Following a healthy lifestyle is challenging for many people but can be nearly impossible in some communities. Certain people live, work, and/or learn in under-resourced areas that do not provide access to the basic needs that support a healthy lifestyle or treat a chronic illness. 

These environmental and social factors, also known as social determinants of health, when negative, lead to a higher risk of developing chronic kidney disease (CKD) and greater difficulty managing it successfully. Learn more about the key SDoH associated with poor health and CKD.* 

What exactly are social determinants of health? 

According to the U.S. Department of Health and Human Services, social determinants of health (SDoH) are the conditions in environments where people live, learn, work, play, worship, and age that affect a wide range of health and quality of life outcomes and risks. SDoH have been broken into multiple categories that include:

• Community and social context (support systems, community engagement, discrimination, stress)
• Economic stability (employment opportunities, income, expenses, medical bills)
• Education (literacy, language, higher education, early childhood education)
• Food (access to healthy options, hunger)
• Healthcare systems (access to health care, health coverage, quality of care)
• Neighborhood and physical environment (housing, transportation, walkability, safety, parks, and other green spaces) 

Which SDoH contributes most to poor health and CKD? 

Understanding the key SDoH leading to poor health is crucial to improving the circumstances for people living in conditions that don’t support vibrant health. Food insecurity, housing instability, unreliable transportation, safety fears, and inadequate access to utilities are among the key social and environmental factors driving poor health and increasing the prevalence of CKD. 

Moreover, many patients in areas with few healthcare resources often don’t discover they have CKD until the disease is advanced and life-threatening, and distance from transplant centers and supportive services factors into who is most likely to receive an available organ. Transplantable organs are in short supply as it is; someone who is not set up for a successful transplant is unlikely to make it to the top of the list.

Who is being affected most?

A disproportionate number of minorities face disparities and inequities in healthcare. Black/African Americans, Hispanic/Latinx Americans, and Indigenous Americans are at higher risk for developing kidney failure related to inadequate resources in their geographic and social environments. 

What can we do to improve SDoH? 

Eliminating health inequities requires multiple approaches and ongoing commitment and collaboration from all community stakeholders—patients, advocates, politicians, public health officials and workers, law enforcement, educators, nonprofits, and local businesses. 

*Social Determinants of Kidney Disease. (2022, April 6). National Kidney Foundation. https://www.kidney.org/atoz/content/kidneydiscauses