AI Article Synopsis
Article Abstract
Background And Objectives: Black patients referred for kidney transplantation have surpassed many obstacles but likely face continued racial disparities before transplant. The mechanisms that underlie these disparities are unclear. We determined the contributions of socioeconomic status (SES) and comorbidities as mediators to disparities in listing and transplant.
Design, Setting, Participants, & Measurements: We studied a cohort (=1452 black; =1561 white) of patients with kidney failure who were referred for and started the transplant process (2009-2018). We estimated the direct and indirect effects of SES (self-reported income, education, and employment) and medical comorbidities (self-reported and chart-abstracted) as mediators of racial disparities in listing using Cox proportional hazards analysis with inverse odds ratio weighting. Among the 983 black and 1085 white candidates actively listed, we estimated the direct and indirect effects of SES and comorbidities as mediators of racial disparities on receipt of transplant using Poisson regression with inverse odds ratio weighting.
Results: Within the first year, 876 (60%) black and 1028 (66%) white patients were waitlisted. The relative risk of listing for black compared with white patients was 0.76 (95% confidence interval [95% CI], 0.69 to 0.83); after adjustment for SES and comorbidity, the relative risk was 0.90 (95% CI, 0.83 to 0.97). The proportion of the racial disparity in listing was explained by SES by 36% (95% CI, 26% to 57%), comorbidity by 44% (95% CI, 35% to 61%), and SES with comorbidity by 58% (95% CI, 44% to 85%). There were 409 (42%) black and 496 (45%) white listed candidates transplanted, with a median duration of follow-up of 3.9 (interquartile range, 1.2-7.1) and 2.8 (interquartile range, 0.8-6.3) years, respectively. The incidence rate ratio for black versus white candidates was 0.87 (95% CI, 0.79 to 0.96); SES and comorbidity did not explain the racial disparity.
Conclusions: SES and comorbidity partially mediated racial disparities in listing but not for transplant.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274281 | PMC |
| http://dx.doi.org/10.2215/CJN.12541019 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Universal Genetic Counseling and Testing for Black Women: A Risk-Stratified Approach to Addressing Breast Cancer Disparities.
Clin Breast Cancer
December 2024
Department of Internal Medicine, Rogel Cancer Center, University of Michigan, Ann Arbor, MI.
Black women experience disproportionate breast cancer-related mortality, with similar overall incidence to White women. Approaches to address these racial health disparities should be multifaceted. Universal genetic counseling and testing for Black women could represent one dimension of a comprehensive approach in guiding early identification of those more likely to experience higher breast cancer-related mortality.
View Article and Find Full Text PDFRacial disparities in gestational weight gain and adverse pregnancy outcomes among Black and White pregnant people with obesity.
Obesity (Silver Spring)
December 2024
Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
Objective: This study of pregnant people with obesity examined two aims in testing the hypothesis that the COVID-19 pandemic widened racial disparity in maternal health in high-risk pregnancies; it compared by race both (1) gestational weight gain (GWG) patterns and (2) patterns of preexisting conditions and adverse pregnancy outcomes.
Methods: This retrospective chart review included birth certificate and delivery records from a large women's specialty hospital in Louisiana between 2018 and 2022. Differences in preexisting conditions, GWG, and adverse pregnancy outcomes were explored across early-, peak-, and late-pandemic periods using log-linear regression and robust Poisson models.
Race disparities in dental care use from adolescence to middle adulthood in the USA.
J Epidemiol Community Health
December 2024
School of Dentistry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
Background: This study examines the longitudinal patterns of dental care use from adolescence to middle adulthood (ages 11-43) and investigates racial and ethnic disparities in these patterns.
Methods: Data from Waves I through V of the National Longitudinal Study of Adolescent to Adult Health (1993-2018; ages 11-43). Semiparametric group-based trajectory model identified distinct dental care use trajectories.
Racial and ethnic disparities in Meniere's disease clinical trials: A systematic review.
Am J Otolaryngol
December 2024
Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America.
Objective: Our study aims to shed light on racial, ethnic, and geographic disparities in phase 2/3 Meniere's disease (MD) clinical trials, with the ultimate goal of enhancing the inclusivity and effectiveness of future MD research.
Methods: We conducted a systematic review of phase 2/3 MD Randomized Controlled Trials (RCTs). Using the search terms "Meniere's Disease" and "Endolymphatic hydrops", we searched ClinicalTrials.
Ethnicity does not change burn resuscitation and time to first excision.
Burns
December 2024
Parkland Health, 5200 Harry Hines Blvd, Dallas, TX 75235, USA. Electronic address:
Health and racial disparities can limit access to preventative, trauma, and chronic disease care but have not been addressed in burn resuscitation. Over- and under-resuscitation contribute to increased overall hospital costs, and morbidity and mortality rates. The primary objective of this study was to identify potential racial disparities that may exist during the initial fluid resuscitation after burn injury.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!