#NephMadness 2022: Whom Do You See When You See Me? Please, My Humanity Over My Race

Submit your picks! | NephMadness 2022 | #NephMadness | #Inequities

Patrick Gee @PGee51

Patrick Gee, PhD, is a former PD and in-center Hemodialysis patient and current kidney transplant recipient. He is also the Founder and CEHD of iAdvocate, Inc., a faith-based health & wellness organization that focuses on health and social inequities within marginalized communities of color.

Competitors for the Inequities Region

Governmental Policies vs Institutional Initiatives

Environmental Determinants of Health vs Social Determinants of Health

Every morning when I get dressed for the day, I take an inventory of the scars I have endured from various afflictions. Some of my scars are from medical procedures, and others are from being an active child. I also have open wounds that most people have not seen, nor has the medical community addressed to my satisfaction. These are the wounds of racial discrimination, lack of access to adequate medical care, and institutional biases against African Americans.

When you consider the term “race,” it is more social than biological. According to Hasan Jeffries, Associate Professor in the Department of History at the Ohio State University, “This idea of race, it just simply isn’t real. It is not real in the biological sense.” So, if we know that race is a social construct, why is it so prevalent when considering the significant impact race plays in the social determinants of health? Some people of color are still bound in a free society because of limited humanitarian treatment for all. In 1948, the United Nations created the Universal Declaration of Human Rights, which detailed the 30 fundamental human and civil rights applicable to all humans beings. Yet, 74 years later, all humans are not treated equally.

As a person of African descent, I grew up in an impoverished, low-income community. My community did not have access to health literacy, healthy food options, housing safety, vocational training, or early childhood educational opportunities. I imagine that I would have received health literacy on type 2 diabetes, chronic kidney disease, and hypertension if I had lived in a better community. If I did not live in food apartheid, my nutritional lifestyle would have helped me stave off type 2 diabetes. Yet, after moving out of that environment, there are still others who face worsening conditions.

IT IS MIND-BOGGLING when I think about kidney disease and how social determinants of health affect kidney health.

Social determinants of health: key domains. Based on information available from the Healthy People 2020 initiative. Figure 2 from Hall, AJKD, © National Kidney Foundation.

The social determinants of health have a significant influence on health inequities – the unfair and avoidable differences in health status seen within and between countries. Health and illness follow a social gradient in countries at all income levels: the lower the socioeconomic position, the worse the health.” – WHO

How does the statement above from the World Health Organization impact African Americans living with chronic kidney disease?

From the Inequities Region:

Disparities in kidney outcomes and access to care—including pre-dialysis care, dialysis, and transplantation—exist around the world. In the United States, Black and Latinx/Hispanic people are 3.4 and 1.3 times more likely to develop end stage kidney disease (ESKD), respectively. Racial minorities are less likely to have a timely pre-dialysis nephrology referral, have an arteriovenous fistula for vascular access, or be treated with home hemodialysis (HD) or peritoneal dialysis (PD). Black patients are less likely to be referred for transplant evaluation, have longer wait list times, and are less likely to receive a pre-emptive transplant or living donor kidney transplant. These outcomes are a few of the many examples illustrating the complex interplay of biology and social conditions that leads to disparities in kidney health.  

Fundamental influences on health (on the basis of Warnecke et al. Figure 1 from Boulware and Mohottige, CJASN, © American Society of Nephrology. Reproduced with permission.

Kidney disease results from the complex interplay between biological and socio-environmental factors. Many things are needed to fix the inequities in kidney health. However, as a person of color living with chronic kidney disease, I would like to offer where we can create a dialogue for change.

What if we all began to think like properly functioning kidney functions?

“Our kidneys remove waste and extra fluid from our bodies. They also remove acid produced by the cells of your body and maintain a healthy balance of water, salts, and minerals – such as sodium, calcium, phosphorous, and potassium – in your blood.” –NIDDK

Like the kidney, why don’t we remove all the wasteful and toxic rhetoric surrounding race that has plagued this world since biblical days and create a healthy dialogue regarding cultural competencies? By doing so, we can embrace the importance of seeing those most impacted by these disparities as more than a race of people from marginalized communities. For us at iAdvocate, this means viewing everyone as an image-bearer of our Creator and not as a social construct.

– Guest Post written by Patrick Gee @PGee51

As with all content on the AJKD Blog, the opinions expressed are those of the author of each post, and are not necessarily shared or endorsed by the AJKD Blog, AJKD, the National Kidney Foundation, Elsevier, or any other entity unless explicitly stated.

Click to read the full Inequities Region

Submit your picks! | #NephMadness | @NephMadness | #Inequities

1 Comment on #NephMadness 2022: Whom Do You See When You See Me? Please, My Humanity Over My Race

  1. Katherine R. Tuttle // March 18, 2022 at 3:11 pm // Reply

    Many thanks, Dr. Patrick Gee, for your strong voice of enlightenment! Change begins with knowledge and recognition. Your light shines bright!

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