New Study Exposes Stark Health Disparities in Sickle Cell Disease Outcomes Tied to Social Vulnerability
Sickle Cell Disease Patients with High Social Vulnerability Are Five Times as Likely to Die
Approximately 100,000 individuals in the United States live with sickle cell disease (SCD), with one in every 365 African Americans born with the condition, and eight million affected worldwide. A new study led by New York Medical College internal medicine resident Jia Yi Tan, M.D., published in JAMA Network Open reveals that patients facing the highest social vulnerabilities experience the most profound health impacts from SCD.
“While I anticipated a higher mortality rate among patients with greater social vulnerability, I was struck by the extent of the disparity we found, with those with the highest social vulnerability nearly five times more likely to die from SCD as compared to those with the lowest vulnerability,” says Dr. Tan. “Our study clearly demonstrates how deeply social factors, such as poverty, lack of transportation, and crowded housing, are intertwined with patient outcomes.”
The cross-sectional study included 2,625 adults with SCD and combined county-level data from the Centers for Disease Control and Prevention (CDC) and Agency for Toxic Substances and Disease Registry Social Vulnerability Index with SCD mortality data from the CDC Wide-Ranging Online Data for Epidemiologic Research database from 2016 to 2020.
“As one of the most common inherited blood disorders in the U.S., individuals with SCD are less likely to receive comprehensive care, especially those residing in low-income and rural areas,” emphasized Dr. Tan. “With the rapid advancements in disease-modifying therapies, understanding the associations between mortality rate and social vulnerability is crucial to determining whether these advancements benefit patients.”
“We hope that by shining a spotlight on this alarming disparity, a more comprehensive approach to health care for adults with SCD—especially those from socially vulnerable backgrounds—will be adopted,” says Dr. Tan. “This could inspire policies that directly address these inequities and foster programs aimed at reducing the impact of social determinants of health on the most vulnerable patients, including expanding access to transportation and increasing funding for community support services.”
