内容摘要：__ Lefteris Pitarakis in Lavrion, Greece contributed to this report

__ Lefteris Pitarakis in Lavrion, Greece contributed to this report

“Lots of time when we see health inequities, we just assume there’s nothing we can do about it,” Morse said. “We can make changes to restore faith in the health system and to actually address the unfair and avoidable outcomes that Black people and other people of color face.”Black Americans are over three times more likely than white people to experience kidney failure. Of the roughly 89,000 people currently on the waiting list for a new kidney, about 30% are Black.

Race isn’t a biological factor like age, sex or weight — it’s a social construct. So how did it make its way into calculations of kidney function?The eGFR, or estimated glomerular filtration rate, evaluates kidney health based on how quickly a waste compound called creatinine gets filtered from blood. In 1999, an equation used to calculate eGFR was modified to adjust Black people’s results compared to everyone else’s, based on some studies with small numbers of Black patients and a long-ago false theory about differences in creatinine levels. Until recently that meant many lab reports would list two results — one calculated for non-Black patients and another for Black patients that could overestimate kidney function by as much as 16%.Not every Black kidney candidate was affected. Some may have had kidney failure diagnosed without that test. For others to have a chance at benefitting from UNOS’ mandated lookback, transplant center staff-turned-detectives often worked after hours and weekends, hunting years-old records for a test that, recalculated without the race adjustment, might make the difference.

“You’re reaching out to the nephrologist, their primary care doctors, the dialysis units to get those records,” said Dr. Pooja Singh of Jefferson Health’s transplant institute in Philadelphia, where Evans received her new kidney. “That first patient getting transplanted for us was such a great moment for our program that the work didn’t feel like work after that.”A high school sports physical first spotted Evans’ kidney disease at age 17. While finishing her master’s degree and beginning to earn her Ph.D. at Temple University, she started dialysis — for nine hours a night while she slept — and was placed on the transplant list.

How long it takes to get a kidney transplant depends on patients’ blood type, medical urgency and a mix of other factors — including how long they’ve spent on the waiting list. Evans was first listed in April 2019. When the Jefferson transplant center unearthed her old lab tests, they found she should have qualified in September 2015.

“Just for context, when I was still an undergrad I should have been on the list,” she said, recalling the anger she felt as she read the letter. What she called “a mind-blowing” credit of 3½ more years waiting also provided “a glimmer of hope” that she’d be offered a matching kidney soon.There are other surveys that look at youth smoking and drug use, including the University of Michigan’s federally funded “Monitoring the Future”

But the federal studies looked at both adults and adolescents, and provided insights into drug use by high school dropouts. The CDC also delved into specific vaping and tobacco products in the ways that other surveys don’t, and was a driver in the federal push to better regulate electronic cigarettes.“There was overlap among the surveys, but each one had its own specific focus that the other ones didn’t cover,“ said Richard Miech, who leads the Michigan study.

Work to modernize data collection has been derailed. That includes an upgrade to a 22-year-old system that helps local public health departments track diseases and allows CDC to put together a national picture.Another casualty was the