Table of Contents
Barriers to Kidney Transplant Access for Racialized Populations
The disparities in kidney transplantation access have been well documented, highlighting a critical area of concern for health equity in Canada and beyond. Racialized populations, particularly First Nations, Inuit, Métis, African, Caribbean, and Black Canadians, face significant barriers in accessing kidney transplants (Gill & Kaur, 2025). First Nations, Inuit, and Métis patients are 66% less likely to receive kidney transplantation compared to their white counterparts, despite experiencing a threefold higher risk of kidney failure. Similar trends are observed in African, Caribbean, and Black (ACB) Canadians who are 65% to 69% less likely to receive living donor transplants (Gill & Kaur, 2025).
These barriers stem from a complex interplay of intersecting realities, including race, age, gender, geographic isolation, socioeconomic status, and cultural beliefs. Racialized patients often encounter delays in referrals, evaluations, and wait-listing processes, which can lead to poorer health outcomes (Gill & Kaur, 2025). For instance, lower-income patients from these communities often struggle with logistical challenges, including transportation to medical facilities, which can hinder access to essential care. Furthermore, systemic issues such as bias within healthcare systems create an environment where marginalized populations may feel distrustful, ultimately deterring them from seeking transplantation (Gill & Kaur, 2025).
Table 1: Kidney Transplant Access Disparities
| Population Group | Likelihood of Receiving Transplant (%) |
|---|---|
| First Nations | 34% |
| Inuit | 34% |
| Métis | 34% |
| African/Caribbean/Black | 31-35% |
| East Asian Canadians | 29-73% |
| South Asian Canadians | 23-50% |
Impact of Rural Hospital Closures on Nursing Home Residents
The closure of rural hospitals has profound implications for nursing home residents and the overall healthcare landscape in rural communities. Since 2005, 194 rural hospitals have closed in the United States, raising significant concerns about healthcare access, particularly for older adults who often rely on these facilities for essential services (Keesee et al., 2025). This study focuses on the relationship between rural hospital closures and nursing home outcomes, specifically examining utilization and resident health.
Research indicates that although hospital closures do not significantly impact occupancy rates or the health of nursing home residents, they do lead to a 0.13 decline in hospitalizations per resident per year (Keesee et al., 2025). This reduction may suggest that residents are experiencing fewer emergency admissions, potentially reflecting a decrease in emergent or urgent healthcare needs. However, the implications for long-term care and health outcomes remain unclear, necessitating further investigation into how closures affect residents’ overall health status and care needs.
Table 2: Impact of Rural Hospital Closures
| Outcome Measure | Change Post-Closure |
|---|---|
| Nursing Home Occupancy Rate | No significant change |
| Percentage of Medicare Residents | No significant change |
| Average Resident ADL Score | No significant change |
| Hospitalizations per Resident Year | Decreased by 0.13 |
Integrative Health Strategies for Black Feminist Healing Practices
The contributions of Black womxn to integrative medicine highlight the importance of incorporating culturally relevant healing modalities into healthcare practices. Black feminist healing practices encompass communal care, storytelling, and artistic expression, providing essential tools for resilience and well-being in the face of systemic oppression (Bogan & Harr, 2025). These modalities not only address physical health but also promote emotional and spiritual healing, offering a holistic approach to care.
Integrative medicine has traditionally focused on Western medical practices, often overlooking the wisdom and practices of marginalized communities. By integrating Black feminist healing modalities, healthcare providers can foster a more inclusive healthcare environment that respects and uplifts the health needs of Black womxn and other marginalized groups. For instance, storytelling has been identified as a powerful tool for building community resilience and promoting healing (Bogan & Harr, 2025).
Table 3: Key Components of Black Feminist Healing Modalities
| Healing Modality | Description |
|---|---|
| Communal Care | Practices such as storytelling and community gatherings that foster resilience. |
| Art as Cultural Strength | Use of creative expression to process trauma and promote healing. |
| Spirituality | Incorporating spiritual practices to enhance emotional well-being. |
Comparative Efficacy of Eating Disorder Prevention Interventions
Eating disorders (EDs) pose significant challenges to individuals’ health and well-being, necessitating effective prevention strategies. Recent research has highlighted the comparative efficacy of various interventions aimed at preventing EDs across different populations (Schlegl et al., 2025). This systematic review and network meta-analysis aims to assess the effectiveness of universal, selective, and indicated interventions for ED prevention.
