Chronic kidney disease is one of the serious health complications among the African American communities in the United States. As Peralta and Ronit (2011) report, the government of the United States has been concerned of this fact. Chronic kidney disease has been one of the leading causes of death in the country. According to Tuyoina (2008), chronic kidney disease may not be causing deaths in this country as heart diseases. However, it is a major cause of death. Besides this, it has other serious consequences on the socio-economic conditions of the victims and their families. When one is suffering from chronic kidney disease, such an individual may not be able to perform certain activities. Such an individual may also have a drastic change in lifestyle because of this. It is for this reason that the government of the United States has made a deliberate effort to ensure that it fights this disease (Neal, & Frank, 2006).
African Americans (also known as the black Americans) have a higher prevalence of this disease than any other ethnic group in this country because of a number of socio-economic reasons (Gao, & Oliver, 2008). These scholars observe that although this disease is seen as a problem to the entire American populace, African Americans have heavily been impacted by this disease (Tuyoina, 2008). This scholar says that the socio-economic conditions of black Americans make them prone to such health complications as diabetes, which may lead to chronic kidney disease. It would therefore be prudent to investigate the reasons behind this in order to find a concrete solution. This research seeks to investigate chronic kidney disease as a public health issue among the African American communities.
Causes of Chronic Kidney Disease
It will be important to understand some of the main causes of chronic kidney disease before determining how it is related to the African American communities. Kidneys are two bean shaped organs found on the lower end of the pelvic (Gao, & Oliver, 2008). These scholars explain that kidneys are charged with the main responsibility of eliminating wastes from the blood. This organ weighs about quarter of a pound. Blood flows into the kidney, and with the help of the nephrons, the blood is sieved form any impurities. The cleaned blood is then let into the system. This is done continuously as long as an individual is still alive. Any disruption of this system may lead to a serious consequence to the individual. When the nephron is destroyed in any way, Lewis (2012) says that they may stop their vital duties and this can be fatal. Failure of kidney is not a sudden process. It is a systematic and gradual process that may take several years before the patient can realize that he or she is suffering from this disease. The fact that symptoms of the disease may come later in the life of the patient only complicates the matter. It is only through a medical diagnosis that one may be able to determine whether or not he or she is suffering from this disease. For a long time, Donald (2011) says that glomerulonephritis has been considered as one of the main causes of kidney disease. However, this scholar notes that recent researchers have identified a number of possible causes of this disease. The following are some of the causes of chronic kidney disease according to the findings of recent researchers.
- High blood pressure.
- Diabetes, also known as high blood sugar.
- Kidney infections like Pyelonephritis, glomerulonephritis, polycystic kidney disease among others.
- Blocked or narrowed renal artery which carried blood to the kidney.
- Excessive usage of some drugs that have destructive impact on the kidney such as Celebrex, ibuorofen, NSAIDs among others.
These are some of the known causes of chronic kidney disease. According to a report by Lewis (2012), the above factors have been associated with chronic disease in the past recent years. This scholar cautions however, that the above may be the known reasons for the complications of the kidney. However, this scholar says that there are some of the social activities that people engage in that may cause damage to the kidney which may bring about chronic kidney disease. Kidney, just like the blood, receives blood from all parts of the body. When this blood is toxic, Lewis (2012) explains that this organ may be directly affected. The liver and other organs will always try to intoxicate any toxic substance in the blood. However, when the level of toxin is in excess, Neal and Frank (2006) says that some will spill over to the kidney and the consequence will be a damaged kidney. This scholar states that although not directly associated with chronic kidney disease, taking alcohol in excess may have an impact on the kidney in the long run. This is especially so when the toxic substances cannot be eliminated before reaching the kidney. This scholar therefore, urges that it is very important for an individual to stay away from possible cause of kidney complications.
Chronic Kidney Disease as Public Health Issue in African American Communities
Chronic kidney disease may be a general public health issue among the American communities. However, as was noted in the discussion above, this disease is more prevalent among the African Americans than other ethnic groups in this country. Tuyoina (2008) rules out the possibility of the reason behind this being biological. According to this scholar, such a condition may not have a biological explanation because the main difference between the African Americans and Americans of other ethnic groups may be their skin color and nothing much. The skin color may not be justifiable reason to make this ethnic group be prevalent to this disease. The main reason behind this therefore, may be explained from the social perspective. The following socio-economic conditions may be making black Americans be at greater risk of contracting this disease than other ethnic groupings in this country.
The reason why the African Americans have a higher risk of contracting chronic kidney disease may be due to a number of socio-economic issues. The following are some of the socio-economic factors that may have direct effect on the black Americans, making them more prone to contracting chronic kidney disease.
