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Introduction
The following essay is about the end stage renal disease prevalence among the elderly African American patients. The essay discusses the implications of the research on policies that may affect organisation.
The Population
The population targeted by this research is the elderly African American patients who suffer from the End Stage Renal Disease. There are more than five hundred thousand people working in the United States suffering from this condition where one third of the population is African Americans (United States Renal Data System, 2006).
Statistics have shown that the relative rate of End Stage Renal Disease is 3.6 times higher for the African Americans compared to the white population (United States Renal Data System, 2006).
This data is imperative as it signifies the need to address the problem of end stage renal disease among the elderly African Americans suffering from this condition who have limited access to medical facilities (Koresh, 2007).
Behavioural Dimensions of the Disease
The End Stage Renal Disease involves failure of kidney’s ability to filter waste and fluids from the blood in the body (Jamerson, 2005).
Several causes of the disease are suggested where the first one is diabetes, which is caused by high level of sugar in the blood, a condition that leads to renal failure. High sugar intake resulting to diabetes is an etymology of the disease (Crook, 1999).
The end stage renal disease manifests through acute headache, prolonged thirst, reduced or no urine. It also includes slowed body growth in children and bone damage among adults. Its symptoms include fatigue, lethargy and general body weakness (Crook 2002).
Psychosocial Dimension of ESRD
This psychosocial aspect refers to the nature of the disease as well as other persons who are affected. It relates to the care and nursing attributes, which either inhibit the disease or accelerate the individual’s kidney condition such that it reaches stage five (Wilson, 1987).
The psychosocial factor may involve lack of care or medical follow up. Among the African American patients who do not have nephrologists, family members assist them with dialysis and in monitoring the progress to improve the condition. This support is common in the African American community than in the white community and provides emotional as well as social support that is required for survival (Massey, 2004).
The sense of community is more prevalent in the African American society compared to the whites. Since kidney failure is traumatic, most of the patients suffer psychologically and it may increase mortality rate if they do not receive social support. The dialysis reduces social interaction and movement of the patient. Therefore, without social support the patient is likely to experience posttraumatic stress disorders such as nightmares and sleeping disturbances (Levy, 1983).
Environmental Dimension
Individuals who live alone are at higher exposure of mortality because social support may be lacking despite the fact that it is necessary for people suffering from End Stage Renal Disease (Robert, 1998). This may explain why the whites have high mortality rates especially the elderly people who live alone with no one to care for them.
The African Americans live in crowded environments with their friends. Therefore, the elderly African Americans may survive the condition longer because they overcome the stress, have social support and live in secure areas unlike the younger population exposed to stress (Robert, 1998).
Prevention Programs Implemented In The Past
There are various measures adopted to prevent the disease and ensure the survival of patients. The first one is dialysis, which involves artificial cleaning of the blood system using the dialysis machine (Wilson, 1987).
The other treatment is the kidney transplant where the individual may receive kidney from a healthy donor to replace the malfunctioning one (Crook 2002).
Individuals with proteinuria should pursue aggressive treatment with drugs, which slows down the deterioration of kidney function. There are risk factors that are hereditary, and depend on the family history (Crook, 1999).
Public Health Policy Implications
Public health implications involve the development of insurance policies to cater for the African Americans population so that they can afford dialysis Policies to incorporate the social support groups as part of the medication procedure will assist in the treatment of those suffering from this condition (Krieger, 2003).
Conclusion
The government of the United States needs to assist the African Americans population with medication to prolong life. The non-black population on the other hand can learn to control cardiovascular diseases and eventually conquer ESRD through social support networks.
Annotated Bibliography
Crook, E. (1999). The role of hypertension, obesity, and diabetes in causing renal vascular disease. American Journal of Medical Science, 3, 183-188.
Eroll Crook is a nephrologists and a professor in the University of South Alabama where he is the director of the centre for healthy communities. This article investigates the etiological factors that lead to the end stage renal disease. It investigates the role of sugars and sugar related diseases in causing kidney failure by sampling data on individuals suffering from ESRD and their sugar levels. The author discusses observation results after monitoring hypertension, obesity, diabetes, and renal vascular disease.
