Narrating Survival: A Culture-Centered Analysis of Chronic Kidney Disease Management among African American and Hispanic Adults

Structural barriers profoundly shape the healthcare experiences of African American and Hispanic adults managing chronic kidney disease (CKD). Guided by the Culture-Centered Approach (CCA) and utilizing narrative analysis, this study explores how participants construct meaning, resist institutional neglect, and draw on cultural resources through storytelling. Participants’ narratives illuminate three central domains: (1) Structural Barriers—limited access to health information and inadequate communication in medical settings; (2) Agency—the strategies individuals employ to navigate and adapt to CKD management; and (3) Culture—the role of community, faith, and social networks in shaping treatment decision-making. This study highlights the importance of attending to the lived, phenomenological experiences of African American and Hispanic adults as they confront systemic inequities in dialysis and transplantation care. The findings contribute to ongoing discussions on health equity by offering both theoretical insights and practical implications for addressing structural barriers in CKD management.