Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Semin Nephrol. 2021 May;41(3):203-210. doi: 10.1016/j.semnephrol.2021.05.001.
Kidney disease has disparate effects on racial and ethnic minority groups, who have higher rates of chronic kidney disease and generally poorer outcomes. These disparate rates and outcomes have been attributed to social determinants of health; however, these social determinants of health are related to governmental and societal structural barriers that have created inequities not only in kidney disease, but also in other chronic diseases and in maternal/fetal health outcomes. The societal barriers to health equity include income inequality, inadequate education, environmental injustice, mass incarceration, and the enduring effects of the legacy of slavery. The approach to reducing disparities in kidney outcomes must be viewed through the lens of social justice to address these societal barriers.
肾脏病在不同种族和族裔群体中有着不同的影响，这些群体的慢性肾脏病发病率更高，总体预后更差。这些差异的发生率和结果归因于健康的社会决定因素；然而，这些健康的社会决定因素与政府和社会结构障碍有关，这些障碍不仅在肾脏病，而且在其他慢性疾病和母婴健康结果方面造成了不平等。健康公平的社会障碍包括收入不平等、教育不足、环境不公正、大规模监禁以及奴隶制遗留下来的持久影响。减少肾脏病结果差异的方法必须从社会正义的角度来看待，以解决这些社会障碍。
