Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
Clin Transplant. 2018 May;32(5):e13195. doi: 10.1111/ctr.13195. Epub 2018 Feb 11.
Prior work has demonstrated how neighborhood poverty and racial composition impact racial disparities in access to the deceased donor kidney transplant waitlist, both nationally and regionally. We examined the association between neighborhood characteristics and racial disparities in time to transplant waitlist in Chicago, a diverse city with continued neighborhood segregation.
Using data from the United States Renal Data System (USRDS) and the US Census, we investigated time from dialysis initiation to kidney transplant waitlisting for African American and white patients in Chicago using cause-specific proportional hazards analyses, adjusting for individual sociodemographic and clinical characteristics, as well as neighborhood poverty and racial composition.
In Chicago, African Americans are significantly less likely than whites to appear on the renal transplant waitlist (HR 0.73, P < .05). Compared to whites in nonpoor neighborhoods, African Americans in poor neighborhoods are significantly less likely to appear on the transplant waitlist (HR 0.61, P < .05). Over 69% of African Americans with ESRD live in these neighborhoods.
Consistent with national data, African Americans in Chicago have a lower likelihood of waitlisting than whites. This disparity is explained in part by neighborhood poverty, which impacts the majority of African American ESRD patients in Chicago.
先前的研究已经证明了邻里贫困和种族构成如何影响全国和地区范围内获得已故供体肾移植候补名单的种族差异。我们研究了邻里特征与芝加哥（一个具有持续邻里隔离的多元化城市）中种族差异与移植候补名单之间的关联。
使用来自美国肾脏数据系统（USRDS）和美国人口普查局的数据，我们使用特定原因的比例风险分析，对芝加哥的非洲裔美国人和白人患者从开始透析到肾脏移植候补名单的时间进行了研究，调整了个体社会人口统计学和临床特征以及邻里贫困和种族构成。
在芝加哥，非洲裔美国人出现在肾脏移植候补名单上的可能性明显低于白人（HR 0.73，P <.05）。与非贫困社区的白人相比，贫困社区的非洲裔美国人出现在移植候补名单上的可能性明显降低（HR 0.61，P <.05）。超过 69%的患有终末期肾脏疾病的非裔美国人居住在这些社区。
与全国数据一致，芝加哥的非裔美国人比白人更有可能不被列入候补名单。这种差异部分归因于邻里贫困，这影响了芝加哥大多数患有终末期肾脏疾病的非裔美国人。
