Social Determinants of CKD Hotspots

doi:10.1016/j.semnephrol.2019.02.003

Review

. 2019 May;39(3):256-262.

doi: 10.1016/j.semnephrol.2019.02.003.

Social Determinants of CKD Hotspots

Deidra C Crews¹, Tessa K Novick²

Affiliations

¹ Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland; Johns Hopkins Center for Health Equity, Johns Hopkins Medical Institutions, Baltimore, Maryland. Electronic address: dcrews1@jhmi.edu.
² Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland; Johns Hopkins Center for Health Equity, Johns Hopkins Medical Institutions, Baltimore, Maryland.

PMID: 31054624
PMCID: PMC6508089
DOI: 10.1016/j.semnephrol.2019.02.003

Review

Social Determinants of CKD Hotspots

Deidra C Crews et al. Semin Nephrol. 2019 May.

. 2019 May;39(3):256-262.

doi: 10.1016/j.semnephrol.2019.02.003.

Authors

Deidra C Crews¹, Tessa K Novick²

Affiliations

¹ Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland; Johns Hopkins Center for Health Equity, Johns Hopkins Medical Institutions, Baltimore, Maryland. Electronic address: dcrews1@jhmi.edu.
² Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland; Johns Hopkins Center for Health Equity, Johns Hopkins Medical Institutions, Baltimore, Maryland.

PMID: 31054624
PMCID: PMC6508089
DOI: 10.1016/j.semnephrol.2019.02.003

Abstract

Chronic kidney disease (CKD) hotspots are defined as countries, regions, communities, or ethnicities with a higher than average incidence of CKD when compared with the worldwide, country, or regional rates. Here, we describe what is known about socially determined CKD hotspots, that is, the burden of CKD among socially defined communities that often collocate geographically. We focus on the poor, the homeless, and the food insecure, and their intersection with other social determinants of health, including race/ethnicity. In addition to discussing the burden of CKD in these communities, we describe some efforts to mitigate this burden and identify gaps in current knowledge.

Keywords: Food insecurity; epidemiology; health disparities; homelessness; poverty.

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Conflict of interest statement

Conflict of interest statement: none.

Figures

**Figure 1.**
A potential bidirectional relation of poverty and CKD.

**Figure 2.**
Proposed relationship between housing instability and ESKD.

**Figure 3.**
Proposed mechanisms by which food insecurity can lead to CKD/CKD progression. Abbreviations: HPA, hypothalamic–pituitary– adrenal; SNS, sympathetic nervous system

See this image and copyright information in PMC

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References

1. The World Bank. Poverty & Equita Data, 2012; http://data.worldbank.org/topic/poverty, Accessed August 15, 2016.
1. Chetty R, Stepner M, Abraham S, et al. The Association Between Income and Life Expectancy in the United States. 2001–2014. Jama. Apr 26 2016;315(16):1750–1766. - PMC - PubMed
1. Hossain MP, Goyder EC, Rigby JE, El Nahas M. CKD and poverty: a growing global challenge. American journal of kidney diseases : the official journal of the National Kidney Foundation. January 2009;53(1):166–174. - PubMed
1. Shoham DA, Vupputuri S. Kaufman JS, et al. Kidney disease and the cumulative burden of life course socioeconomic conditions: the Atherosclerosis Risk in Communities (ARIC) study. Soc Sci Med October 2008;67(8):1311–1320. - PMC - PubMed
1. Food and Agriculture Organization of the United Nations. The FAO Hunger Map 2015. 2015. http://www.fao.org/hunger/en/.

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[1] The World Bank. Poverty & Equita Data, 2012; http://data.worldbank.org/topic/poverty, Accessed August 15, 2016.

[2] The World Bank. Poverty & Equita Data, 2012; http://data.worldbank.org/topic/poverty, Accessed August 15, 2016.

[3] Chetty R, Stepner M, Abraham S, et al. The Association Between Income and Life Expectancy in the United States. 2001–2014. Jama. Apr 26 2016;315(16):1750–1766. - PMC - PubMed

[4] Chetty R, Stepner M, Abraham S, et al. The Association Between Income and Life Expectancy in the United States. 2001–2014. Jama. Apr 26 2016;315(16):1750–1766. - PMC - PubMed

[5] Hossain MP, Goyder EC, Rigby JE, El Nahas M. CKD and poverty: a growing global challenge. American journal of kidney diseases : the official journal of the National Kidney Foundation. January 2009;53(1):166–174. - PubMed

[6] Hossain MP, Goyder EC, Rigby JE, El Nahas M. CKD and poverty: a growing global challenge. American journal of kidney diseases : the official journal of the National Kidney Foundation. January 2009;53(1):166–174. - PubMed

[7] Shoham DA, Vupputuri S. Kaufman JS, et al. Kidney disease and the cumulative burden of life course socioeconomic conditions: the Atherosclerosis Risk in Communities (ARIC) study. Soc Sci Med October 2008;67(8):1311–1320. - PMC - PubMed

[8] Shoham DA, Vupputuri S. Kaufman JS, et al. Kidney disease and the cumulative burden of life course socioeconomic conditions: the Atherosclerosis Risk in Communities (ARIC) study. Soc Sci Med October 2008;67(8):1311–1320. - PMC - PubMed

[9] Food and Agriculture Organization of the United Nations. The FAO Hunger Map 2015. 2015. http://www.fao.org/hunger/en/.

[10] Food and Agriculture Organization of the United Nations. The FAO Hunger Map 2015. 2015. http://www.fao.org/hunger/en/.

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Social Determinants of CKD Hotspots

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Social Determinants of CKD Hotspots

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