In the work proposed for analysis, the primary purpose was to examine the potential association between racial discrimination that respondents may have experienced and patterns of chronic kidney disease. This study did not collect primary data on its own but used a set of 14,355 participants between the ages of 35 and 74 collected as part of a longitudinal study from ELSA-Brasil (Camelo et al., 2018). It is worth clarifying that 750 respondents who did not fit the criteria of the ongoing study were excluded from the original population provided by ELSA-Brasil (n = 15,105). The total sample was divided into four age groups (35 to 44, 45 to 54, 55 to 64, and 65 to 74), for which patterns of racial discrimination were measured according to the participants’ racial backgrounds. Thus, one of the main preliminary findings was the determination that black respondents in all age groups were subject to maximum racial discrimination, with this trend decreasing as age increased. In contrast, white respondents claimed significantly lower racial discrimination, and this pattern remained virtually unchanged as age increased.
Academic bias is a significant problem, affecting the quality of the results and often leading to skewed conclusions. In the paper under discussion, there are several sources that potentially downgrade the unbiased nature of the data (Pannucci & Wilkins, 2010). In particular, the authors use data nearly a decade old (from the date of publication of the paper) to form the sample, which could affect the unbiased nature of the study through changing patterns over time. In particular, it is unlikely that trends in racial discrimination could have changed over a decade, so the relationship found may be inaccurate or skewed. Another sensitivity issue in this study is the effect of historical perceptions of racial discrimination in relation to race: it is possible that being black led respondents to think that they were targets of discrimination even if they had never experienced such episodes. Finally, the study included a sample of highly educated, qualified employees and students at Brazilian universities, which implies that the results of the data analysis were biased against the general population. In other words, it could not be extrapolated to all patients who experienced racial discrimination and had a potential risk of developing chronic kidney disease.
There were several exciting findings in this study that reveal the problem of the relationship between racial discrimination and the risks of chronic kidney disease. In particular, it was stated that “black individuals aged <55 years had lower mean eGFR compared with white individuals in the same age group” (Camelo et al., 2018, p. 1029). Given that eGFR determines renal efficiency, this statistically significant result shows that the eGFR for black respondents was lower by 1.54 mL/min/1.73 m2 (p <.001). In other words, this result indicates an association between the racial discrimination trial for the respondents and reduced renal structure function, which supports the authors’ research hypothesis. A second interesting finding was that age was a significant predictor for differences in the effect of discrimination on eGFR. In both age groups (<55 and ≥55), racial discrimination was a significant factor for reduced renal function, but this effect attenuated as age increased. For example, for respondents who used tobacco and alcohol, engaged in physical activity, and had other chronic conditions, respondents under age 55 had about 2.38 times (p <.001) lower eGFR than older respondents with the same characteristics. It follows that age affects the relationship between discrimination and eGFR: one implication of this finding is the possible differences in respondents’ perception of racial discrimination depending on age; older people tend to perceive less discrimination — or are less exposed to it — which in turn has less effect on lower eGFR.
In conclusion, it is worth clarifying that the authors of this article did a great deal of work to identify the relationship between seemingly non-obvious variables. As it turns out, an abstract phenomenon such as racial discrimination has a direct biological effect on organismal structures, namely reduced renal activity. It follows that patients potentially susceptible to the renal disease are particularly vulnerable because they may suffer from the development of renal abnormalities if racial discrimination is evaluated. This is a phenomenal result that shows just how much socially stigmatized phenomena can affect the human body.
References
Camelo, L. V., Giatti, L., Ladeira, R. M., Griep, R. H., Mill, J. G., Chor, D., & Barreto, S. M. (2018). Racial disparities in renal function: the role of racial discrimination. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Journal of Epidemiological Community Health, 72(11), 1027-1032. Web.
Pannucci, C. J., & Wilkins, E. G. (2010). Identifying and avoiding bias in research.Plastic and Reconstructive Surgery, 126(2), 619-625. Web.