Characterisation of medical conditions of children with sickle cell disease in the USA: findings from the 2007–2018 National Health Interview Survey (NHIS)
Joyce Gyamfi,
Jumoke Opeyemi,
Temitope Ojo,
Dorice Vieira,
Gbenga Ogedegbe,
Cong Wang,
Nessa Ryan,
Emmanuel Peprah,
Nana H Osei-Tutu,
Siphra Tampubolon,
Justin Tyler Lee,
Farha Islam,
Wanqiu Qiao,
Andi Mai,
Deborah Adenikinju,
Shreya Meda
Affiliations
Joyce Gyamfi
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Jumoke Opeyemi
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Temitope Ojo
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Dorice Vieira
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Gbenga Ogedegbe
Institute for Excellence in Health Equity (IEHE), New York University Grossman School of Medicine, New York, New York, USA
Cong Wang
Department of Biostatistics, New York University, New York, New York, USA
Nessa Ryan
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Emmanuel Peprah
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Nana H Osei-Tutu
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Siphra Tampubolon
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Justin Tyler Lee
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Farha Islam
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Wanqiu Qiao
Department of Biostatistics, New York University, New York, New York, USA
Andi Mai
Department of Biostatistics, New York University, New York, New York, USA
Deborah Adenikinju
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Shreya Meda
School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
Objectives We used the National Health Interview Survey (NHIS) data set to examine the prevalence of comorbid medical conditions; explore barriers to accessing healthcare and special educational services; and assess the associations between sickle cell disease (SCD) status and demographics/socioeconomic status (SES), and social determinants of health (SDoH) on comorbidities among children in the USA.Design Cross-sectional.Setting NHIS Sample Child Core questionnaire 2007–2018 data set.Participants 133 481 children; presence of SCD was determined by an affirmative response from the adult or guardian of the child.Main outcome measures Multivariate logistic regression was used to compare the associations between SCD status, SES and SDoH for various medical conditions for all races and separately for black children at p<0.05.Results 133 481 children (mean age 8.5 years, SD: 0.02), 215 had SCD and ~82% (weighted) of the children with SCD are black. Children with SCD were more likely to suffer from comorbid conditions, that is, anaemia (adjusted OR: 27.1, p<0.001). Furthermore, children with SCD had at least two or more emergency room (ER) visits (p<0.001) and were more likely to have seen a doctor 1–15 times per year (p<0.05) compared with children without SCD. Household income (p<0.001) and maternal education were lower for children with SCD compared with children without SCD (52.4% vs 63.5% (p<0.05)). SCD children with a maternal parent who has < / > High School degree were less likely to have no ER visits or 4–5 ER visits, and more likely to have 2–3 ER visits within 12 months.Conclusion Children with SCD experienced significant comorbid conditions and have high healthcare usage, with black children being disproportionately affected. Moreover, maternal education status and poverty level illustrates how impactful SES can be on healthcare seeking behaviour for the SCD population. SDoH have significant implications for managing paediatric patients with SCD in clinical settings.
