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Social Environmental Stressors, Psychological Factors, and Kidney Disease
  1. Marino A. Bruce, PhD*,
  2. Bettina M. Beech, DrPH, MPH,
  3. Mario Sims, PhD,
  4. Tony N. Brown, PhD,
  5. Sharon B. Wyatt, PhD, CANP, FAAN,
  6. Herman A. Taylor, MD, MPH,
  7. David R. Williams, PhD, MPH§,
  8. Errol Crook, MD
  1. From the *Department of Family and Community Medicine, Meharry Medical College; †Vanderbilt University, Nashville, TN; ‡University of Mississippi Medical Center, Jackson, MS; §Harvard University, Cambridge, MA; and ∥University of South Alabama, Mobile, AL.
  1. Received September 6, 2008, and in revised form January 13, 2009.
  2. Accepted for publication January 13, 2009.
  3. Reprints: Marino A. Bruce, PhD, Department of Family and Community Medicine, Meharry Medical College, 1005 Dr DB Todd Jr Blvd, Nashville, TN 37208. E-mail: mabruce{at}mmc.edu.
  4. Dr Bruce was supported by career development award 1 K01 HL88735-01 from the National Heart, Lung, and Blood Institute, Bethesda, MD, and clinical translation science awards 1TL1RR024978-01, 1KL2RR024977-01, and 1UL1RR024975-01 from the National Center for Research Resources, Bethesda, MD. Dr Beech was supported by clinical translation science awards 1TL1RR024978-01, 1KL2RR024977-01, and 1UL1RR024975-01 from the National Center for Research Resources. Dr Sims was supported by career development award 1 K01 HL084682-01 from the National Heart, Lung, and Blood Institute and research grant N01-HC-95171 from the Jackson Heart Study, Jackson, MS. Dr Taylor was supported by research grant N01-HC-95171 from the Jackson Heart Study. Dr Crook was supported by research grant 1P20 MD002314-01 from the National Center on Minority Health and Health Disparities, Bethesda, MD.
  5. Conflict of Interest: The authors have no financial conflicts of interest.

Abstract

Kidney disease is one of the most striking examples of health disparities in American public health. Disparities in the prevalence and progression of kidney disease are generally thought to be a function of group differences in the prevalence of kidney disease risk factors such as diabetes, hypertension, and obesity. However, the presence of these comorbidities does not completely explain the elevated rate of progression from chronic kidney disease (CKD) to end-stage renal disease among high-risk populations such as African Americans. We believe that the social environment is an important element in the pathway from CKD risk factors to CKD and end-stage renal disease. This review of the literature draws heavily from social science and social epidemiology to present a conceptual frame specifying how social, economic, and psychosocial factors interact to affect the risks for and the progression of kidney disease.

Key Words
  • psychosocial factors
  • socioeconomic factors
  • environmental factors
  • end-stage renal disease
  • chronic kidney disease

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