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
Add to Briefcase
See more stories about...
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 »
RESTROOM ISSUES RETURN
Trump To Rescind Trans Protections
50 minutes ago
THE DETAILS

Donald Trump is planning to reverse an Obama-era order requiring that schools allow students to use the bathroom that coincides with their gender identity. Trump "has green-lighted the plan for the Justice Department and Education Department to send a “Dear Colleague” letter to schools rescinding the guidance." A case is going before the Supreme Court on March 28 in which Gavin Grimm, a transgender high school student, is suing his high school for forbidding him to use the men's room.

Source:
NAIVE, RISK TAKER
Russia Compiling Dossier on Trump’s Mind
1 hours ago
WHY WE CARE

Retired Russian diplomats and members of Vladimir Putin's staff are compiling a dossier "on Donald Trump's psychological makeup" for the Russian leader. "Among its preliminary conclusions is that the new American leader is a risk-taker who can be naïve, according to a senior Kremlin adviser."

Source:
“HORRIBLE” AND “PAINFUL”
Trump Addresses Threats On Jewish Community Centers
3 hours ago
THE DETAILS
COULD COME TUESDAY
Trump Set To Issue New Travel Ban
4 hours ago
THE DETAILS

Donald Trump is set to issue a new and more focused executive order clarifying the scope of his travel ban, hoping that the order will survive legal challenges. The new order would focus on the same seven countries, "but would only bar entry to those without a visa and who have never entered the United States before. Unlike the original order, people from those countries who already have permanent U.S. residency (green cards) or visas would not face any restrictions." Some lawyers believe the government will now have much stronger standing, though lawyers who challenged the initial order see the same core problems with the forthcoming ban.

Source:
KELLOGG WILL RETURN TO NSC COS
Trump Taps Lt. Gen. McMaster as NSC Head
4 hours ago
THE LATEST

"President Donald Trump announced Monday that Lt. Gen. H.R. McMaster will serve as his next national security adviser, filling the void left last week by the sudden dismissal of Michael Flynn. ... Retired Lt. Gen. Keith Kellogg, who had been serving as the acting national security adviser since Flynn's exit, will return to his role as chief of staff of the National Security Council." The pick was widely praised on both sides of the aisle.

Source:
×
×

Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.

Login