Division of Nephrology, Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin.
Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, Texas.
Am J Kidney Dis. 2024 Jul;84(1):111-119. doi: 10.1053/j.ajkd.2024.01.521. Epub 2024 Mar 6.
Kidney disease disproportionately impacts people with low socioeconomic status, and low socioeconomic status is associated with worse outcomes for people with kidney disease. Unstable housing, which includes housing insecurity and homelessness, is increasing due to rising housing costs. There is mounting evidence that unstable housing and other health-related social needs are partially driving worse outcomes for people with low socioeconomic status. In this perspective, we consider the challenges to addressing housing for people with kidney disease, such as difficulty with identification of those with unstable housing, strict eligibility criteria for housing support, inadequate supply of affordable housing, and flaws in communities' prioritization of affordable housing. We discuss ways to tailor management for people experiencing unstable housing with kidney disease, and the importance of addressing safety, trauma, and emotional concerns as a part of care. We identify opportunities for the nephrology community to surmount challenges through increased screening, investment in workforce dedicated to community resource navigation, advocacy for investment in affordable housing, restructuring of communities' prioritization of affordable housing, and conducting needed research. Identifying and addressing housing needs among people with kidney disease is critical to eliminating kidney health disparities.
肾脏病在社会经济地位较低的人群中发病率不成比例,而社会经济地位较低与肾脏病患者的预后较差有关。由于住房成本上升,住房不稳定(包括住房无保障和无家可归)的情况正在增加。越来越多的证据表明,住房不稳定和其他与健康相关的社会需求是导致社会经济地位较低的人群预后较差的部分原因。在这篇观点文章中,我们考虑了为肾脏病患者提供住房所面临的挑战,例如难以确定住房不稳定的患者,住房支持的严格资格标准,经济适用房供应不足,以及社区在优先考虑经济适用房方面的缺陷。我们讨论了针对患有肾脏病且住房不稳定的患者进行管理的方法,以及将安全、创伤和情绪问题作为护理的一部分来解决的重要性。我们确定了肾脏病社区通过增加筛查、投资专门从事社区资源导航的劳动力、倡导投资经济适用房、调整社区对经济适用房的优先排序以及开展必要的研究来克服挑战的机会。确定和解决肾脏病患者的住房需求对于消除肾脏健康差距至关重要。