Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=99393
Story Retrieval Date: 5/20/2013 3:36:46 AM CST

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Kidney Education Program Hosts Screening in Minority Community

by Breeanna Hare
Sep 30, 2008


Barbara Burgess refuses to back down from a fight, especially one against chronic kidney disease and the disproportionately high toll it takes among African-Americans.

Armed with pamphlets, vials, and a friendly smile, Burgess takes her fight to health fairs, churches, schools and community centers across the Chicago area. 

She is the program coordinator for the Minority Intervention and Kidney Education (MIKE) program in Chicago and she calmly and readily refutes every excuse people make for not participating in the free kidney screenings offered at health care events.

Men and women, young and old lingered at her booth recently at the Charles Earle Elementary School in Englewood, interested but hesitant. She can relate to the feeling of fear and apprehension that hovered around the table, she said.

“I have high blood pressure in my family, and it’s scary. I guess people feel like if they don’t know, they think it won’t hurt them,” Burgess said.

She gestured towards a middle-aged African-American couple who just declined her offer for a full, free kidney screening. It included a blood pressure check, blood draw and urine analysis. “See? They didn’t want to be screened because they didn’t think they needed it.”

Unfortunately, for African-Americans more than other groups, that may not be the case.  Blacks have higher rates of high blood pressure and diabetes, two of the main causes of chronic kidney disease, according to the Centers for Disease Control and Prevention.

Approximately 40 percent of African-American adultss suffer from high blood pressure as compared 30 percent of white Americans.

In addition, new research from the National Institutes of Health found that individuals of African descent are more likely than whites to carry a variation of the gene MHY9. The gene is associated with the onset of the most fatal type of kidney disease, the form that leads to kidney failure. 

So Burgess was working hard to convince people to get screened.

“Part of it is awareness,” said MIKE Associate Director Courtney Nicholas. “That’s why we started this program. We’re not diagnosing anyone, we’re just highlighting those individuals who are more at risk and encouraging them to follow-up with a primary care practitioner.”

The American Kidney Fund implemented the MIKE program in 2005 in an attempt to curb the increasing rates of kidney failure in minority communities, specifically in Chicago, Atlanta, Washington, D.C., and New York.

“If you look at the zip code data for Chicago, the highest rates for kidney failure are on the west and south sides of the city and, anecdotally noting who lives where in Chicago, it’s obvious that African-Americans in particular are most affected by kidney failure,” Nicholas said.

Aside from medical reasons and genetic links, Nicholas said that she believes social factors also play a large part in the disparity.

“It may indeed be the high rates of obesity in our community, overuse of salt and lack of [balanced]nutrition. If you plot that [zip codes]of the highest rates of kidney failure, that sort of overlaps with the food deserts – areas where there is little to no fresh fruits and vegetables - here in Chicago,” Nicholas said.

She also cites lack of routine exercise as one of the probable causes. “If you live in a community that has high crime, you are unlikely to get up and walk in your neighborhood early in the morning or even at the end of the day in the evening.”

“It’s not just what we eat, it’s not just our lack of exercise. It’s lack of access, and lack of ability to do those all those things, and, ultimately, lack of awareness,” Nicholas said. The MIKE literature stresses awareness and education about these contributing factors.

This rang particularly true for health fair attendee Debbie Davis. At 38, Davis said she felt it was time to start paying more attention to her health, and stopped by the fair simply to collect information, never intending to be screened for kidney disease. After speaking with Burgess, she agreed to go through the paces of the screening despite the absence of kidney disease in her family history.

“I had no idea about kidney disease; I wouldn’t even know where to start. It wouldn’t have occurred to me to learn about it,” Davis said.

Charlean Curtis, a nurse who has volunteered with the MIKE program for two years, said that “for the poor and poorly-informed, we wouldn’t see them until they’re in a crisis” without MIKE. Since there aren’t any symptoms that can suggest early onset directly, by the time an individual experiences lower back pain or has bloody urine, “it’s too late,” Burgess said.

As a program, MIKE has been “phenomenally successful” in Chicago, Nicholas said, recalling that MIKE screened more than 1,800 people for kidney disease in African-American communities last year, and expects to surpass that number again.

“It’s not that we’re diagnosing them, we’re arming them with information,” she said. “We don’t want doctor visits to be a passive experience; part of the issue is really knowing what questions to ask.”