SDOH and kidney disease

Posted on Wednesday, March 24, 2021

What puts someone at risk for Chronic Kidney Disease (CKD)?

  • Having diabetes or heart disease? Check.
  • Being 60 years of age or older? Check.
  • Being obese? Check.

But did you know that not having a car may also be a factor in one’s risk for developing CKD? And that how far someone lives from a full-service grocery store is too? They’re just a few of the conditions related to where someone is born, grows up, and lives that impact a person’s health. They’re called Social Determinants of Health (SDOH) and they underly many of our nation’s most serious health care issues.

How do these determinants impact people with CKD? Just three examples illustrate only part of the problem.

Food insecurity – When someone doesn’t have regular access to nutritious food it’s called “food insecurity,” and it’s a key SDOH. In fact, a 2017 U.S. Department of Agriculture study estimated that 40 million Americans lacked regular access to affordable, nutritious food. People face food insecurity for many reasons, particularly lack of money to purchase food and lack of transportation to access food.

Ironically, one study by America’s Health Insurance Plans (AHIP) reports that food insecurity also leads to increased health care costs for those who can least afford it. The study shows that food insecure households spend 45 percent more on medical care than people in food-secure households.

Without enough nutritious food, managing a chronic illnesses is difficult. That’s particularly true for CKD patients who should eat a carefully balanced diet of fresh foods, lean proteins, and certain vitamins and minerals to reduce stress on their kidneys.

Employment – A steady job with a decent wage is the foundation for having shelter, food, safety, access to services, and more. If someone living with CKD is on a tight budget due to lack of employment or underemployment, food insecurity is a big concern -- but so is health care. Without access to regular health care, it’s difficult to get an accurate, early diagnosis of the condition and afford the regular monitoring and prescriptions that help keep CKD in check.

Geography – Many people live in “food deserts” with few, if any, grocery stores selling fresh foods. Without reliable transportation – owning a car or having access to mass transit services – people living in food deserts must shop for their food at the many convenience stores and fast-food restaurants that tend to populate these neighborhoods. While these establishments may be easy to access, most of the options they offer – highly processed foods and sugary drinks – are poor nutritional choices for people with CKD and other complications including diabetes and heart disease.

There are other Social Determinants of Health that impact the vulnerable and chronically ill including equity issues, education, community, and more. Fortunately, efforts are underway at the state and federal level to address them and improve access to food and health care services for all Americans affected by SDOH.

Mom’s Meals helps overcome some of these challenges and helps people living with CKD manage their chronic illness by delivering renal-friendly, nutritionally tailored meals right to their doorsteps.

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