African American End Stage Renal Disease & Medication Adherence: What Are the Effects of Everyday Racism?

End-stage renal disease (ESRD) is the ninth leading cause of death in the US. African Americans are nearly four times more likely to develop ESRD compared to Whites. ESRD requires a complex medication regimen, and poor medication adherence leads to increased hospitalizations, morbidity, and mortality in end-stage renal disease (ESRD) patients. Studies demonstrate that African American ESRD patients have poorer rates of medication adherence when compared to Whites. However, the reasons for this racial inequity are not understood. This is the first study to explore how everyday racism within the healthcare system, contributes to this disparity. A mixed methods study was conducted to investigate the relationship between everyday racism and medication adherence within the African American ESRD community using Critical Race Theory (CRT) as the theoretical foundation. Data were collected from 46 African American ESRD patients in the South. All participants completed a cross-sectional survey comprised of a medication adherence survey and an everyday racism in the healthcare setting survey. Additionally, 27 of the total sample (N=46) participated in in-depth interviews. A statistically significant negative relationship was found between medication adherence and everyday racism in the healthcare setting (r = -.477, p < .01). Interviews revealed that everyday racism perpetuated within the healthcare setting negatively affected participants’ medication adherence. Three themes were identified: 1) Concern that medical providers did not explain or properly manage medication regimen they prescribed 2) Concern that the medications are not safe 3) Information about medication and labs were withheld or not fully explained