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Seeking justice, equity, diversity and inclusion in pediatric nephrology
Patricia Seo-Mayer1, Isa Ashoor2, Nicole Hayde3
1Division of Pediatric Nephrology, Inova Children's Hospital, University of Virginia School of Medicine-Inova Campus, Fairfax, VA, United States.
Insights
Social determinants of health, including racism and inequity, significantly affect children with kidney disease. Addressing these issues is crucial for improving pediatric nephrology care and outcomes.
Area of Science:
- Pediatric Nephrology
- Health Equity
- Social Determinants of Health
Background:
- Health care disparities, inequity, and racism negatively impact children with kidney disease.
- Systemic biases affect chronic kidney disease care and transplant outcomes.
- The pediatric nephrology workforce lacks diversity.
Purpose of the Study:
- Define social determinants of health and their impact on pediatric nephrology.
- Outline the effects of racism on chronic kidney disease and transplant outcomes.
- Critique the diversity within the pediatric nephrology workforce.
- Propose strategies to dismantle bias, improve care access, and enhance workforce diversity.
Main Methods:
- Literature review on social determinants of health in pediatric nephrology.
- Analysis of systemic biases and racism in chronic kidney disease care.
- Assessment of diversity metrics in the pediatric nephrology workforce.
- Development of actionable strategies for inclusivity.
Main Results:
- Social determinants of health significantly influence pediatric kidney disease care.
- Racism and bias are linked to poorer chronic kidney disease and transplant outcomes.
- The pediatric nephrology field faces challenges in workforce diversity.
- Specific strategies are needed to address bias and improve inclusivity.
Conclusions:
- Acknowledging historical and current limitations is key to progress.
- Implementing strategies to combat racism and bias is essential.
- Cultivating inclusive training and practice environments is a primary goal.
- Dismantling bias will improve care for children with kidney disease.
Abstract:
Inequity, racism, and health care disparities negatively impact the well-being of children with kidney disease. This review defines social determinants of health and describes how they impact pediatric nephrology care; outlines the specific impact of systemic biases and racism on chronic kidney disease care and transplant outcomes; characterizes and critiques the diversity of the current pediatric nephrology workforce; and aims to provide strategies to acknowledge and dismantle bias, address barriers to care, improve diversity in recruitment, and strengthen the pediatric nephrology community. By recognizing historical and current realities and limitations, we can move forward with strategies to address racism and bias in our field and clinical practices, thereby cultivating inclusive training and practice environments.
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