In June of 2016, Professor Kathleen Stewart, PhD Student Yanjia Cao, and Dr. Roberto Kalil, Medical Director of the VA Kidney Transplant Program, University of Iowa Hospitals and Clinics, published a paper entitled, “Geographic patterns of end-stage renal disease and kidney transplants in the Midwestern United States” in Applied Geography. The research investigated geographic patterns of end-stage renal disease (ESRD) and kidney transplantation at county level in a study area that covers eleven states in the MidWest U.S. during 2004-2011. This research analyzed the degree to which disparities for different population groups (white, black, and Native American) of ESRD patients might exist with respect to the occurrence of ESRD and spatial access to kidney transplantation. The kidney transplant rate is 73% lower among black ESRD patients than for white patients in this study region. Spatial accessibility to kidney transplants was analyzed using the enhanced two-step floating catchment area method to account for dissimilarities in treatment catchment sizes due to varying travel times and county populations. We found that Native American and black population groups have lower overall spatial access scores than other groups. Patients in rural counties have higher ESRD incidence rates and lower spatial access scores than those in urban counties. The results found that 76% of counties in the study area that correspond to the highest ESRD incidence rates correspond to the lowest two categories of spatial accessibility (Figure 1a, 1b, 1c – right). These results provide the impetus for further exploration of spatial patterns for end-stage renal disease in other regions of the U.S.
