Meaningful Causal Decompositions in Health Equity Research: Definition, Identification, and Estimation Through a Weighting Framework.

Causal decomposition analyses can help build the evidence base for interventions that address health disparities (inequities). They ask how disparities in outcomes may change under hypothetical intervention. Through study design and assumptions, they can rule out alternate explanations such as confounding, selection bias, and measurement error, thereby identifying potential targets for intervention.

Stony the road we trod: towards racial justice in kidney care.

The COVID-19 pandemic and the Movement for Black Lives have focused attention on racial disparities in kidney health outcomes. In 2020, kidney professionals highlighted threats posed by racism and other negative social drivers of kidney health, and proposed solutions to address these issues through scholarship and advocacy for social justice.

Trends in Internal Medicine Faculty by Sex and Race/Ethnicity, 1980-2018.

Importance: Increasing diversity in the physician workforce is a fulcrum for reducing health disparities. Efforts to increase the diversity in the internal medicine (IM) workforce may improve health equity among an increasingly diverse population with increasing prevalence of chronic disease.

Objectives: To assess diversity trends in the academic IM workforce and evaluate how well these trends reflected medical student diversity and the changing demographic composition of the general population.

National Trends in the Prevalence of Chronic Kidney Disease Among Racial/Ethnic and Socioeconomic Status Groups, 1988-2016.

Importance: The overall prevalence of chronic kidney disease (CKD) has stabilized in the United States in recent years. However, it is unclear whether all major sociodemographic groups experienced this trend.

Objective: To examine trends in CKD prevalence across major sociodemographic groups as defined by race/ethnicity and socioeconomic status.

COVID-19, Racism, and Racial Disparities in Kidney Disease: Galvanizing the Kidney Community Response.

PodcastThis article contains a podcast athttps://www.asn-online.org/media/podcast/JASN/2020_07_21_JASN2020060809.

The RICH LIFE Project: A cluster randomized pragmatic trial comparing the effectiveness of health system only vs. health system Plus a collaborative/stepped care intervention to reduce hypertension disparities.

Unlabelled: Disparities in the control of hypertension and other cardiovascular disease risk factors are well-documented in the United States, even among patients seen regularly in the healthcare system. Few existing approaches explicitly address disparities in hypertension care and control. This paper describes the RICH LIFE Project (Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone) design.

Historical Insights on Coronavirus Disease 2019 (COVID-19), the 1918 Influenza Pandemic, and Racial Disparities: Illuminating a Path Forward.

The coronavirus disease 2019 (COVID-19) pandemic is exacting a disproportionate toll on ethnic minority communities and magnifying existing disparities in health care access and treatment. To understand this crisis, physicians and public health researchers have searched history for insights, especially from a great outbreak approximately a century ago: the 1918 influenza pandemic. However, of the accounts examining the 1918 influenza pandemic and COVID-19, only a notable few discuss race.

Association of Socioeconomic Status and Comorbidities with Racial Disparities during Kidney Transplant Evaluation.

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.

Chronic Kidney Disease Awareness and Longitudinal Health Outcomes: Results from the REasons for Geographic And Racial Differences in Stroke Study.

Background: The majority of people with chronic kidney disease (CKD) are unaware of their kidney disease. Assessing the clinical significance of increasing CKD awareness has critical public health and healthcare delivery implications. Whether CKD awareness among persons with CKD is associated with longitudinal health behaviors, disease management, and health outcomes is unknown.

Housing Insecurity and Risk of Adverse Kidney Outcomes.

Background: Housing insecurity is characterized by high housing costs or unsafe living conditions that prevent self-care and threaten independence. We examined the relationship of housing insecurity and risk of kidney disease.

Methods: We used longitudinal data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study (Baltimore, MD).

Neighborhood Environment Characteristics and Control of Hypertension and Diabetes in a Primary Care Patient Sample.

Background: Hypertension control and diabetes control are important for reducing cardiovascular disease burden. A growing body of research suggests an association between neighborhood environment and hypertension or diabetes control among patients engaged in clinical care.

Objective: To investigate whether neighborhood conditions (i.

Achieving equity in dialysis care and outcomes: The role of policies.

Socially disadvantaged persons, including racial and ethnic minorities, individuals with low incomes, homeless persons, and non-US citizens bear a disproportionate burden of end-stage kidney disease (ESKD). Inequities in nephrology referral, vascular access, use of home dialysis modalities, kidney transplantation, and mortality are prominent. Public policies, including the Patient Protection and Affordable Care Act, end-stage renal disease Quality Incentive Program, and the Prospective Payment System, were enacted to improve healthcare access and dialysis care.

Awareness and Discussions About Chronic Kidney Disease Among African-Americans with Chronic Kidney Disease and Hypertension: a Mixed Methods Study.

Background: Routine primary care visits provide an educational opportunity for African-Americans with chronic kidney disease (CKD) and CKD risk factors such as hypertension. The nature of patient-physician discussions about CKD and their impact on CKD awareness in this population have not been well explored.

Objective: To characterize patient CKD awareness and discussions about CKD between patients and primary care physicians (PCPs).

Hypertension Self-management in Socially Disadvantaged African Americans: the Achieving Blood Pressure Control Together (ACT) Randomized Comparative Effectiveness Trial.

Background: Effective hypertension self-management interventions are needed for socially disadvantaged African Americans, who have poorer blood pressure (BP) control compared to others.

Objective: We studied the incremental effectiveness of contextually adapted hypertension self-management interventions among socially disadvantaged African Americans.

Design: Randomized comparative effectiveness trial.

Leveraging Delivery of Blood Pressure Control Interventions among Low-income African American Adults: Opportunities to Increase Social Support and Produce Family-level Behavior Change.

Purpose: Few family-oriented cardiovascular risk reduction interventions exist that leverage the home environment to produce health behavior change among multiple family members. We identified opportunities to adapt disease self-management interventions included in a blood pressure control comparative effectiveness trial for hypertensive African American adults to address family-level factors.

Methods: We conducted and analyzed semi-structured interviews with five intervention study staff (all study interventionists and the study coordinator) between December 2016 and January 2017 and with 11 study participants between September and November 2015.