TY - JOUR
T1 - Chronic kidney disease and socio-economic status
T2 - A cross sectional study
AU - Ritte, Rebecca E.
AU - Lawton, Paul
AU - Hughes, Jaquelyne T.
AU - Barzi, Federica
AU - Brown, Alex
AU - Mills, Phillip
AU - Hoy, Wendy
AU - O’Dea, Kerin
AU - Cass, Alan
AU - Maple-Brown, Louise
PY - 2020/1/2
Y1 - 2020/1/2
N2 - 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.
AB - 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.
KW - aboriginal and torres strait islander peoples
KW - Chronic kidney disease
KW - disadvantage
KW - indigenous peoples
KW - socio-economic status
UR - http://www.scopus.com/inward/record.url?scp=85032801792&partnerID=8YFLogxK
U2 - 10.1080/13557858.2017.1395814
DO - 10.1080/13557858.2017.1395814
M3 - Article
C2 - 29088917
AN - SCOPUS:85032801792
SN - 1355-7858
VL - 25
SP - 93
EP - 109
JO - Ethnicity and Health
JF - Ethnicity and Health
IS - 1
ER -
