Addressing the Issue: Health Disparities and Social Determinants of Health Among Blacks/African Americans in Comparison to Non-Minorities with Chronic Kidney Disease

2021 ◽  
Vol 48 (5) ◽  
pp. 489
Author(s):  
Jami S. Brown
Keyword(s):  
Chronic Kidney Disease ◽  
Health Disparities ◽  
African Americans ◽  
Kidney Disease ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Issue Health

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 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 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.

Social determinants of health affecting treatment of pediatric brain tumors

2019 ◽  
Vol 24 (2) ◽  
pp. 159-165
Author(s):  
Jillian M. Berkman ◽  
Jonathan Dallas ◽  
Jaims Lim ◽  
Ritwik Bhatia ◽  
Amber Gaulden ◽  
...  
Keyword(s):  
African American ◽  
Health Disparities ◽  
Brain Tumors ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Cns Tumor ◽  
Initial Symptoms ◽  
Caucasian Patients

OBJECTIVELittle is understood about the role that health disparities play in the treatment and management of brain tumors in children. The purpose of this study was to determine if health disparities impact the timing of initial and follow-up care of patients, as well as overall survival.METHODSThe authors conducted a retrospective study of pediatric patients (< 18 years of age) previously diagnosed with, and initially treated for, a primary CNS tumor between 2005 and 2012 at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Primary outcomes included time from symptom presentation to initial neurosurgery consultation and percentage of missed follow-up visits for ancillary or core services (defined as no-show visits). Core services were defined as healthcare interactions directly involved with CNS tumor management, whereas ancillary services were appointments that might be related to overall care of the patient but not directly focused on treatment of the tumor. Statistical analysis included Pearson’s chi-square test, nonparametric univariable tests, and multivariable linear regression. Statistical significance was set a priori at p < 0.05.RESULTSThe analysis included 198 patients. The median time from symptom onset to initial presentation was 30.0 days. A mean of 7.45% of all core visits were missed. When comparing African American and Caucasian patients, there was no significant difference in age at diagnosis, timing of initial symptoms, or tumor grade. African American patients missed significantly more core visits than Caucasian patients (p = 0.007); this became even more significant when controlling for other factors in the multivariable analysis (p < 0.001). African American patients were more likely to have public insurance, while Caucasian patients were more likely to have private insurance (p = 0.025). When evaluating survival, no health disparities were identified.CONCLUSIONSNo significant health disparities were identified when evaluating the timing of presentation and survival. A racial disparity was noted when evaluating missed follow-up visits. Future work should focus on identifying reasons for differences and whether social determinants of health affect other aspects of treatment.

Health Disparities and the Social Determinants of Health: Ethical and Social Justice Issues

2019 ◽  
pp. 265-276
Author(s):  
Sridhar Venkatapuram
Keyword(s):  
Health Disparities ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Global Justice ◽  
Social Epidemiology ◽  
Social Groups ◽  
Determinants Of Health ◽  
Housing Conditions ◽  
Early Infant ◽  
The Social

The term health disparities (also called health inequalities) refers to the differences in health outcomes and related events across individuals and social groups. Social determinants of health, meanwhile, refers to certain types of causes of ill health in individuals, including lack of early infant care and stimulation, lack of safe and secure employment, poor housing conditions, discrimination, lack of self-respect, poor personal relationships, low community cohesion, and income inequality. These social determinants stand in contrast to others, such as individual biology, behaviors, and proximate exposures to harmful agents. This chapter presents some of the revolutionary findings of social epidemiology and the science of social determinants of health, and shows how health disparities and social determinants raise profound questions in public health ethics and social/global justice philosophy.

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