Chronic kidney disease is a growing concern in England, with substantial human and financial costs resulting from the disease. In this study, we examine the prevalence of chronic kidney disease (CKD) in the East of England, with a specific interest in understanding the disparity of this health outcome between coastal and inland areas. This study aimed to investigate if there are inter-regional disparities in CKD between coastal and non-coastal communities in the East of England and to find out the underlying sources of these health disparities. A nationally representative dataset from the United Kingdom Household Longitudinal Study (UKHLS) with biomarker measures was used in this study. We linked the individual-level biomarker data to neighbourhood-level data from the English deprivation indices at the Lower Layer Super Output Area (LSOA) level. Oaxaca-Blinder decomposition combined with unconditional quantile regression analysis was used to examine coastal differences in the estimated glomerular filtration rate (eGFR) and to show the extent to which coastal differentials are explained. The results showed that coastal communities have lower eGFR levels than the inland areas, translating to a higher risk of CKD. The decomposition results indicate a large contribution of demographic factors towards the coastal-inland disparities in CKD of 66% at the 10th and 64% at the 25th quantile. The age of the population contributes to the higher share of this disparity at the lower tail of the distribution. Socioeconomic status is the second largest contributor to the overall coastal-inland inequalities in CKD, with household income contributing the largest at 21%. Interventions are needed to address the coastal area and reduce coastal disparities in CKD.

Co-authors

Professor Lee Shepstone; Associate Professor Mizanur Khondoker; Associate Professor David Turner, University of East Anglia