The black Americans have been the marginalized group for a very long time in the American society. Unlike other ethnic groups, Donald (2011) says that most of them came to this country as slaves. When the slavery was ended, the tag remained. They were still considered second class citizens of this country. They could not get decent jobs because of discriminative policies that were practiced in this country. As a result of this, they remained financially challenged although the country was flourishing in wealth. Due to this financial challenge, these people are not able to afford the luxury of going for regular tests to determine if they are suffering from this disease. As a result of this, their conditions would get worse and this could possibly lead to late diagnosis of the disease (Neal & Frank, 2006). In most cases, the diagnosis comes too late when the only option is to have a transplant of kidney. The cost of the treatment may also be too expensive for some of the African Americans, a fact that may jeopardize chances of their survival from this disease.
According to Donald (2011), the level of education among the African Americans is relatively lower than those of other ethnic groups in this country. This may also be attributed to the discrimination that was always directed to the blacks for a very long period. The blacks were expected to attend different schools from their white counterparts. Even after going through the school system successfully, the college graduates could not still get jobs because of the discrimination. This made school going children, and even their parents, lose hope in education. It was apparent that education was not able to transform their lives for the better. Although many of the African Americans made concerted effort to go to school and get formal education, a good number opted to leave school at very early stages. This made them ignorant about several issues on health (Josina, 2008). They could not understand what a kidney is and how it could be related to some of the social practices such as taking of alcohol. Creating awareness about this disease among these semi-literate individuals was therefore, very complex. Making them understand the importance of going for as a diagnosis.
Social behavior on individuals may contribute the prevalence of one contracting chronic kidney disease. Lewis (2012) explains that it may be wrong to suggest that African Americans in the United States are socially irresponsible. However, behavior such as excessive alcohol taking may result contributes to developing this health condition, and some African Americans are alcoholic. This may jeopardize their health and expose them to health conditions such as chronic kidney disease. Alcohol has toxic ingredients that may affect the kidney. It is also a fact that when one takes alcohol, the kidney will be affected due to the excessive task it will be given of eliminating some of the ingredients of alcohol. In the process, the kidney nephrones will face the danger of destruction (Neal, & Frank, 2006).
Lewis (2012) explains that other lifestyle activities may also affect health of an individual. For instance, the type of job one does may expose one to dangerous chemicals which when inhaled, may expose one to chronic kidney disease. This scholar explains that because of limited education of some of the African Americans, they are always willing to undertake some jobs that are loathed by other members of this country. Some of these jobs may lead to chronic kidney disease. This factor makes African Americans to be at greater risk of contracting this disease than any other ethnic population in this country.
Access to Social Amenities in the Country
The United States of America is the leading democracy in the world. However, until recently, the country has experienced a massive discrimination against the African Americans. According to Lesley and Robert (2011), there were various discriminative policies regarding access to various social amenities. The African Americans were not expected to live in some of the estates that were declared exclusively for the whites. This saw these individuals pushed to the ghettos where most of them still reside even to date. In these slums, African Americans lack proper medical attention. Most of the big hospitals with facilities that can manage treatment of this disease are not in these slums. The Health Bill (also known as the Obamacare) might have come as a timely support for those who could not get these services before. To others however, this came too late. The disease had taken toll on them and they were leading desperate lives. Claus and Otto (2011) explain that some of the residents of these slums lead reckless lives and this worsen their ability to get medical attention. This scholar appreciates the effort done by the government to improve welfare of these people and ensure that diseases such as chronic kidney disease are completely eliminated.
Social Consequences of Chronic Kidney Disease
Chronic kidney disease has five stages. In the first stage of this disease, there are minor pathological abnormalities in the urine and blood of the patient. The kidney will experience slight diminishing functionality. This will deteriorate until stage four where the reduction of GFR will be severe. At the final stage (stage five), Josina (2008) says that there will be an established kidney failure. These stages come with consequences. The consequences of chronic kidney disease is always felt by the patient who is suffering from the disease, the family of the patient, health experts involved in the treatment, and the government.
The patient will experience a massive impact from this disease. Today, racial discrimination has almost completely been eliminated in this country. However, its effect is still felt in some regions among the black Americans. When one is suffering from this disease, there will be needed to go to a hospital where proper care will be offered (Donald, 2011). There are cases where some of the individuals (now in their middle or old age) did not go to school because of discrimination witnessed then. This means that these people do not have capacity to be employed in the current blue-chip companies which offer very attractive salaries. These individuals will be forced to undergo pain and psychological torture because of the financial challenge. If it happens that such an individual is the bread winner of the family, the individual will be psychologically tortured by the fact that he will not have the capacity of taking care of the family (Lewis, 2012).
