Racial and Socioeconomic Disparities in CKD in the Context of Universal Health Care Provided by the Military Health System

Norton, Jenna M.; Grunwald, Lindsay; Banaag, Amanda; Olsen, Cara; Narva, Andrew S.; Marks, Eric S; Koehlmoos, Tracey Pérez

doi:10.1016/j.xkme.2021.08.015

Cited by 12 publications

(7 citation statements)

References 36 publications

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“…Norton et al (2021) investigated disparities in CKD within the context of the military healthcare system. The results of their cross-sectional study suggest that there is an increased incidence of CKD in older enlisted service members as compared to senior officers [ 33 ]. Because the military provides all its members with adequate insurance coverage through the TRICARE Health Plan, this disparity is unlikely to be caused by differences in insurance coverage.…”

Section: Reviewmentioning

confidence: 99%

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Social Determinants of Health Impacting Access to Renal Dialysis for Racial/Ethnic Minorities

Mercen,

Curran,

Belmar

et al. 2023

Cureus

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Although widespread, the burden of disease presented by chronic kidney disease (CKD) is not equally distributed among all demographics. Examining the social determinants of health (SDOH) that relate to barriers to renal dialysis care in CKD can help to prevent future disparities. There has not been a study addressing the social factors that create barriers to care for ethnic minority patients with CKD. The aim of this scoping review is to address the SDOH that affects access to renal dialysis for ethnic minority patients in the United States. This study was based on the protocol published by the Joanna Briggs Institute. A total of 349 studies were identified from PubMed, EBSCOhost, and Embase. Each article was screened against population, concept, and context criteria in order to be considered for inclusion. The population was determined to be adults of all genders from underrepresented minority populations. The selected concept was SDOH. The context of this study was the United States population. From the articles selected by the search criteria, neighborhood of residence, mental health care access, glomerular filtration rate (GFR) methodology, socioeconomic status (SES), language barriers, immigration status, and military rank were identified as SDOH affecting access to renal dialysis care. While this study identified four social determinants, more research is needed for the investigation of other possible SDOH contributing to disparities related to CKD and access to renal dialysis care.

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Section: Reviewmentioning

confidence: 99%

“…Because the military provides all its members with adequate insurance coverage through the TRICARE Health Plan, this disparity is unlikely to be caused by differences in insurance coverage. The authors conclude that the findings of their study may be attributable to social and cultural factors [ 33 ].…”

Section: Reviewmentioning

confidence: 99%

Social Determinants of Health Impacting Access to Renal Dialysis for Racial/Ethnic Minorities

Mercen,

Curran,

Belmar

et al. 2023

Cureus

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“…Social determinants of health that have been associated with depression and anxiety in CKD include sex, race or ethnicity, education, employment, marital status, and specific comorbidities (e.g., psychiatric illness, diabetes mellitus, hypertension, cardiovascular heart disease, and hypoalbuminemia). 34,37 Although there are knowledge gaps with respect to effective treatment options for depression and anxiety in ESKD, early identification and treatment of emotional symptoms is critical. Pharmacological treatment approaches are frequently used, but nonpharmacological approaches, including pragmatic and evidence-based psychological interventions should also considered.…”

Section: Depression and Anxietymentioning

confidence: 99%

Living Well With Kidney Disease and Effective Symptom Management: Consensus Conference Proceedings

Rhee

Edwards²,

Ahdoot

et al. 2022

Kidney International Reports

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“…5,6 The Living Donor Navigator program (LDN) is one such effort, with one study having found that people who chose to participate in the program were 7 times more likely to receive a living donor kidney transplant. 5 Patients with end-stage kidney disease across sex, race/ethnicity, age, socioeconomic status, and geographic boundaries are disproportionately disadvantaged, low-resourced, and lack adequate transportation compared to the general population 7–10 ; often, additive resources, such as advocacy training programs, perpetuate difficulties in program uptake and sustainability in such a vulnerable population. 11 Thus, innovative strategies designed to bring the living donor kidney transplantation educational programming to the participant, such as telehealth, are warranted.…”

Section: Introductionmentioning

confidence: 99%

Interpersonal Connections Are Important for Virtual Kidney Transplant Educational Program Development

Carter,

Qu,

Reed

et al. 2023

Prog Transpl

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Introduction: The Living Donor Navigator program is designed to mitigate disparities in living donor kidney transplantation, although geographic disparities in program participation were observed in the initial years of implementation. The purpose of this study was to understand participant perspectives regarding the use of a virtual option/alternative to expand program participation. Methods: Previous participants of the in-person navigator program were purposively sampled. Using the nominal group technique, a well-structured formative methodology to elicit participant perspectives, 2 meetings were conducted among transplant recipients and advocates (N = 13) to identify and prioritize responses to the question “What things would concern you about participating in a virtual and remote Living Donor Navigator program?” Findings: Mean participant age was 59.3 (9.3) years, and participants were 54% male and 62% white. Education levels varied from less than high school to master’s degrees. Participants generated 70 unique responses, of which 36 (51.4%) received prioritization. The top 5 ranked responses of each nominal group technique meeting received approximately 50 percent (47.6% vs. 66.7%, respectively) of the total votes and described the potentially limited interpersonal connections, time conflicts, and differing content in a virtual navigator program compared to the in-person model. Discussion: These data suggest that previous participants were concerned with upholding the original design of the program, thus, virtual living donor kidney transplantation programs should aim to maintain interpersonal connections and consistency of content to ensure adequate programmatic engagement. Future research will focus on program fidelity independent of delivery modality.

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Racial and Socioeconomic Disparities in CKD in the Context of Universal Health Care Provided by the Military Health System

Cited by 12 publications

References 36 publications

Social Determinants of Health Impacting Access to Renal Dialysis for Racial/Ethnic Minorities

Social Determinants of Health Impacting Access to Renal Dialysis for Racial/Ethnic Minorities

Living Well With Kidney Disease and Effective Symptom Management: Consensus Conference Proceedings

Interpersonal Connections Are Important for Virtual Kidney Transplant Educational Program Development

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