Are county codes more indicative of kidney health than genetic codes? [Editorial]

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Stanifer, John W., and Yoshio N. Hall. “Are county codes more indicative of kidney health than genetic codes? [Editorial]” AJKD [American Journal of Kidney Diseases], vol. 72, no. 1, July 2018, pp. 4-6.


In this editorial, Stanifer and Hall discuss a county-level data approach to studying and responding to the incidence of end-stage renal disease (ESRD) in the United States. They focus on Robeson County, North Carolina, which is the poorest county in the state, “ranks last in nearly every metric of health in the state,” and has incidence rates of ESRD among the highest in the nation (p. 4).

They explain that they have “used a systems science approach that leverages an extensive network of collaborators and stakeholders” (including nephrologists, local medical providers, nonprofit organizations, and community leaders) to help them further understand and begin to address the high incidence of ESRD in Robeson County (p. 5).

The authors issue a strong call for “reforms that aim to reduce marked inequities in social determinants such as income, housing, education, and health coverage,” which will potentially have the most impact on promoting health equity in nephrology.

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