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Low use of routine medical care among African Americans with high CKD risk: the Jackson Heart Study.

  • Author(s): Diamantidis, Clarissa J;
  • Davenport, Clemontina A;
  • Lunyera, Joseph;
  • Bhavsar, Nrupen;
  • Scialla, Julia;
  • Hall, Rasheeda;
  • Tyson, Crystal;
  • Sims, Mario;
  • Strigo, Tara;
  • Powe, Neil R;
  • Boulware, L Ebony
  • et al.
Abstract

Background

Use of routine medical care (RMC) is advocated to address ethnic/racial disparities in chronic kidney disease (CKD) risks, but use is less frequent among African Americans. Factors associated with low RMC use among African Americans at risk of renal outcomes have not been well studied.

Methods

We examined sociodemographic, comorbidity, healthcare access, and psychosocial (discrimination, anger, stress, trust) factors associated with low RMC use in a cross-sectional study. Low RMC use was defined as lack of a physical exam within one year among participants with CKD (estimated glomerular filtration rate < 60 mL/min/1.73m2 or urine albumin-to-creatinine ratio > 30 mg/g) or CKD risk factors (diabetes or hypertension). We used multivariable logistic regression to estimate the odds of low RMC use at baseline (2000-2004) for several risk factors.

Results

Among 3191 participants with CKD, diabetes, or hypertension, 2024 (63.4%) were ≥ 55 years of age, and 700 (21.9%) reported low RMC use. After multivariable adjustment, age < 55 years (OR 1.61 95% CI 1.31-1.98), male sex (OR 1.71; 1.41-2.07), ConclusionsHigh-risk African Americans who were younger, male, less-educated, and with low trust in providers were more likely to report low RMC use. Efforts to improve RMC use by targeting these populations could mitigate African Americans' disparities in CKD risks.

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