0
0
A recent study published in JAMA Internal Medicine has shed light on concerning racial disparities in access to live donor kidney transplantation (LDKT), revealing lower access rates for Black candidates, particularly those residing in high-segregation neighborhoods.
Led by Yiting Li, MPH, from the Department of Surgery at the New York University Grossman School of Medicine, the study analyzed data from 162,587 adults who underwent LDKT between January 1995 and December 2021 at 214 transplant centers across the United States. The researchers focused on the association between segregation levels in residential neighborhoods and transplant center neighborhoods and access to LDKT.
The findings unveiled stark disparities, with Black candidates in high-segregation neighborhoods experiencing a 10% lower access rate to LDKT compared to their counterparts in low-segregation neighborhoods. Notably, no such difference was observed for White candidates.
Moreover, both Black and White candidates listed at transplant centers situated in high-segregation neighborhoods faced reduced access to LDKT compared to those listed at centers in low-segregation neighborhoods. Access to LDKT was particularly compromised for candidates residing in predominantly minority high-segregation neighborhoods, with a 46% lower access rate compared to those in predominantly White high-segregation neighborhoods.
The study underscores the critical role of segregation in perpetuating racial disparities in healthcare access, particularly in the context of organ transplantation. “Segregation at the residential and transplant center neighborhoods may be a key mechanism driving racial inequalities,” the authors noted, emphasizing the need for targeted interventions at both community and healthcare levels to address these disparities.
However, the study also acknowledged limitations, including the use of zip codes as proxies for neighborhoods, potential misclassification of race and ethnicity data, and the inability to capture the multidimensional aspects of structural racism.
Despite these limitations, the study’s findings underscore the urgent need to address systemic barriers that hinder equitable access to life-saving treatments such as LDKT. Recognizing the multifaceted nature of racial disparities in healthcare, concerted efforts are needed to dismantle structural inequalities and ensure equitable access to transplantation for all individuals, regardless of race or neighborhood segregation.
The study was supported by grants from the National Institute on Aging, the National Institute of Diabetes and Digestive and Kidney Diseases, and the National Institute of Allergy and Infectious Diseases, highlighting the importance of continued research and investment in addressing healthcare disparities.
