Date of Conferral

2023

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Harrison Ndetan

Abstract

AbstractChronic kidney disease (CKD) is one of the significant health conditions that cause high morbidity and mortality in the United States. Although African Americans (AA) are only 12.9% of the population, they disproportionately suffer 25.1% of deaths due to CKD. It was not obvious how factors such as education and unemployment further complicate the condition. Thus, this quantitative study aimed to examine the association between CKD and educational level, unemployment, and race when controlling for gender and underlying health conditions such as hypertension, obesity, and diabetes, which tend to exacerbate renal insufficiency. The study was based on the socio-ecological model, which clarifies how individual lifestyles, interpersonal connections, and community-based, and enabling environmental programs can promote kidney health. A secondary data analysis was performed using combined data from the 2016-2021 Behavior Risk Factor Surveillance System, applying the multi-variable logistic regression model. While controlling for gender, hypertension, obesity, and diabetes, race was not associated with CKD (p=0.25), among AA, there was a statistically significant association between levels of education/ unemployment and CKD such that those who graduated high school were more than twice as likely to report having CKD compared to those who did not (AOR=2.44, 95% CI=1.00, 5.92, p=0.049), as well as the unemployed as compared to their employed counterparts (AOR=2.83, 95% CI=1.84, 4.35, p=<0.001). The favorable social change implication is that while the findings of this study highlight the need for further studies to help close the gap in the literature concerning factors that may exacerbate CKD among AA, public health professionals need to design initiatives to help address unemployment and promote kidney health in the AA community.

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