Salvatore Viscomi MD, CEO and cofounder of Carna Health, is an entrepreneur with a passion for digital health.
Chronic kidney disease (CKD) is increasingly recognized as a major global health issue, and disparities in healthcare access play a critical role in this crisis. These disparities, deeply rooted in social and economic inequities, lead to significant differences in CKD prevalence and outcomes across various populations globally.
Integrating affordable and accessible digital health technologies can significantly improve CKD outcomes, especially in middle to lower-income countries with limited resources and increased healthcare inequities.
Addressing Healthcare Disparities In CKD
In many countries, including the U.S., CKD disproportionately affects marginalized communities.
For instance, Black and Hispanic populations are more likely to suffer from CKD. This increased risk is largely due to the higher prevalence of diabetes and hypertension—key risk factors for CKD—within these groups. Limited access to nutritious food and healthcare services can further exacerbate these conditions, leading to higher CKD rates and more severe disease stages by the time it is diagnosed.
The socioeconomic barriers faced by these communities include restricted access to preventive care, which impedes early detection and management of CKD. As a result, many individuals are diagnosed at more advanced stages of the disease, making treatment more challenging and costly.
Worldwide, CKD affects approximately 850 million people. While the global burden of CKD continues to rise in nearly every country, some are disproportionately impacted largely in part due to inequities in healthcare access and increased risk factors. For example, in the general population of Cameroon, about one in ten adults were identified with advanced disease (stage three to give). Findings from my company’s recent pilot study in Cameroon also showed that while CKD is common in older adults, the burden of CKD is also increasingly impacting younger patients.
Gender Disparities In CKD Care
Gender also significantly influences healthcare disparities related to CKD. In lower and middle-income countries, women often face additional challenges in managing chronic illnesses.
As primary caregivers for their families, they may struggle to seek and receive adequate medical care. Furthermore, women typically experience longer wait times and have reduced access to dialysis services compared to men, which exacerbates existing gender inequities in healthcare access.
Sex and gender also affect the causes of CKD, the prevalence of comorbidities and the progression of the disease. These differences arise from a complex interplay of biological, social and systemic factors. For instance, women are 29% more likely to develop CKD than men, yet men have a higher mortality rate from the disease.
Notably, despite facing a greater risk of death, men are 47% more likely to access dialysis or receive a kidney transplant. Understanding these intricate dynamics of age, sex and gender is crucial for developing effective health system responses to address these disparities.
Digital Health Solutions For Reducing Disparities
Addressing healthcare disparities requires innovative solutions that move beyond traditional systems, which often involve expensive procedures that can be significant barriers for many individuals.
Advanced technologies present promising alternatives for improving healthcare delivery. For instance, rapid screening tools enable quick assessments of kidney function in community settings, facilitating the early identification of CKD.
Deploying advanced digital health screening technologies in underserved regions could significantly enhance the early detection and management of CKD through several key features:
• Educational components can empower patients with knowledge about their conditions and available care options.
• Interaction modules can improve communication between physicians and patients, fostering better engagement in the care process.
• Reporting features can assist governments in allocating resources more effectively based on regional needs, ultimately enhancing health outcomes across diverse communities.
By identifying CKD earlier, healthcare providers can offer interventions that may alter the disease’s trajectory and significantly improve patient outcomes. Research shows that these technologies are effective in detecting and treating CKD.
However, methods for early identification vary globally, leading to significant differences in reported prevalence. Standardizing measurement techniques for early detection, particularly for high-risk populations, is essential. Ensuring access to appropriate interventions for those diagnosed will enhance program effectiveness and patient outcomes.
Overcoming Barriers To Technology Adoption In CKD Care
While point-of-care screening and advanced technologies hold great promise for enhancing early detection and management of CKD, several barriers prevent these innovations from reaching their full potential.
One major challenge is funding, particularly in underserved communities where there are limited resources and budget constraints, making it difficult to invest in new technologies. Without adequate funding, these communities cannot acquire the necessary equipment and training for staff, hindering implementation.
In addition to financial limitations, the lack of in-house technical expertise poses a significant obstacle. Advanced technologies, particularly AI-driven diagnostic tools, require specialized knowledge for effective operation. Hospitals may not have personnel with the necessary training, creating a gap that can delay adoption.
Patient trust is another critical factor. Many individuals may be hesitant to embrace new technologies, particularly AI, due to concerns about privacy, data security and reliability. Education is essential—not only for patients but also for healthcare providers.
Collaboration among governments, healthcare providers and technology developers will be vital for ensuring that these solutions reach those most in need. By promoting equitable access to healthcare and integrating innovative technologies into community settings, we can make significant strides in closing the care gap.
Initiatives that encourage shared resources, training and community outreach can facilitate smoother transitions to new technologies. Additionally, raising awareness about the importance of early CKD detection with advanced screening tools can help build patient trust.
Conclusion
While POC screening and advanced technologies can significantly improve CKD management, challenges related to funding, expertise, patient trust and education must be addressed.
By focusing on these strategies and collaborating across sectors, we can mitigate the impact of CKD and improve health outcomes for all populations, regardless of socioeconomic status or geographic location. It is crucial to address both systemic factors contributing to CKD and ensure that every individual has the necessary resources and care to manage and prevent this chronic disease effectively.
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