title: Family structure and patient survival in an African-American end-stage renal disease population: a preliminary investigation.
abstract: Few studies have examined the influence of the family on the course of chronic illness in African-Americans. We explore the relationship between family structure, defined as marital status and household composition, and patient survival. Patient gender was examined as a possible moderator in this relationship. Using data from a survey of 476 African-American end-stage renal disease (ESRD) patients, a significant association between household composition and patient survival was found. Results from Cox proportional hazards model, controlling for patient age, indicated that patients who live in 'complex' households (i.e. those with a partner and/or others) are at greater risk for shortened survival as compared to those who live alone or with a spouse/partner (p < 0.05). When we examined whether patient gender moderates this relationship, female patients who live in these households were found to be at 2 times greater risk for shortened survival (p < 0.01) than female patients who live alone or with their spouse/ partner only. Family structure was not significantly associated with survival in male patients. Discussion and implications of findings are addressed.
authors.affiliation: Department of Mental Hygiene, School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. jturner@jhsph.edu
authors.forename: J
authors.initials: J
authors.lastname: Turner-Musa
authors.forename: D
authors.initials: D
authors.lastname: Leidner
authors.forename: S
authors.initials: S
authors.lastname: Simmens
authors.forename: D
authors.initials: D
authors.lastname: Reiss
authors.forename: P L
authors.initials: PL
authors.lastname: Kimmel
authors.forename: B
authors.initials: B
authors.lastname: Holder
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002423:Cause of Death; D005195:Family Relations / Q000208:ethnology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000401:mortality* / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012494:Sampling Studies; D017678:Sex Distribution; D016019:Survival Analysis; D015996:Survival Rate; D014481:United States / Q000453:epidemiology