Skip to main content
Duke University Libraries
DukeSpace Scholarship by Duke Authors
  • Login
  • Ask
  • Menu
  • Login
  • Ask a Librarian
  • Search & Find
  • Using the Library
  • Research Support
  • Course Support
  • Libraries
  • About
View Item 
  •   DukeSpace
  • Duke Scholarly Works
  • Scholarly Articles
  • View Item
  •   DukeSpace
  • Duke Scholarly Works
  • Scholarly Articles
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

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

Thumbnail
View / Download
796.7 Kb
Date
2019-01-10
Authors
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
Show More
(11 total)
Repository Usage Stats
139
views
19
downloads
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), <high school diploma (OR 1.31; 1.07-1.62), absence of hypertension (OR 1.74; 1.27-2.39) or diabetes (OR 1.34; 1.09-1.65), and tobacco use (OR 1.43; 1.18-1.72) were associated with low RMC use. Low trust in providers (OR 2.16; 1.42-3.27), high stress (OR 1.41; 1.09-1.82), high daily discrimination (OR 1.30; 1.01-1.67) and low burden of lifetime discrimination (OR 1.52; 1.18-1.94), were also associated with low RMC use. CONCLUSIONS:High-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.
Type
Journal article
Subject
Chronic kidney disease
Routine care
Trust
Permalink
https://hdl.handle.net/10161/17914
Published Version (Please cite this version)
10.1186/s12882-018-1190-0
Publication Info
Diamantidis, Clarissa J; Davenport, Clemontina A; Lunyera, Joseph; Bhavsar, Nrupen; Scialla, Julia; Hall, Rasheeda; ... Boulware, L Ebony (2019). Low use of routine medical care among African Americans with high CKD risk: the Jackson Heart Study. BMC nephrology, 20(1). pp. 11. 10.1186/s12882-018-1190-0. Retrieved from https://hdl.handle.net/10161/17914.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
  • Scholarly Articles
More Info
Show full item record

Scholars@Duke

Bhavsar

Nrupen Bhavsar

Associate Professor in Medicine
I am a quantitative epidemiologist with methodological expertise in the design and analysis of observational studies that leverage data from cohort studies, registries, and the electronic health record (EHR). My background, training, and research is in the measurement and characterization of biomarkers, risk factors and treatment outcomes for chronic disease using real-world datasets. My primary research interests are in the use of novel sources of data, including the EHR, to conduct chronic
Boulware

L. Ebony Boulware

Nanaline Duke Distinguished Professor of Medicine
Dr. Boulware directs the Duke Clinical and Translational Science Institute as Vice Dean for Translational Science and Associate Vice Chancellor for Translational Research, and she is Chief of the Duke Division of General Internal Medicine in the Department of Medicine. She is a general internist, physician-scientist and clinical epidemiologist focused on improving health and h
Davenport

Tina Davenport

Biostatistician, Senior
Dr. Davenport has extensive collaborative research experience investigating factors that may explain racial disparities in health outcomes, primarily in kidney disease, but also in diabetes, hypertension cardiovascular disease, and other areas. She teaches a first-year masters level class and is passionate about teaching, mentorship, and the importance of diversity and equity in research and healthcare.
Diamantidis

Clarissa Jonas Diamantidis

Associate Professor of Medicine
Hall

Rasheeda Kamial Hall

Assistant Professor of Medicine
I am a board-certified nephrologist, and my academic career focus is geriatric nephrology. Older adults with kidney disease are one of the most vulnerable sub-populations of patients because of their high morbidity, mortality, and functional limitations and the complexity of our fragmented healthcare system. Research and clinical efforts to enhance the quality of care and quality of life of these patients is paramount. My research involves epidemiology and health services research methodologies.
Lunyera

Joseph Lunyera

Medical Instructor in the Department of Medicine
I am a clinical epidemiologist with a life-long desire to advance our understanding of etiologic mechanisms of kidney disease, and to advocate for policies that promote the highest quality care for individuals with kidney disease. Specifically, I am interested in delineating mechanisms by which exposures in the social environment perpetuate disparate adverse kidney outcomes such as chronic kidney disease and acute kidney injury.
Scialla

Julia Jarrard Scialla

Adjunct Associate Professor in the Department of Medicine
Dr. Scialla is an Associate Professor of Medicine in Nephrology at Duke University and a faculty member at the Duke Clinical Research Institute.  Dr. Scialla trained in Internal Medicine, Nephrology, and Clinical Epidemiology at the Johns Hopkins University School of Medicine and the Johns Hopkins Bloomberg School of Public Health.  Her research focuses on chronic kidney disease (CKD) epidemiology and prevention, with an emphasis on the role of metabolic complications and nutri
Tyson

Crystal Cenell Tyson

Assistant Professor of Medicine
As a board-certified nephrologist and a certified clinical hypertension specialist (ASH-SCH), I take care of patients with kidney disorders and/or high blood pressure. Patients with chronic kidney disease and high blood pressure have an increased risk for developing complications of cardiovascular disease, such as heart attacks, congestive heart failure, strokes, kidney failure requiring dialysis or a kidney transplant, and a shortened lifespan. My clinical focus is to slow the progression of
More Authors
Alphabetical list of authors with Scholars@Duke profiles.
Open Access

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy

Rights for Collection: Scholarly Articles


Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info

Make Your Work Available Here

How to Deposit

Browse

All of DukeSpaceCommunities & CollectionsAuthorsTitlesTypesBy Issue DateDepartmentsAffiliations of Duke Author(s)SubjectsBy Submit DateThis CollectionAuthorsTitlesTypesBy Issue DateDepartmentsAffiliations of Duke Author(s)SubjectsBy Submit Date

My Account

LoginRegister

Statistics

View Usage Statistics
Duke University Libraries

Contact Us

411 Chapel Drive
Durham, NC 27708
(919) 660-5870
Perkins Library Service Desk

Digital Repositories at Duke

  • Report a problem with the repositories
  • About digital repositories at Duke
  • Accessibility Policy
  • Deaccession and DMCA Takedown Policy

TwitterFacebookYouTubeFlickrInstagramBlogs

Sign Up for Our Newsletter
  • Re-use & Attribution / Privacy
  • Harmful Language Statement
  • Support the Libraries
Duke University