(HealthDay News) — For preschool-aged children with sickle cell disease (SCD), social determinants of health (SDOH) are associated with the risk for complications and hospitalizations, according to a study published online Oct. 7 in Blood Advances.
Hamda Khan, from St. Jude Children’s Research Hospital in Memphis, Tennessee, and colleagues examined whether preschool children with SCD living in poor neighborhoods with higher socioeconomic distress would experience increased acute care utilization (ACU [emergency department visits and hospitalizations]) despite receipt of disease-modifying therapy. Census tract environmental data were used to map participants’ home addresses.
The researchers found that SDOH indicators, including limited access to food, lack of vehicle, low income, and inadequate education, were associated with higher ACU in analyses adjusted for sickle genotype and disease-modifying therapies. Among children with SCD younger than 6 years, living in households with children more than one mile from a supermarket was associated with more hospitalizations and ACU (odds ratios, 1.44 and 1.37, respectively). Less ACU (odds ratio, 0.67) and fewer hospitalizations (odds ratio, 0.67) were experienced by children in households with at least one bachelor’s degree.
“The data suggest that, regardless of how much care you provide and how many new therapies are out there for patients who have chronic illnesses like SCD, unless you start addressing these deep-rooted issues, like food deserts or quality of life from the neighborhood standpoint, it’s always going to be extremely tricky to holistically provide care to our patient population,” Khan said in a statement.
What is sickle cell disease?
Sickle cell disease is a group of inherited blood disorders that affect the shape of red blood cells. It is caused by a genetic mutation that alters the structure of hemoglobin, the protein in red blood cells that carries oxygen. In individuals with sickle cell disease, the abnormal hemoglobin causes red blood cells to become rigid and sickle-shaped, resembling the crescent moon of a sickle.
These misshapen cells are less flexible than normal red blood cells, making it difficult for them to flow smoothly through blood vessels. As a result, they can become trapped in small blood vessels, blocking blood flow and leading to a variety of complications. Common symptoms of sickle cell disease include severe pain, fatigue, anemia, and frequent infections.
The severity of sickle cell disease can vary widely among individuals. Some people may experience mild symptoms, while others may suffer from life-threatening complications. These complications can include stroke, organ damage, and chronic pain. While there is currently no cure for sickle cell disease, advancements in medical research have led to improved treatments and management strategies.
Treatment for sickle cell disease typically involves managing pain, preventing infections, and addressing complications as they arise. Blood transfusions, medications, and in some cases, bone marrow transplants may be necessary. Ongoing research is focused on developing new therapies, including gene editing techniques, that could potentially cure sickle cell disease.
What are social determinants of health (SDOH)?
Social determinants of health are the broader social, economic, and environmental conditions that influence our health and well-being. These factors go beyond individual behaviors and genetics and are crucial in determining health outcomes.
Some key social determinants of health include:
- Economic Stability: Income, employment, housing, and food security all significantly impact health. Financial stress can lead to increased risk of chronic diseases, mental health problems, and limited access to health care.
- Education: Education level is linked to health outcomes in various ways. Higher education is often associated with better health knowledge, job opportunities, and income, all of which contribute to improved health.
- Social Connection: Social relationships, support networks, and community involvement are essential for health. Isolation and loneliness can negatively affect mental and physical health.
- Neighborhood and Built Environment: The physical environment, including the safety of neighborhoods, access to green spaces, and the availability of healthy food options, can influence health.
- Health care Access and Quality: Access to quality health care services is a fundamental determinant of health. This includes affordability, availability, and cultural competency of health care providers.
Understanding and addressing social determinants of health is essential for promoting health equity and improving the overall well-being of individuals and communities. By addressing these underlying factors, we can create a more just and equitable society where everyone has the opportunity to live a healthy life.
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