Journal Article Research Support, N.I.H., Extramural Epublish 4 citations
PubMed: 36854589 DOI: 10.1136/bmjopen-2022-069075
Characterisation of medical conditions of children with sickle cell disease in the USA: findings from the 2007-2018 National Health Interview Survey (NHIS).
BMJ Open 13(2):e069075
Authors: Joyce Gyamfi, Siphra Tampubolon, Justin Tyler Lee, Farha Islam, Temitope Ojo, Jumoke Opeyemi, Wanqiu Qiao, Andi Mai, Cong Wang, Dorice Vieira, Nessa Ryan, Nana H Osei-Tutu, Deborah Adenikinju, Shreya Meda, Gbenga Ogedegbe, Emmanuel Peprah
Affiliations
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA.
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA.
- Department of Biostatistics, New York University, New York, New York, USA.
- Medical Library Services, New York University School of Medicine, New York, New York, USA.
- Institute for Excellence in Health Equity (IEHE), New York University Grossman School of Medicine, New York, New York, USA.
Abstract
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.
MeSH
Cells, Anemia, Sickle Cell, Anemia, Public Health, Education, Child