Online Program

Race, Racism, and Access to Renal Transplantation

Monday, November 2, 2015 : 8:30 a.m. - 8:50 a.m.

Kimberly R. Jacob Arriola, PhD, MPH, Department of Behavioral Sciences & Health Education, Emory-Rollins School of Public Health, Atlanta, GA
Bekeela Watson, MPH, Department of Behavioral Sciences & Health Education, Emory University, Atlanta, GA
End stage renal disease (ESRD) has become increasingly prevalent in the United States.  As a result, the number of patients in need of a kidney transplant, which is the optimal therapy for many ESRD patients, also continues to increase. However, the scientific research literature documents clear and compelling disparities in access to transplant based on patient race; yet the reasons for these disparities are complex and not well elucidated.

The purpose of this presentation is to describe a newly created conceptual framework for exploring the role that racism plays in creating and perpetuating racial disparities in access to renal transplant.  We present an overview of three theorized levels of racism (Institutionalized, Personally-mediated, Internalized)1 and describe the ways in which they are manifested at each level of the social ecology (Intrapersonal, Interpersonal, Institutional, Community, and Public Policy) to propagate racial disparities in access to renal transplant.  Illustrative arguments draw from findings in the empirical research literature.  For example, the concentration of poor African Americans is a byproduct of policies and laws that were created to promote racial residential segregation; it creates communities plagued by high rates of chronic disease (including ESRD) that over time, have become characterized by a large number of dialysis centers with poor transplant rates.  Research findings demonstrate that dialysis centers in poor, Black areas tend to have lower transplant rates.2  This presentation will conclude with the identification of areas of research that are needed to further understanding the interplay of racism and renal transplantation.

Learning Areas:

Diversity and culture
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the role that racism plays in to access to renal transplant. List the steps involved in obtaining a kidney transplant. Identify the three levels of racism. Describe how the three levels of racism operate within each level of the social ecological framework.

Keyword(s): Health Disparities/Inequities, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Associate Professor in the Rollins School of Public Health of Emory University in the Department of Behavioral Sciences and Health Education (BSHE). I earned a MA in 1996 and a PhD in 1998 from Northeastern University (both in Social Psychology), and I earned an MPH in 2001 from Emory University (in Epidemiology). All of my work focuses on improving the health of marginalized populations and communities of color.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.