National Medical Association (NMA): Racial Disparities Contribute to Low Rate of Kidney Transplants Among Minorities
African Americans have the highest rate of kidney failure in the country, yet are among the least likely to receive a transplant, according to an article in the February issue of the Journal of the National Medical Association (JNMA). The article, titled "Racial and Ethnic Disparities in Renal Transplantation," identifies racial disparities as the main culprit for the low rate of kidney transplants among African Americans and other minorities. The article notes that the disparities arise from such factors as socioeconomic status, unfavorable residential locations, mistrust of the medical profession, and cultural differences. NMA Contact: Alisa Mosley 202-347-1895
Washington, DC (PRWEB) February 4, 2005
article, titled "Racial and Ethnic Disparities in Renal Transplantation," identifies racial disparities as the main culprit for the low rate of kidney transplants among African Americans and other minorities. The article notes that the disparities arise from such factors as socioeconomic status, unfavorable residential locations, mistrust of the medical profession, and cultural differences.
The author of the article is Joanne Churak, a physician's assistant at the Renal Section of the Veterans Affairs Medical Center in West Haven, Conn. Churak based her article on an analysis of several studies that documented disparities in the provision of kidney transplantation between 1983 and 2004. Findings showed that African Americans and other minorities in the U. S. have a two-to-four times greater risk of developing ESRD (end-stage renal disease) than whites. Although blacks make up 12.7 percent of the U. S. population, they comprised 32% of the ESRD population in 2000. Out of the nearly 15,000 kidney transplants in 2002, only 22.5% were received by blacks and 13% by Hispanics.
The JNMA article points out that by the year 2050 minorities will comprise nearly half of the U. S. population. Continued racial disparities in ESRD and kidney transplantation rates will have serious implications on the quality of life and the future cost of health care.
The article suggests that while numerous solutions need to be implemented to resolve the problem, emphasis should be placed on educating practitioners as well as patients. "Education is key," states Churak. "People need to understand that disparities exist and that all patients deserve the same opportunities."
Overcoming misconceptions about organ donation and transplantation remains a major challenge in many African-American and minority communities. For example, there is a myth that being an organ donor would cause physicians to forego life-saving efforts in order to harvest organs. Other problems arise from the lack of contact with physicians and caregivers who can provide accurate information about ESRD and transplants. Recognizing religious and cultural opposition to organ donation must also be addressed in efforts to inform African Americans and minorities about kidney transplantation.
The article notes that in addition to disparities due to culture and race, biologic differences also factor into low kidney transplantation rates among minorities. HLA matching is a primary determinant of kidney allocation, and in general, blacks have less well-defined HLA antigenic specificities than do whites. The closer the HLA antigen match, the less the likelihood that a kidney will be allocated to a black person, since the majority of donated kidneys are from whites. Additionally, blacks have a higher prevalence of blood type O than whites, and given the necessity for blood-type compatibility, patients with type O are less likely to receive a kidney transplant than patients with other blood types.
Among its recommendations, the article proposes changes in the structure and finance of health policies to address racial, economic and cultural differences. It also calls for a more balanced health care system that promotes a partnership between the medical profession and public health workers to assist communities in the promotion of healthy lifestyles.
The full text of the article can be viewed on the NMA web site at www. nmanet. org or through a direct link at http://www. nmanet. org/OC153.pdf (http://www. nmanet. org/OC153.pdf).
The Journal of the National Medical Association was established in 1909 and is published monthly by the National Medical Association. The NMA is the nation's oldest and largest medical association representing the interests of minority physicians and their patients. The NMA has a long and distinguished record of advocating for health policies to assure equitable and quality health care for all people.
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