The findings indicate that while numerous interventions exist, their effectiveness varies significantly based on the population and the specific characteristics of the intervention. Universal prevention programs, particularly media literacy interventions, have shown promise in reducing risk factors associated with EDs (Schlegl et al., 2025). However, selective and indicated interventions targeting at-risk populations have also demonstrated significant improvements in reducing ED symptoms and behaviors.
Table 4: Comparative Efficacy of ED Prevention Interventions
| Intervention Type | Effectiveness Level |
|---|---|
| Universal Prevention | Moderate to High |
| Selective Prevention | High |
| Indicated Prevention | Variable |
Community-Led Initiatives to Address Health Disparities in Canada
Community-led initiatives play a pivotal role in addressing health disparities, particularly among marginalized populations. In Canada, various organizations and coalitions are working to promote health equity by addressing the unique needs of diverse communities (Gill & Kaur, 2025). These initiatives often focus on culturally tailored interventions that empower communities to take charge of their health outcomes.
Recent efforts have included the establishment of community-based educational programs targeting kidney health and transplantation, which aim to increase awareness and understanding of organ donation among racialized communities (Gill & Kaur, 2025). By fostering community engagement and collaboration, these initiatives not only seek to reduce disparities in access to transplantation but also to build trust and improve overall health outcomes.
Table 5: Overview of Community-Led Initiatives
| Initiative | Focus Area | Target Population |
|---|---|---|
| ACB Organ Health | Kidney health education | African, Caribbean, Black Canadians |
| Saskatchewan First Nations Network | Organ donation awareness | Indigenous communities |
| BRIDGE to Transplant | Patient navigation and education | Indigenous kidney patients |
Conclusion
Enhancing health equity in kidney transplantation and addressing health disparities among marginalized communities requires a multifaceted approach that includes understanding the barriers to access, the impact of rural hospital closures, and the incorporation of integrative health practices rooted in cultural relevance. By focusing on community-led initiatives and recognizing the unique contributions of Black feminist healing practices, we can create a more inclusive healthcare system that supports the needs of all individuals.
FAQ
What are the main barriers to kidney transplantation for marginalized communities?
Marginalized communities face barriers such as systemic racism, socioeconomic disparities, lack of access to healthcare, and cultural mistrust towards medical institutions. These factors contribute to lower rates of kidney transplantation among these populations.
How do rural hospital closures affect nursing home residents?
Rural hospital closures can lead to decreased access to emergency and specialized care for nursing home residents, potentially impacting their health outcomes and care quality.
What are Black feminist healing practices?
Black feminist healing practices are holistic approaches that incorporate communal care, storytelling, art, and spirituality, aimed at promoting well-being and resilience among Black womxn and marginalized communities.
How can community-led initiatives improve health outcomes?
Community-led initiatives empower marginalized populations by providing culturally relevant education and resources, fostering trust, and encouraging community engagement in health decision-making.
What is the significance of understanding social determinants of health in addressing disparities?
Understanding social determinants of health is crucial for identifying and addressing the root causes of health disparities, enabling the development of targeted interventions that promote equity in healthcare access and outcomes.
References
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Gill, J., & Kaur, R. (2025). Life on the Line: Prioritizing Equity in Kidney Transplantation for Populations Marginalized by Race and Ethnicity. Canadian Journal of Kidney Health and Disease
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Keesee, E., Malone, T., Gurzenda, S., & Pink, G. (2025). Rural hospital closures and nursing home outcomes. Journal of Rural Health
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Bogan, E., & Harr, E. (2025). Health Equity Through Black Feminist Healing: A Narrative Review on the Contributions of Black Womxn to Integrative Medicine. Global Advances in Integrative Medicine and Health
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Schlegl, S., Hirler, F., Gerich, A., & Højlund, M. (2025). Comparative efficacy and acceptability of interventions for universal, selective and indicated prevention of eating disorders: study protocol for a systematic review and network meta-analysis. Journal of Eating Disorders. Retrieved from https://doi.org/10.1186/s40337-025-01244-8
