scholarly journals The cumulative impact of social determinants of health factors on mortality in adults with diabetes and chronic kidney disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mukoso N. Ozieh ◽  
Emma Garacci ◽  
Rebekah J. Walker ◽  
Anna Palatnik ◽  
Leonard E. Egede
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Health Outcomes ◽  
Food Insecurity ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Determinant ◽  
Determinants Of Health ◽  
Cumulative Impact ◽  
Health Factors

Abstract Background A growing body of evidence supports the potential role of social determinants of health on health outcomes. However, few studies have examined the cumulative effect of social determinants of health on health outcomes in adults with chronic kidney disease (CKD) with or without diabetes. This study examined the cumulative impact of social determinants of health on mortality in U.S. adults with CKD and diabetes. Methods We analyzed data from National Health and Nutrition Examination Surveys (2005–2014) for 1376 adults age 20 and older (representing 7,579,967 U.S. adults) with CKD and diabetes. The primary outcome was all-cause mortality. CKD was based on estimated glomerular filtration rate and albuminuria. Diabetes was based on self-report or Hemoglobin A1c of ≥6.5%. Social determinants of health measures included family income to poverty ratio level, depression based on PHQ-9 score and food insecurity based on Food Security Survey Module. A dichotomous social determinant measure (absence vs presence of ≥1 adverse social determinants) and a cumulative social determinant score ranging from 0 to 3 was constructed based on all three measures. Cox proportional models were used to estimate the association between social determinants of health factors and mortality while controlling for covariates. Results Cumulative and dichotomous social determinants of health score were significantly associated with mortality after adjusting for demographics, lifestyle variables, glycemic control and comorbidities (HR = 1.41, 95%CI 1.18–1.68 and HR = 1.41, 95%CI 1.08–1.84, respectively). When investigating social determinants of health variables separately, after adjusting for covariates, depression (HR = 1.52, 95%CI 1.10–1.83) was significantly and independently associated with mortality, however, poverty and food insecurity were not statistically significant. Conclusions Specific social determinants of health factors such as depression increase mortality in adults with chronic kidney disease and diabetes. Our findings suggest that interventions are needed to address adverse determinants of health in this population.

scholarly journals Epidemiology of chronic kidney disease in Peru and its relation to social determinants of health

2019 ◽  
Vol 12 (4) ◽  
pp. 264-271
Author(s):  
Noé Atamari-Anahui ◽  
Maycol Suker Ccorahua-Rios ◽  
Mirian Condori-Huaraka ◽  
Yerika Huamanvilca-Yepez ◽  
Elard Amaya ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Insurance Coverage ◽  
Secondary Analysis ◽  
Public Health Problem ◽  
Education Level ◽  
Determinants Of Health ◽  
Health Coverage

Abstract Background Chronic kidney disease (CKD) is a growing public health problem and an important cause of morbidity and mortality. Disparities in CKD may be related to social determinants and health inequalities in low- and middle-income countries. This study determined how social determinants of health influence trends in the prevalence and mortality of CKD in Peru. Methods This was an ecological study based on a secondary analysis of health care and death records obtained from the Ministry of Health of Peru for the period 2010–2016. The standardized prevalence and mortality rates of CKD were descriptively reported using geospatial exploratory analysis. We also determined the association with social determinants of health according to the domains suggested by Healthy People 2020. Results In the studied period, CKD prevalence increased by 300% and was associated with the health insurance coverage rate (β=5.9 [95% CI 0.82 to 10.92]), proportion of people with a secondary education level (β=11.4 [95% CI 1.94 to 20.93]), mean age (β=−10.7 [95% CI −19.33 to −2.12]), monetary poverty rate (β=−2.2 [95% CI −3.88 to −0.60]) and gross domestic product per capita (β=−63.2 [95% CI −117.81 to −8.52]). The standardized mortality decreased by 10% and was associated with mean age (β=−0.6 [95% CI −1.22 to −0.06]) and the proportion of people with a primary education level (β=−0.5 [95% CI −0.9 to −0.05]). Conclusions During the period 2010–2016, the prevalence of CKD increased and the mortality associated with CKD decreased. The observed changes were associated with some social determinants of health, such as increased health coverage and education. The health system of Peru must be prepared to take on the challenge.

scholarly journals Exploring the Intersection of Education and Indigenous Status from a Social Determinants of Health Perspective: Parent and Family Engagement in Secondary School in Nunavik

2016 ◽  
Vol 7 (4) ◽  
Author(s):  
Nicole Ives ◽  
Vandna Sinha
Keyword(s):  
Secondary School ◽  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Determinant ◽  
Determinants Of Health ◽  
Positive Health ◽  
School Students ◽  
Indigenous Status ◽  
Inuit Community

In Canada, Indigenous Peoples’ health and wellbeing is linked with the legacies of colonization. A social determinants of health model shifts focus from individual-level health contexts to broader socioeconomic, cultural, and environmental conditions associated with population health outcomes. Education is a key social determinant of health, closely tied to both positive health outcomes and socioeconomic status. In communities across Canada, educational success remains out of reach for disproportionately large numbers of Indigenous youth and adults. This qualitative study examined the intersection of two social determinants of health—Indigenous status and education—by exploring educational engagement in secondary school for Inuit parents and families, secondary school students, educators, and other Inuit community members in an Inuit community in Nunavik, northern Quebec.

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 Frameworks and inequalities in healthcare: some applications

2021 ◽  
pp. 115-120
Author(s):  
Pietro Renzi ◽  
Alberto Franci
Keyword(s):  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Inequalities ◽  
Economic Status ◽  
Determinants Of Health ◽  
Health Determinants ◽  
Quadrant Analysis ◽  
Inequality Measures ◽  
Health Objectives

Background Social determinants of health (SDOH) have increasingly entered health policy conversations as a growing body of researches, reveal the direct relationship between social determinants and health outcome. In fact, the recent literature is moving from the traditional model that focus on how health affects economic status, to a new view that economic status affects health. Objectives To investigate the principal conceptual frameworks for action on social determinants of health. Another aim is to contribute on the ongoing discourse on feasible measures which could be used to alert regions to inequalities in the distribution of health. Methodology, Italian data are used as a demonstration. Quadrant charts illustrate associations between how much regions spend on health and how effectively health system functions. The relevant inequality measures are used to rank health inequalities. Main results Frameworks have been presented to help communities, health professionals and others begin to better understand and address a variety of factors that affects health. Quadrant analysis technique shows the extent to which spending more on health, translates into better health outcomes, higher quality of care and improve access to care across the Italian regions, whilst also recognition the importance of major risk factors. Conclusions The social inequalities in health and what this means for how we understand and reduce them, as not to date been compressively examined empirically. There is an urgent need to expand our knowledge with comparable data on health determinants and more refined health outcomes. Furthermore, there is a need for feasible inequality measures in the health information systems. The measures used in this study, provide a step to inform and guide the uptake of equity-sensitive policies.

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