The Role of the Social Milieu On Health Outcomes: Is It Who You Know or What Who You Know Knows?
METHODS: In 2007-2008, the following research questions were addressed in an investigation in Chicago, IL: (1) What is the role of social networks in providing information about kidney transplantation to black hemodialysis patients? (2) What is the relationship between social networks and a patient’s likelihood of being seen at a kidney transplant center? From a stratified sample of dialysis units in the area, a purposive sample of 228 black patients were surveyed while they received treatment about their social networks and kidney transplant status.
RESULTS: The odds of black hemodialysis patients being seen at a kidney transplant center increase with income (OR 1.38, 95%CI: 1.09-1.76, p<.01), and patients who have people in their social network with information about kidney transplant were significantly more likely to be seen at a kidney transplant center. Specifically, black dialysis patients who get informational social support from their dialysis team (OR 1.76, 95%CI: 1.5-2.1, p<.001) and social networks (OR 1.63, 95%CI: 1.2-2.3, p<.001) were significantly more likely to be seen at kidney transplant centers.
IMPLICATIONS: Health parity is a multifaceted social problem, and considering black dialysis patients’ social milieu can be complimentary to the important existing research regarding kidney transplantation outcomes. The logistic regression models imply that correct information about a kidney transplant and success of being seen at a kidney transplant center can be differentiated on the basis of considering social network informational attributes and income. Dialysis health teams, which include a Master’s level social worker on every team, can augment patients’ social networks through their own interventions or by linking patients with mentors or patient navigators.
U.S. Renal Data System. (2011). Annual Data Report. Bethesda, MD: National Institutes of Health & National Institute of Diabetes and Digestive and Kidney Diseases.