Tackling Health Inequities for Children and Adolescents With CKD—A Call to Advocacy and Action Across the Life Course

Social Deprivation and Incidence of Pediatric Kidney Failure in France

“…Another potential explanation could be that deprivation may have an impact on health care earlier in the CKD course, with poorer management of CKD when diagnosed, including lower health literacy, treatment adherence issues, etc., resulting in faster progression to kidney failure and lower preparation for planned KRT. 38 , 39 , 40 , 41 , 42 Poorer health literacy, lower adherence to treatment, and potential delayed diagnosis could explain the higher incidence of glomerular disease we observed in higher deprivation areas. Indeed, when treated in time, glomerular diseases can be treated or at least mitigated.…”

Socioeconomic Position and Health Among Children and Adolescents With CKD Across the Life-Course

“…The life-course approach is increasingly recognized as having strong relevance to socioeconomic inequities in child health, 4 , 14 including in CKD. 15 , 16 This approach recognizes that health is a dynamic capacity that develops across the life-course, which is shaped by complex interactions between socioeconomic, biological, environmental, and psychological factors over time. 17 , 18 It highlights the interdependence between life stages, generations, and individuals across society; with health being shaped by factors experienced in previous life stages and generations.…”

“…Advocacy for whole-of-government and intersectoral action on the social determinants of health is critical, particularly upstream determinants such as SEP and material factors (e.g., income, education, employment, and housing), and action to prevent adverse social consequences for families and young people with CKD. 15 , 78 , 121 Ensuring comprehensive income support, flexible work for caregivers, and comprehensive universal healthcare are key priority areas. 44 , 78 , 122 Support systems should be easy to navigate for families with low health literacy, and coverage of costs must involve rapid payments or preimbursement and cover the full spectrum of costs (e.g., transport, home modifications, medications, and healthcare).…”

“… 44 , 86 , 125 Policies that ensure stable high quality housing and prevent food insecurity are also important. 15 , 34 , 121 , 126 To prevent adverse socioeconomic outcomes for young people, policies and legislation that ensure educational supports, as well as legal protections against work discrimination and the right to work adjustments and flexible work, are critical. 127 , 128 …”