Did you know that Black Americans are almost four times as likely as White Americans to develop kidney failure? While Black Americans make up about approximately 13 percent of the population, they account for approximately 35 percent of the people with kidney failure in the United States. Minority populations have much higher rates of high blood pressure, diabetes, obesity and heart disease, all of which increase the risk for kidney disease.
Why is there an increased risk?
A number of factors contribute to the higher risk of kidney disease among African American people.
They include the following:
Racism in medicine
Racism in medicine may increase the risk of African American people developing kidney disease. It may also increase the risk of people not receiving a correct diagnosis and treatment.
Numerous studies have documented a pattern of racism in medicine. For example, according to one 2021 paper, genetic variation is actually greatest between members of the same racial group, not between different racial groups. This indicates that race really is a social construct, not a biological reality.
However, doctors continue to treat race as a biological factor, attributing differences in the prevalence of certain medical conditions to race and genetics.
Doctors in training found that about half of them endorsed at least one racist myth about Black patients, such as the myth that they have thicker skin or feel less pain. These false ideas could directly affect their treatment of patients, such as by causing them not to correctly diagnose or treat pain.
Doctors score tests of kidney function in Black people differently, based on early but flawed research, suggesting that there might be some differences in kidney function. The estimated glomerular filtration rate (eGFR) test can measure how well the kidneys function. However, doctors apply a multiple to Black people’s scores that elevates their number, potentially making it appear as though their kidneys function better than they do.
In 2020, the American Society of Nephrology and the National Kidney Foundation created a task force to reevaluate the calculations that doctors use to measure kidney disease in African American people.
Lower access to healthcare
African American people may struggle to access quality healthcare due to a variety of factors including:
- residential segregation that may mean that they do not live near quality doctors
- low incomes that may make it more difficult to afford healthcare
- a low willingness to seek medical care when needed due to factors such as fear of racism