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

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dc.contributor.authorRitte, R.E.
dc.contributor.authorLawton, P.
dc.contributor.authorHughes, J.T.
dc.contributor.authorBarzi, F.
dc.contributor.authorBrown, A.
dc.contributor.authorMills, P.
dc.contributor.authorHoy, W.
dc.contributor.authorO Dea, K.
dc.contributor.authorCass, A.
dc.contributor.authorMaple-Brown, L.
dc.date.issued2020
dc.description.abstractObjective: 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.
dc.description.statementofresponsibilityRebecca E. Ritte, Paul Lawton, Jaquelyne T. Hughes, Federica Barzi, Alex Brown, Phillip Mills, Wendy Hoy, Kerin O’Dea, Alan Cass and Louise Maple-Brown
dc.identifier.citationEthnicity and Health, 2020; 25(1):93-109
dc.identifier.doi10.1080/13557858.2017.1395814
dc.identifier.issn1355-7858
dc.identifier.issn1465-3419
dc.identifier.orcidBrown, A. [0000-0003-2112-3918]
dc.identifier.urihttp://hdl.handle.net/2440/130957
dc.language.isoen
dc.publisherTaylor & Francis
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/545202
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1021460
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/631947
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/605837
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1078477
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/490348
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1092576
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1038529
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1027204
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/631947
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/511081
dc.rights© 2017 Informa UK Limited, trading as Taylor & Francis Group
dc.source.urihttps://www.tandfonline.com/doi/full/10.1080/13557858.2017.1395814
dc.subjectChronic kidney disease; Aboriginal and Torres Strait Islander peoples; Indigenous peoples; socio-economic status; disadvantage
dc.titleChronic kidney disease and socio-economic status: a cross sectional study
dc.typeJournal article
pubs.publication-statusPublished

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