The influence of socio-economic status on the severity of sickle cell disease.

The influence of socio-economic status on morbidity was studied in 122 unselected consecutive patients with homozygous sickle cell disease in steady state. They included 65 females and 57 males, divided into three social classes (I, II and III, from highest to lowest). The morbidity indices used were, frequency of bone pain crisis, leg ulceration, growth index and the degree of anaemia as denoted by the mean steady haemoglobin level. It was found that the frequency of bone pain crisis was significantly higher in social class III patients than in social class I and social class II (P < 0.01). Leg ulceration was significantly more common in patients of social class III than in patients of social class I (P < 0.05). There was no correlation between the growth index and social class (r = 0.067, P > 0.05). The mean haemoglobin level was found to fall slightly from the highest to the lowest social class although the differences were not statistically significant. Our findings suggest that socio-economic status has some modifying influence on morbidity in sickle cell disease.