For citation purposes: Johns TS, Crews DC. Racial and socioeconomic disparities in end-stage renal disease in the United States. OA Nephrology 2013 Oct 17;1(2):18.

Review

 
Epidemiology

Racial and socioeconomic disparities in end-stage renal disease in the United States

TS Johns, DC Crews
 

Authors affiliations

(1) Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA

(2) Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA

*Corresponding author Email: dcrews1@jhmi.edu

Abstract

Introduction

African Americans are disproportion ately burdened by advanced chronic kidney disease and end-stage renal disease. Low socioeconomic status has been shown to be associated with an increased risk of end-stage renal disease and mortality. Low socioeconomic status may affect end-stage renal disease risk and outcomes through social and psychosocial factors, which in turn manifest as unhealthy choices and encumbrance to access health care or health information. Individuals of low socioeconomic status may also have negative health consequences from factors related to the physical environment such as overexposure to toxins or pollutants. Race and socioeconomic status are highly correlated in the United States, and certain ethnic minority groups, namely African Americans, Hispanics and Native Americans, are more likely to experience poverty and may do so for their entire lifespan, thus leading many to surmise that socioeconomic status -related factors might explain the disparities in end-stage renal disease incidence and outcomes observed in African Americans. However, low socioeconomic status appears to have a stronger association with end-stage renal disease risk among African Americans than among whites intimating that socioeconomic influences may be different or cumulative among African Americans. This review discusses the role of socioeconomic status in explaining racial disparities in end-stage renal disease incidence and outcomes and illuminates gaps in our current knowledge and potential areas of future research.

Conclusion

The interplay between race and socioeconomic status in end-stage renal disease risk and outcomes is complex and not well understood. Socioeconomic factors, both community and individual level, are likely to contribute to racial disparities in end-stage renal disease risk through many different mechanisms.

Licensee OA Publishing London 2013. Creative Commons Attribution License (CC-BY)
Keywords