Inner-City Nephrology

"Suboptimalhealth of inner-city blacks, hispanics, and otherminority populations in the U.S. is attributed to multivariate causes includinginadequate access to good medical care, racial discrimination, alienation from the healthcare system as well as underutilization of medical care by those with health insurance. However, an overlooked variable is thathealthcare providers in the inner-city overwhelmed by stresses of patient care, may be unaware of major unique issues and recentfindings specific to inner-city health care that may affect the outcome andwell-being of patients under their care.Theincreased susceptibility of minorities to kidney failure has not been fullyexplained and probably represents a complex interplay of genetic, cultural, andenvironmental influences. While the U.S. population is about 13% African-American, 35% ofthose on dialysis are African-American. African-Americans tend to have kidneyfailure earlier, and it tends to be associated with declining socioeconomicstatus.Accordingto our analysis and program review over the past decade, issues specific toinner-city nephrology are minimally - if at all - addressed in-depth atnational and international nephrology meetings or in any of the standardnephrology textbooks. Accordingly, thisbook intends to confront these admittedly difficult issues in a manner designedto construct strategies for improving outcomes in nephrology care amonginner-city residents."