The patient may also face the risk of losing his or her job when he or she becomes bed ridden for a long period of time. Some employers may not withstand the fact that an employer fails to come to work for a long period of time (Howard, Areef, & Brent, 2012). Such employers may therefore, consider replacing such employees. Then there will be the physiological pain that the patient will experience given the fact that his or her body will be lacking the ability to eliminate waste substances. The process of kidney transplant may also be complex, and it solely will depend on willingness of donors.
The experience of having a family member with a chronic disease that can be terminal is always daunting. The attention of the family will be turned to the patient and it will be anguishing, tying to find a cure for the disease (Tuyoina, 2008). The family will be forced to spend a lot of money in the treatment of the patient. In some cases, there may be needed to take such a patient to a private health facility. This will be an extra cost to this family. If the patient happens to be the bread winner of the family, the situation will become worse. They may have serious financial challenge trying to make ends meet. The family members will be forced to come up means of having livelihood.
It is a routine for doctors to experience patients who are suffering from different infection. However, as Tuyoina (2008) says, these experts always wish to encounter minor cases where a disease is at its initial stages. The treatment at this stage is easier and less enjoyable. This wish is not always realized, especially for doctors who work in districts where African Americans are the majority. These doctors always have cases where a patient with chronic kidney disease comes to the hospital when his or her condition is at the terminal stage. The doctor, being a human being, will be affected by the anguish of the patient (Josina, 2008).
The government of the United States is committed to offering its citizens free quality health care. This means that every time a patient walks into a health facility within this country, the government of the United States will have to feel the financial consequence. The government will also be forced to equip various hospitals within the country to be able to offer quality treatment that is needed.
Measures to Help Mitigate Consequences of Chronic Kidney Disease among African Americans
Chronic kidney disease is a concern for all the stakeholders in this country because, as shown in the discussion above, all members of the society will be affected by it in one way or the other. This country no longer has discriminative policies that may justify reckless living of some of the citizens. The society has embraced unity, and everyone has an opportunity to make his or her life better. It should therefore be the responsibility of everyone to ensure that he or she leads a responsible life, irrespective of race or ethnic groups. Actions associated with chronic kidney disease such as excessive alcohol taking should be avoided (Lewis, 2012).
Chronic kidney disease is very prevalent among the African Americans in the United States. A number of reasons might be given to justify the reason for this. The main reason that a number of scholars have identified for this disparity is the fact that at some point in time, African Americans were socially discriminated by other ethnic groups. A number of socio-economic and behavioral factors have been identified as the main causes of this disease among the African Americans. These scholars however, agree that this disease can be fought if all the citizens of this country, irrespective of their race, become responsible in all their actions.
Claus, P., & Otto, M. (2011). Mineral and bone disorders in children with chronic kidney disease. Nature Reviews Nephrology, 6(7), 624-634.
Donald, R. T. (2011). Handbook of chronic kidney disease management. Philadelphia: Lippincott Williams & Wilkins Health.
Gao, S., & Oliver, K. (2008). Assessment of Racial Disparities in Chronic Kidney Disease Stage 3 and 4 Care in the Department of Defense Health System. Journal of the American Society of Nephrology, (2)2, 442-449.
Howard, A., Areef, I., & Brent, C. (2012). Chronic Kidney Disease Stages 1–3: Screening, Monitoring, and Treatment. Comparative Effectiveness Review, 11(12), 559-1003.
Josina, H. (2008). Chronic kidney Disease: Early identification and management of chronic kidney disease in adults in primary and secondary care. National Collaborating Center for Chronic Conditions Journal, (5), 78-119.
Lesley, R. & Robert, H. (2011). Nutrition and growth in children with chronic kidney disease. Nature Reviews Nephrology, (7)1, 615-623.
Lewis, R. (2012). Understanding chronic kidney disease: A guide for the non-specialist. Keswick: M and K Update.
Neal, D., & Frank, P. (2006).Racial Differences in the Prevalence of Chronic Kidney Disease among Participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort Study. American Society of Nephrology, (17)6, 1710-1715.
Peralta, A., & Ronit, K. (2011). Racial and Ethnic Differences in Kidney Function Decline among Persons without Chronic Kidney Disease. Journal of the American Society of Nephrology, (22)7, 1327-1334
Tuyoina, U. (2008). Diagnosis and management of chronic kidney disease: a national clinical guideline. Scottish Intercollegiate Guidelines Network, (9)6, 61-117.