Abstract Body: Introduction: SDOHs are strongly associated with kidney disease and, more broadly, impairment. Studies of SDOHs and kidney impairment may further identify relationships with more severe disease, especially for cardiovascular-kidney-metabolic health. Nationally, increased socioeconomic adversity (SEA) affects kidney impairment and disease, particularly in Hispanic/Latino (HL) populations. We assessed SEA, a SDOH composite of income, education, and occupation, with kidney impairment in a US-Mexico border population.
Hypothesis: We hypothesized higher SEA was associated with increased kidney impairment prevalence.
Methods: We used cross-sectional data of 2,138 Cameron County Hispanic Cohort participants (67.4% female, ages 18-95). SEA was a composite of 3-level SDOH variables: self-reported income, education, and occupation, with the upper 50% representing higher SEA/lower SES. Kidney impairment was classified using eGFR_CR <90 ml/min/1.73m, kidney hospitalization history, or dialysis use. We included gender, age, US nativity, health insurance status, diabetes status (ADA guidelines), hypertension status (2017 AHA guidelines), CVD treatment, and having high cholesterol as potential confounders. We used a stepwise approach to build Poisson regression models.
Results: Of 2,138 participants, 1,439 (67.4%) were higher SEA and 659 (30.9%) had kidney impairment. Among high SEA individuals vs. low, 48.5% had no insurance (vs. 34.7%), the mean age was 57.4 years with SD 14.2 (vs. 50.8, SD 13.7), and 28.0% were US-born (vs. 54.7%). Also, in the high SEA group, 33.7% had kidney impairment (vs. 25.3%), 38.4% had diabetes (27.6%), 53.4% had hypertension (vs. 46.9%), 37.4% were CVD treated (vs. 26.7%), and 42.1% had high cholesterol (vs. 35.7%). Those with high SEA had 1.49 times the odds of kidney impairment (95% CI 1.22, 1.83) compared to participants with low SEA, though the association was attenuated in the adjusted model (aOR 1.16, 95% CI 0.91, 1.49). No SEA component was statistically significant for kidney impairment in a full model. Models stratified by nativity showed a 1.23 OR in US-born (95% CI 0.93, 1.63) vs OR 0.94 in non-US born (95% CI 0.68, 1.31).
Conclusions: While not statistically significant, we found a positive relationship between high SEA and kidney impairment in a HL cohort on the US-Mexico border. This is inconsistent with national findings in HL populations and suggests that there may be unique sociocultural dynamics that mitigate this relationship.