Chronic kidney disease and socio-economic status: a cross sectional study

Ritte, Rebecca E., Lawton, Paul, Hughes, Jaquelyne T., Barzi, Federica, Brown, Alex, Mills, Phillip, Hoy, Wendy, O'dea, Kerin, Cass, Alan, and Maple-Brown, Louise (2020) Chronic kidney disease and socio-economic status: a cross sectional study. Ethnicity and Health, 25 (1). pp. 93-109.

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Objective: This cross-sectional study investigated the relationship between individual-level markers of disadvantage, renal function and cardio-metabolic risk within an Indigenous population characterised by a heavy burden of chronic kidney disease and disadvantage.

Design: Using data from 20 Indigenous communities across Australia, an aggregate socio-economic status (SES) score was created from individual-level socio-economic variables reported by participants. Logistic regression was used to assess the association of individual-level socio-economic variables and the SES score with kidney function (an estimated glomerular function rate (eGFR) cut-point of <60 ml/min/1.73 m(2)) as well as clinical indicators of cardio-metabolic risk.

Results: The combination of lower education and unemployment was associated with poorer kidney function and higher cardio-metabolic risk factors. Regression models adjusted for age and gender showed that an eGFR < 60 ml/min/1.73 m(2) was associated with a low socio-economic score (lowest vs. highest 3.24 [95% CI 1.43-6.97]), remote living (remote vs. highly to moderately accessible 3.24 [95% CI 1.28-8.23]), renting (renting vs. owning/being purchased 5.76[95% CI 1.91-17.33]), unemployment (unemployed vs employed 2.85 [95% CI 1.31-6.19]) and receiving welfare (welfare vs. salary 2.49 [95% CI 1.42-4.37]). A higher aggregate socio-economic score was inversely associated with an eGFR < 60 ml/min/1.73 m(2) (0.75 [95% CI 063-0.89]).

Conclusion: This study extends upon our understanding of associations between area-level markers of disadvantage and burden of end stage kidney disease amongst Indigenous populations to a detailed analysis of a range of well-characterised individual-level factors such as overall low socio-economic status, remote living, renting, unemployment and welfare. With the increasing burden of end-stage kidney disease amongst Indigenous people, the underlying socio-economic conditions and social and cultural determinants of health need to be understood at an individual as well as community-level, to develop, implement, target and sustain interventions.

Item ID: 66089
Item Type: Article (Research - C1)
ISSN: 1465-3419
Keywords: Chronic kidney disease, aboriginal and torres strait islander peoples, indigenous peoples, socio-economic status, disadvantage
Copyright Information: © 2017 Informa UK Limited, trading as Taylor & Francis Group
Funders: Australian National Health and Medical Research Council (NHMRC), Kidney Health Australia, Colonial Foundation Trust, Rebecca L Cooper Medical Research Foundation, SeaSwift, Thursday Island, Charles and Sylvia Viertel Charitable Foundation (CSVCF)
Projects and Grants: NHMRC Project grant number 545202, NHMRC Project grant number 1021460, NHMRC Program grant number 631947, NHMRC Fellowship [grant number 605837, NHMRC Practitioner Fellowship grant number 1078477, NHMRC Scholarship grant number 490348, NHMRC Fellowship grant number 1092576, NHMRC Scholarship grant number 1038529, NHMRC Principal Research Fellowship grant number 1027204, NHMRC Program grant number 631947, NHMRC Australia Fellowship grant number 511081, CSVCF Senior Medical Research Fellowship
Date Deposited: 30 Dec 2020 07:31
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320214 Nephrology and urology @ 50%
45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450419 Aboriginal and Torres Strait Islander social determinants of health @ 50%
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