Embedded Bias Series: The Fight Against Racial Disparities in Kidney Care
The battle against racial disparities in kidney care continues in Brooklyn, where One Brooklyn Health, a safety net hospital system, is at the forefront of efforts to remove race from calculations that assess kidney disease. Serving a predominantly Black population insured by Medicaid or Medicare, the hospital system faces the harsh realities of disparities that plague American kidney care.
Despite early adoption of eliminating race from kidney function estimation equations, the day-to-day challenges at One Brooklyn Health paint a grim picture of the deep-seated social problems, scarce resources, and severely ill patients that hinder progress. The new algorithms have significantly increased the number of potential kidney patients, creating a daunting task for healthcare providers.
Chronic kidney disease is rampant in Central Brooklyn, affecting one in four people, yet many patients do not seek care until it is too late. The hospital struggles to reach those in need, treating fewer than 2,000 patients for kidney disease out of an estimated 350,000 who could benefit from care. The stark reality of missed opportunities for preventive care and late-stage diagnoses underscores the limited impact of changing clinical algorithms alone.
Despite these challenges, One Brooklyn Health remains committed to improving outcomes for its patients. A new partnership with NYU Langone Transplant Institute aims to make transplant services more accessible for the hospital system’s sickest patients and provide aggressive treatment for all kidney disease patients. Additionally, a new diabetes center offers state-of-the-art technologies to prevent the onset of kidney disease and improve patient outcomes.
Nephrologists like Gilda-Ray Grell are dedicated to inspiring and empowering patients to take control of their health. However, the systemic barriers to care, including lack of primary care access, transportation issues, and financial hardships, continue to hinder progress. The hospital’s efforts to prevent kidney failure are often overshadowed by the harsh realities of untreated chronic conditions and delayed diagnoses.
As One Brooklyn Health navigates the complex landscape of healthcare disparities, Chief Medical Officer Kusum Viswanathan acknowledges the importance of serving the community’s most vulnerable populations. Despite the challenges, the hospital remains steadfast in its commitment to implementing the new kidney function equations and expanding access to care for underserved patients.
The ultimate goal is to improve access to kidney transplants for Brooklyn residents, many of whom have been underserved in the past. The partnership with NYU Langone’s kidney transplant program offers hope for faster placement on transplant lists and shorter wait times for patients like Earl David Jackson, who recently received a life-saving kidney transplant after years of waiting.
As Brooklyn residents await the potential for life-changing transplants, the fight against racial disparities in kidney care continues at One Brooklyn Health. Through dedication, compassion, and partnerships with leading healthcare institutions, the hospital system strives to provide equitable and effective care for all patients in need.
