Life Course Socioeconomic Status, Race, and Kidney Function Across the Adult Life Span
Open Access
- Author:
- Surachman, Agus
- Graduate Program:
- Human Development and Family Studies
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- June 08, 2021
- Committee Members:
- David Almeida, Chair & Dissertation Advisor
Alexis Santos, Major Field Member
Lacy Alexander, Outside Unit Member
Jonathan Daw, Outside Field Member
Christopher Coe, Special Member
Charles Geier, Program Head/Chair - Keywords:
- age-related decrements
aging
kidney function
life course framework
racial disparities
socioeconomic status - Abstract:
- Chronic kidney disease (CKD), an umbrella term for various disorders associated with kidney damage and progressive decline in kidney function, is currently a public health concern in the United States. An unhealthy pattern of kidney functioning among relatively healthy individuals, indicated by steeper age-related decrements in kidney function, is a risk factor for faster progression to CKD. This dissertation utilized the life course framework to examine the role of life course socioeconomic status (SES) and race on creating disparities in kidney functioning across the adult life span among relatively healthy Black and white American adults. This dissertation included a systematic review and three empirical papers. The systematic review (Chapter 2) surveyed the current state of the literature and found the lack of utilization of the life course framework on empirical studies examining SES and racial disparities in kidney disease. The first empirical paper (Chapter 3) examined the association between parental education, a proxy for socioeconomic context in early life, and age-related decrements in kidney function and whether the association was conditional on race. In addition, this paper examined racial differences in the life course pathways from parental education to kidney functioning in adulthood through current SES and health-related risk factors. Building on the findings from the first empirical paper, the second empirical paper (Chapter 4) identified and examined the association between intergenerational educational mobility and kidney functioning across adulthood and whether the association was conditional on race. The third empirical paper (Chapter 5) explored the association between multiple indicators of subjective indicators of SES across the life course and kidney functioning across the adult life span. Using latent class analysis, this paper identified the heterogeneity of SES mobility patterns based on multiple indicators of subjective SES across the life course. This paper also examined the association between different patterns of subjective SES mobility and age-related decrements in kidney function and whether the association was conditional on race. Taken together, incorporating the life course framework into the study of disparities in kidney functioning provided novel understandings of how social factors across the life course contribute to the development of risk for accelerated aging kidney functioning and progression to CKD.