of Health: Going Beyond the Basics to Explore Racial Disparities in Kidney Transplantation

2019 ◽  
Vol 104 (7) ◽  
pp. 1324-1325
Author(s):  
Rhiannon D. Reed ◽  
Jayme E. Locke
Keyword(s):  
Kidney Transplantation ◽  
Racial Disparities ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health

scholarly journals Impact of Social Determinants of Health on Chronic Kidney Disease: A Review of Disparities in Renal Transplantation

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Conner Lombardi ◽  
Logan Glosser ◽  
Hanna Knauss ◽  
Teanya Norwood ◽  
Julia Berry ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Impact ◽  
Community Context ◽  
Determinants Of Health ◽  
Economic Stability ◽  
The Social

Background: Striking disparity exists in the incidence and treatment of chronic kidney disease (CKD) secondary to individual social determinants of health.  Additionally, the uninsured, minority racial-ethnic groups, and Medicaid enrollees receive less nephrology care prior to being diagnosed with end-stage renal disease (ESRD). The most effective treatment for the management of kidney failure is kidney transplantation. This review addresses how social determinants of health impact the workup for patients with ESRD, with emphasis on the kidney transplant process.   Methods: A search was conducted via multiple online databases (MedLine, PubMed, etc.) for articles that addressed the interplay between CKD, ESRD and kidney transplantation with the social determinants of health.   Findings: The impact of the social determinants of health on CKD, ESRD, and the kidney transplantation process can be qualitatively and quantitatively measured using the five categories of education, health care and access, economic stability, neighborhood and built environment, and social and community context.   Conclusion: Social determinants of health impact outcomes in CKD, ESRD, and kidney transplantation. Public and private initiatives aimed at reducing social disparities among patients with kidney disease must include emphasis on education, health care and access, economic stability, neighborhood and built environment, and social and community context. This initiative is necessary to prevent progression to ESRD and to ensure quality care in the kidney transplantation process.

scholarly journals Social Determinants of Health and Disparities in Linkage to Care Among Newly Diagnosed HIV Cases – South Carolina, 2009–2011

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S419-S420 ◽  
Author(s):  
Harmeet Gill ◽  
Oluwole Babatunde ◽  
Sharon Weissman
Keyword(s):  
South Carolina ◽  
Racial Disparities ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Census Tract ◽  
Linkage To Care ◽  
Male Gender ◽  
Determinants Of Health ◽  
Newly Diagnosed ◽  
Hiv Diagnosis

Abstract Background Key to improved HIV outcomes is early diagnosis, linkage to care (LTC), retention in care (RIC) and viral load (VL) suppression. As treatment for HIV has become more effective, the gap in racial disparities has widened for LTC, RIC and VL. Social determinants of health (SDH) are conditions such as poverty level, income, education, employment that are responsible for most health inequities. SDH are drivers of disparities in HIV prevalence. The objective of this study is to evaluate the impact of SDH on racial disparities on time to LTC for newly diagnosed HIV infected individuals in South Carolina (SC). Methods Data was obtained from the SC enhanced HIV/AIDS Reporting System. Analysis includes individuals diagnosed with HIV in SC from 2009–2011. LTC was calculated as the time from HIV diagnosis to first CD4 or VL test. Early LTC was defined as within 30 days. Late LTC was >30 to 365 days. Individuals not LTC by 365 days were considered to have never been linked to care (NLTC). Census tract data was used to determine SHD (poverty, education, income, and unemployment) based on residence at the time of HIV diagnosis. Descriptive analysis was performed on data from newly infected individuals. Factors potentially associated with late LTC and NLTC including patient demographics, behavioral risk, residence at diagnosis and SDH were investigated. Results From 2009–2011, 2151 individuals were newly diagnosed with HIV. Of these 1636 (76.1%) were LTC early, 285 (13.2%) were LTC late and 230 (10.7%) were NLTC. NLTC was associated with male gender, lower initial CD4 count, and earlier stage of HIV at time of diagnoses (P <0.01). In multivariable analysis early HIV stage at HIV diagnosis (aOR: 1.82; 95% CI 1.3, 2.5) and living in census tracts with lower income (aOR 0.65; 95% CI 0.44, 0.97) are associated with late LTC. Male gender (aOR 2.66; 95% CI 1.49, 4.76) unknown HIV risk group (aOR 2.03; 95% CI 1.11, 2.74) and early HIV stage at diagnosis (aOR 4.59; 95% CI 2.33, 9.04) are associated with NLTC. Conclusion In SC, almost ¼ of newly diagnosed HIV infected individuals from 2009–2011 were LTC late or NLTC. SDH were not associated with late LTC or NLTC. Living in a low income census tract was associated with a lower risk for late LTC, possible because of access to Ryan White Services. Male gender and earlier HIV stage were factors with greatest association with late LTC and NLTC. Disclosures All authors: No reported disclosures.

Addressing the Social Determinants of Health

2019 ◽  
Vol 101 (4) ◽  
pp. 357-395 ◽  
Author(s):  
Saty Satya-Murti ◽  
Jennifer Gutierrez
Keyword(s):  
Twentieth Century ◽  
Los Angeles ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Activism ◽  
Determinants Of Health ◽  
Medical Attention ◽  
Community Center ◽  
Early Twentieth Century ◽  
The Social

The Los Angeles Plaza Community Center (PCC), an early twentieth-century Los Angeles community center and clinic, published El Mexicano, a quarterly newsletter, from 1913 to 1925. The newsletter’s reports reveal how the PCC combined walk-in medical visits with broader efforts to address the overall wellness of its attendees. Available records, some with occasional clinical details, reveal the general spectrum of illnesses treated over a twelve-year span. Placed in today’s context, the medical care given at this center was simple and minimal. The social support it provided, however, was multifaceted. The center’s caring extended beyond providing medical attention to helping with education, nutrition, employment, transportation, and moral support. Thus, the social determinants of health (SDH), a prominent concern of present-day public health, was a concept already realized and practiced by these early twentieth-century Los Angeles Plaza community leaders. Such practices, although not yet nominally identified as SDH, had their beginnings in the late nineteenth- and early twentieth-century social activism movement aiming to mitigate the social ills and inequities of emerging industrial nations. The PCC was one of the pioneers in this effort. Its concerns and successes in this area were sophisticated enough to be comparable to our current intentions and aspirations.

Sign in / Sign up

Export Citation Format

Share Document