Sonenklar Molly, Marks Sarah, Donald Cerelia, Valrie Cecelia, Smith Wally, Sisler India
Division of Pediatric Hematology/Oncology, Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
Department of Health Policy and Behavior and MSTP Program, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
Pediatr Blood Cancer. 2025 Mar;72(3):e31478. doi: 10.1002/pbc.31478. Epub 2024 Dec 9.
Social determinants of health (SDoH) are socioeconomic factors that influence health and well-being, though when unmet can greatly contribute to health disparities. Individuals with sickle cell disease (SCD) are at increased risk of mortality, disability, and healthcare utilization. However, there are limited data linking specific social needs with disease outcomes in this population. Therefore, we sought to identify the unmet needs in one institution and their association with healthcare utilization.
Children with SCD and their guardians answered demographic and SDoH questionnaires during routine Sickle Cell Clinic appointments. We defined an unmet social need as any positive answer to the SDoH questionnaire. Disease outcome variables were electronic health record (EHR)-documented emergency department (ED) visits, hospitalizations, clinic appointment attendance, and guardian-reported acute SCD events in the previous year.
A total of 114 parent-guardian dyads participated, with 103 having complete data to analyze. In all, 52% of subjects reported at least one unmet social need with food insecurity (36%), trouble paying utility bills (28%), and unemployment (16%) being the most prevalent. Subjects with at least one unmet need had two times the rate of ED visits and/or hospitalizations and were 1.15 times more likely to have an SCD event in the past year. However, only the association with ED visits was statistically significant (p = 0.03).
Over half of subjects reported at least one unmet need; the most common being reliable access to food, which has the potential to impact health outcomes of sickle cell patients. Furthermore, unmet social needs are linked to healthcare utilization and SCD-related complications, supporting routine screening for SDoH in this population.
健康的社会决定因素（SDoH）是影响健康和幸福的社会经济因素，若这些因素得不到满足，则会极大地导致健康差异。镰状细胞病（SCD）患者的死亡、残疾和医疗保健利用率风险增加。然而，在这一人群中，将特定社会需求与疾病结局联系起来的数据有限。因此，我们试图确定一家机构中未满足的需求及其与医疗保健利用率的关联。
患有SCD的儿童及其监护人在镰状细胞病门诊常规预约期间回答人口统计学和SDoH问卷。我们将未满足的社会需求定义为对SDoH问卷的任何肯定回答。疾病结局变量为电子健康记录（EHR）记录的急诊科（ED）就诊、住院、门诊预约就诊以及监护人报告的上一年急性SCD事件。
共有114对父母-监护人二元组参与，其中103对有完整数据可供分析。总体而言，5
