Race, socioeconomic status, and risk of a catastrophic health condition in later life

Abstract

Socioeconomic status (SES) is a fundamental social cause of disease. The association of SES with chronic renal failure has received limited study. Older persons and blacks are at significantly increased risk for this health condition, which is also known as end-stage renal disease (ESRD). Among ESRD cases and controls aged 56-88, we investigated whether SES was predictive of ESRD, independent of subjects' race, sex, age, and history of diabetes. Our SES measure combined information about individuals' education and occupation. In race-specific logistic regression models, there was a trend for higher SES to be protective against ESRD. In a combined model, controlling for the effects of race, sex, age, and diabetes, the SES effect was statistically significant. Diabetes and hypertension, important ESRD risk factors, are also related to SES. The adverse “effect” of black race on a health outcome like ESRD may be expressed preferentially among economically disadvantaged persons. Improved understanding of race, SES, and age vis-à-vis a chronic condition such as ESRD requires studies in which cohort changes in health, resources, access to care, and service utilization are monitored longitudinally and analyzed using a life course perspective.

Citation

Kutner, N.G. and Brogan, D. (2000), "Race, socioeconomic status, and risk of a catastrophic health condition in later life", Jacobs Kronenfeld, J. (Ed.) Health, Illness, and use of Care: The Impact of Social Factors (Research in the Sociology of Health Care, Vol. 18), Emerald Group Publishing Limited, Leeds, pp. 151-165. https://doi.org/10.1016/S0275-4959(00)80026-5