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Type: Journal article
Title: Chronic kidney disease and socio-economic status: a cross sectional study
Author: Ritte, R.E.
Lawton, P.
Hughes, J.T.
Barzi, F.
Brown, A.
Mills, P.
Hoy, W.
O Dea, K.
Cass, A.
Maple-Brown, L.
Citation: Ethnicity and Health, 2020; 25(1):93-109
Publisher: Taylor & Francis
Issue Date: 2020
ISSN: 1355-7858
Statement of
Rebecca E. Ritte, Paul Lawton, Jaquelyne T. Hughes, Federica Barzi, Alex Brown, Phillip Mills, Wendy Hoy, Kerin O’Dea, Alan Cass and Louise Maple-Brown
Abstract: 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 m²) 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 m² 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 m² (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.
Keywords: Chronic kidney disease; Aboriginal and Torres Strait Islander peoples; Indigenous peoples; socio-economic status; disadvantage
Rights: © 2017 Informa UK Limited, trading as Taylor & Francis Group
DOI: 10.1080/13557858.2017.1395814
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