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Why so many dialysis centers in Black neighborhoods?

Congressman Rush wants calls on health officials to examine impact on poor populations


U.S. Representatives Bobby L. Rush (D-Ill.) and Katie Porter (D-Cal.) sent a letter to Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, calling on the Administration to consider the impact of both current and future policies on vulnerable populations receiving dialysis treatment.

Representatives Rush and Porter are particularly concerned with the rapid explosion of dialysis centers in poorer, largely minority, communities.

It is currently unknown why more individuals in low-income neighborhoods have kidney disease.

Researchers have pointed to access to health care, environmental toxin exposures more commonly found in higher poverty areas, and individual lifestyle factors as possible contributing factors. Since more patients in low-income areas have kidney disease, it comes as no surprise that they receive more dialysis treatment, but the numbers of low-income and minority individuals receiving dialysis treatment for end-stage renal disease (ESRD) are still striking.

The percentage of adults beginning dialysis for ESRD who live in zip codes with high poverty rates continues to increase. According to a study completed by the Loyola University Chicago Stritch School of Medicine, this percentage rose from 27.4 percent to 34 percent between 1995 and 2010 (an increase of 6.6 percentage points). At the same time, the general population saw an increase from 11 percent to 12.5 percent (an increase of 1.5 percentage points).

“Kidney disease is a terrible illness and I am grateful that many of my constituents are able to rely on dialysis centers in their time of need. However, I am still deeply troubled that members of certain communities, particularly poorer, minority communities, find themselves suffering from kidney diseases at higher rates and are more likely to be referred to dialysis treatment instead of pre-dialysis kidney care when compared to their richer, white counterparts.

“In the poorer parts of our Districts, it sometimes seems that there is a dialysis center on every corner, and the current data appears to back up that observation. Therefore, we must continue to study the relationship between those receiving dialysis and their zip code and stand vigilant against predatory practices affecting the most vulnerable in our communities.

“It is critically important that we understand the factors affecting those receiving dialysis treatments, as well as the barriers that prevent individuals from receiving pre-dialysis kidney care and other forms of life saving preventative medicine.” said Congressman Rush.

“Corporate greed should never be allowed to outweigh patient wellbeing,” Congresswoman Porter said. “I’m concerned that dialysis providers are engaging in predatory practices targeting the most vulnerable in our communities, instead of focusing on providing top-notch care to those who need treatment. The science is clear that we should endeavor to increase preventive and alternative treatments when and where possible, and I’m happy to work with Congressman Rush and the Administration on this important issue.

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