Race and Medicine

Race and Medicine

Disclosures: The authors report no relevant financial disclosures.
May 20, 2021
2 min read

Housing, food insecurity confers fewer protective kidney health measures

Disclosures: The authors report no relevant financial disclosures.
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A study of individuals who resided in Baltimore suggested those with housing or food insecurity were less likely to achieve health parameters known to reduce the risk for kidney disease.

The findings led Tessa K. Novick, MD, MSW, MHS, of the University of Texas at Austin Dell Medical School, and colleagues to recommend specific interventions be developed to maintain kidney health in populations with “social needs.”

Housing and food insecurity and kidney disease risk
Data were derived from Novick TK, et al. Kidney Med. 2021;doi:10.1016/j.xkme.2021.03.005.

“Individuals experiencing health-related social needs, such as housing and food insecurity, face significant health care barriers, and are at increased risk for chronic kidney disease (CKD) and end-stage kidney disease,” the researchers wrote. “Maintaining blood pressure [of equal to or less than] 130/80 mmHg, hemoglobin A1c 7%, sodium intake [of less than] 2,000 mg/day, BMI [of equal to or less than] 25 kg/m2, regular physical activity, and smoking cessation reduce risk of CKD and CKD progression.”

To determine if housing and/or food insecurity may contribute to a lower likelihood of achieving these protective measures, Novick and colleagues used data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study. The study was designed to examine the impact of “race and socioeconomic status on the development of health disparities,” according to the researchers.

The cohort was made up of 1,753 individuals from “socioeconomically diverse neighborhoods,” with 49.9% considered to have social needs based on reported housing and/or food insecurity.

When looking at the entire study population, the researchers found that 76.4% met the blood pressure target of 130/80 or less; 91% had hemoglobin A1c of 7.5% or less; 39.1% reported an average 2-day salt intake of less than 2,000 mg per day; 24% had BMI of 25 kg/m2 or less; 31.8% engaged in physical activity during leisure time; and 58.3% were non-smokers.

When considering differences between individuals with and without social needs, results indicated those with social needs were less likely to achieve at least four protective measures (adjusted risk ratio [aRR] = 0.82; RRs for white and Black individuals were 0.76 and 0.87, respectively).

Further findings demonstrated that experiencing social needs was significantly associated with sodium intake (aRR = 1.22), physical activity (adjusted incidence rate ratio [adjusted IRR] = 0.72) and smoking status (adjusted IRR = 0.79).

“Our work highlights a potential mechanism between previously documented associations between housing insecurity and food insecurity and the development of kidney disease,” Novick and colleagues concluded. “Findings appear to be driven by engagement in physical activity during leisure time and smoking status, highlighting potential intervention targets. Risk reduction efforts specifically targeting kidney protective measures among populations experiencing social needs should be considered.”