The Unemployed Are Less Likely to Receive Kidney Transplants

Recent research concludes that a person with a job is 2.24 times more likely to be put on a list for a transplant than someone who is unemployed.

National Journal
Brian Resnick
Aug. 21, 2013, 8:52 a.m.

Un­em­ploy­ment is hor­rible for your health.

This fact is well-doc­u­mented: Long-term un­em­ploy­ment is as­so­ci­ated with de­clines in men­tal well-be­ing and in­creases in mor­tal­ity. In all, “los­ing a job be­cause of an es­tab­lish­ment clos­ure in­creased the odds of fair or poor health by 54 per­cent, and among re­spond­ents with no preex­ist­ing health con­di­tions, it in­creased the odds of a new likely health con­di­tion by 83 per­cent,” a 2009 study in the journ­al Demo­graphy con­cluded. Even those un­em­ployed who re­tain health in­sur­ance after be­ing axed from their jobs have great­er com­plic­a­tions, as this chart from the Cen­ters for Dis­ease Con­trol and Pre­ven­tion in­dic­ates:

 

But per­haps the more dis­turb­ing in­dic­a­tion is this: Com­bined with the in­creased like­li­hood of health prob­lems, the un­em­ployed have a de­creased like­li­hood of re­ceiv­ing the ap­pro­pri­ate in­ter­ven­tion. This is true even when they re­tain in­sur­ance. Ac­cord­ing to the CDC, “Among adults with private health in­sur­ance, one in sev­en (14.7 per­cent) un­em­ployed adults ex­per­i­enced either a delay or lack of needed med­ic­al care be­cause of cost com­pared with 8.7 per­cent of em­ployed adults.”

This holds true even when the in­ter­ven­tion may mean life or death. End-stage ren­al dis­ease, “the com­plete or al­most com­plete fail­ure of the kid­neys to work,” isn’t pleas­ant. In or­der for a per­son to sur­vive it, they need either con­tinu­al dia­lys­is or a trans­plant. But re­cent re­search re­veals a dis­par­ity fall­ing along em­ploy­ment lines.

In a sur­vey of 429,409 pa­tients with end-stage ren­al dis­ease, those who had jobs were 2.24 times more likely to be placed on a wait­ing list for a kid­ney trans­plant. Once placed on a list, the em­ployed full-time were 1.65 times more likely to re­ceive the trans­plant. And hav­ing in­sur­ance didn’t help the un­em­ployed in this case either. When the re­search­ers ran the num­bers on those un­em­ployed who had in­sur­ance, they found “the res­ults to be es­sen­tially the same and still sig­ni­fic­ant.”

And if all of that isn’t down­er enough for you, con­sider this: The un­em­ployed are much, much more likely to be in need of a kid­ney trans­plant. A 10-year study found “un­em­ploy­ment af­fects up to 75 per­cent of in­cid­ent ES­RD [end-stage ren­al dis­ease] pa­tients,” and “this rate in­creases with time on dia­lys­is.”

So, people with ren­al dis­eases tend to be un­em­ployed, but the un­em­ployed are less likely to re­ceive kid­ney trans­plants when things get dire. The re­search­ers on the trans­plant study sug­gest a couple of reas­ons why the dis­par­ity hap­pens:

  • The un­em­ployed may be seen as ris­ki­er pa­tients. “One of the primary con­cerns of trans­plant cen­ters is the re­cip­i­ent’s abil­ity to af­ford im­mun­osup­press­ive med­ic­a­tions post-trans­plant,” the au­thors write. Those drugs can cost between $2,000 and $14,000  a year. In­ab­il­ity to pay for the drugs  “could be im­plic­ated in al­most half the cases and might be per­ceived as bar­ri­er by a trans­plant pro­gram.”

  • Those stressed with un­em­ploy­ment may not be seek­ing care im­me­di­ately, which can “con­trib­ute to late re­fer­rals by neph­ro­lo­gists and delayed eval­u­ations by trans­plant cen­ters.”

What We're Following See More »
STAFF PICKS
What the Current Crop of Candidates Could Learn from JFK
1 days ago
WHY WE CARE

Much has been made of David Brooks’s recent New York Times column, in which confesses to missing already the civility and humanity of Barack Obama, compared to who might take his place. In NewYorker.com, Jeffrey Frank reminds us how critical such attributes are to foreign policy. “It’s hard to imagine Kennedy so casually referring to the leader of Russia as a gangster or a thug. For that matter, it’s hard to imagine any president comparing the Russian leader to Hitler [as] Hillary Clinton did at a private fund-raiser. … Kennedy, who always worried that miscalculation could lead to war, paid close attention to the language of diplomacy.”

Source:
STAFF PICKS
Maher Weighs in on Bernie, Trump and Palin
1 days ago
WHY WE CARE

“We haven’t seen a true leftist since FDR, so many millions are coming out of the woodwork to vote for Bernie Sanders; he is the Occupy movement now come to life in the political arena.” So says Bill Maher in his Hollywood Reporter cover story (more a stream-of-consciousness riff than an essay, actually). Conservative states may never vote for a socialist in the general election, but “this stuff has never been on the table, and these voters have never been activated.” Maher saves most of his bile for Donald Trump and Sarah Palin, writing that by nominating Palin as vice president “John McCain is the one who opened the Book of the Dead and let the monsters out.” And Trump is picking up where Palin left off.

Source:
×