Crook, E. (2002). Diabetic renal disease in African Americans. American Journal of Medical Science, 2, 78-84.
Eroll Crook is a nephrologists and a professor at the University of South Alabama where he is the director of the centre for healthy communities. Eroll Crook in this article discusses factors that lead to renal diseases among African Americans. The article discusses diabetes as a major factor that exposes an individual to the risk of kidney failure. It discusses the manifestation of chronic kidney disease and its symptoms as its progresses to End Stage Renal Disease.
Jamerson, K. (2005). Preventing chronic kidney disease in special populations. American Journal of Hypertension, 8, 106-111.
Kenneth Allan Jamerson is a professor in the department of internal medicine specialising in cardiology in the University of Michigan. He has investigated the hypertension assessments among the African Americans population in the United States and the link between hypertension and kidney failure as well as cardiovascular diseases. Jamerson looks at the factors that lead to renal disease among the African Americans population and how to reduce mortality rates resulting from kidney failure.
Koresh, J. (2007). Prevalence of chronic kidney disease in the United States. Journal of American Medical Association, 7, 2038-2047.
Joseph Koresh is a Professor and the director of Cardiovascular Epidemiology & Comstock Centre in the University Of John Hopkins School Of Public Health. He has written on cardiovascular disease, which is his area of specialisation. This article investigates the occurrence of chronic kidney disease and ESRD among the American population and explains why there are lower mortality rates among the elderly African American dialysis patients. The author presents data of the number of patients who die from End Stage Renal Disease.
Krieger, N. (2003). Does racism harm health? On explicit questions, critical science, and current controversies: an eco-social perspective. American Journal of Public Health, 2, 194-199.
Nancy Krieger is the professor of Public health in the University of Harvard, she has written extensively regarding appropriate policy measures to safeguard and assist minorities suffering from kidney disease or undergoing dialysis treatment. The article discusses variety of public measures for adoption by the patients especially in terms medication and assisting the patients with social support.
Levy, N. (1983). Psychological problems in kidney failure and their treatment. New York: Plenum Medical Book Company.
Kenneth N. Levy is an associate professor in the City University of New York where he teaches psychology. He is a specialist in clinical psychology where he investigates the outcomes of psychotherapy among patients suffering from chronic illnesses. This book discusses the psychological problems that arise because of kidney failure and the reasons why social support is imperative as part of the treatment.
Massey, D. (2004). Segregation and stratification. Du Bois Review, 1, 7-25.
Douglas Massey is a renowned American sociologist. He is currently a professor at Woodrow Wilson School of public and international affairs at Princeton University. He served as a chairperson of the American sociological society in the past. He has written on residential segregation in the United States and its effect on the society to both the African Americans and the whites.
Robert, S. (1998). Community-level socioeconomic status effects on adult health. Journal of Health Social Behaviour, 1, 18-37.
Stephanie A. Robert is the professor in the institute of social work in the University of Wisconsin- Madison. She has written about health issues in minority populations. In this article, she examines how the African Americans population suffering from chronic illnesses develop social support networks. She presents case studies of patients who have recovered because of support from the immediate society.
United States Renal Data System, USRDS (2006). Annual data report: Atlas of end-stage renal disease in the United States. New York: National Institute of Diabetes and Digestive and Kidney Diseases.
This is data on prevalence of end stage renal disease in the United States. It shows the distribution of the disease across the racial ethnic groups in the United States. This study helps to understand why the elderly African American patients have lower mortality rates than the white counterparts. This study also establishes whether the racial differences in nutrition, inflammation, biological and sociological factors have any effect on this disparity.
Wilson, W. (1987). The truly disadvantaged: The inner city, the underclass, and public policy. Chicago: University of Chicago Press.
William Julius Wilson a professor at the Harvard University has written on sociological issues. He is formerly a chairperson of the American Sociological Association. This book explores the disadvantages of the African American population and the social economic challenges of the old people. It specifically discusses the challenges that African Americans suffering from chronic diseases undergo through such as lack of medication and insurance policies to cater for their dialysis.
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