Kidney disease affects certain populations disproportionately. These include Black or African American, American Indian and Alaskan Native, those of Hispanic ethnicity and Native Hawaiian and Pacific Islander individuals. Underlying inequities in social determinants of health (SDOH), such as income, education, food security, and access to health care, as well as disproportionate exposure to environmental factors (e.g., air pollution) are major contributors to higher risk for earlier onset and more rapid progression of kidney disease, especially among the populations listed above.  Understanding the role of SDOH and environmental factors in kidney disease prevention can reduce health disparities and improve quality of health care. The following maps present county-level estimates of chronic kidney disease in Medicare beneficiaries aged 65 years and older in the context of important social and environmental factors. This section will continue to be expanded in subsequent Kidney Disease Surveillance System updates.

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