Social determinant screening useful for families with pediatric sickle cell disease

October 09, 2019

Individuals with sickle cell disease (SCD) face the burdens of chronic illness and often racial disparities, both of which may increase vulnerability to adverse social determinants of health (SDoH). For children with SCD, living in poverty is associated with lower quality of life, higher healthcare utilization and higher complication rates. However, a new study from Boston Medical Center (BMC) demonstrates that hematologists can uncover the needs of families and connect them to local resources within a clinic visit with the hope of improving quality of life and clinical outcomes for their patients.

Published in Pediatric Blood and Cancer, this study provides insight into the feasibility of improving quality of care for patients diagnosed with SCD through universal screening to identify the specific needs of patients, mitigating the role of provider perception, and facilitating referrals with community organizations using low touch interventions. The prospective study followed 156 patients diagnosed with SCD who were universally screened for SDoH between August 2017 and November 2018 in the pediatric hematology clinic. Using WECARE, the one-page, self-reporting paper screener addressed patients' security of housing, food, medication, transportation, utilities, daycare, and employment, while also requesting information related to interest in education and connection to relevant resources. For each screener administered to a patient, 1.2 SDoH needs were identified. Two thirds of patients screened positive for at least one unmet socioeconomic need, most commonly food insecurity and difficulty paying utilities.

Once identified, clinical staff referred patients to assistance programs based on the identified needs. Forty-five percent of those patients reported reaching out to a community organization, and 69 percent found the assistance of the organization to be helpful. If the family was in imminent need of assistance, families were also scheduled to meet with a social worker.

"As pediatricians and hematologists, we want to improve the well-being of the whole patient, not just their blood disorder," said lead author Alexandra Power-Hays, MD, a pediatrician at BMC. "Now that we've demonstrated that a simple method can begin addressing socioeconomic needs, we hope that pediatric hematologists across the country will also adopt this model for more long-term healing solutions."

In a follow-up from the clinic, patients were asked on a 5-point Likert scale how likely they were to continue discussing socioeconomic matters with the clinic. The average response was 4.1, representing a positive experience with the service. The authors note that this study was designed to overcome barriers to physicians pro-actively asking patients about SDoH, and addressing these may be a cost-effective preventative measure through reducing recurrent hospitalizations and emergency room visits.
Funding for this study was provided through an ASH Scholar Award and under grant # NHLBI 1K23HL135436-01

About Boston Medical Center

Boston Medical Center is a private, not-for-profit, 514-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. It is the largest and busiest provider of trauma and emergency services in New England. Boston Medical Center offers specialized care for complex health problems and is a leading research institution, receiving more than $116 million in sponsored research funding in fiscal year 2017. It is the 15th largest recipient of funding in the U.S. from the National Institutes of Health among independent hospitals. In 1997, BMC founded Boston Medical Center Health Plan, Inc., now one of the top ranked Medicaid MCOs in the country, as a non-profit managed care organization. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet - 14 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit

Boston Medical Center

Related Sickle Cell Disease Articles from Brightsurf:

Acute kidney injury among African Americans with sickle cell trait and disease
New research examines the risk of acute kidney injury in people with sickle cell trait or disease, as well as the effect of acute kidney injury on kidney function decline in these individuals.

New technology diagnoses sickle cell disease in record time
Researchers have developed a new way to diagnose diseases of the blood like sickle cell disease with sensitivity and precision and in only one minute.

Cannabis shows potential for mitigating sickle cell disease pain
Cannabis appears to be a safe and potentially effective treatment for the chronic pain that afflicts people with sickle cell disease, according to a new clinical trial co-led by University of California, Irvine researcher Kalpna Gupta and Dr.

Exploring mechanisms of resistance to HIV in people with sickle cell disease
A new analysis supports prior reports that people with sickle cell disease have lower rates of human immunodeficiency virus (HIV) infection, but follow-up cell studies did not reveal a mechanism to explain the reduced risk.

Light-to-moderate exercise may bring benefits for sickle cell disease
While exercise offers benefits for a wide range of health conditions, it has historically been considered too dangerous for people living with sickle cell disease (SCD).

Social determinant screening useful for families with pediatric sickle cell disease
Individuals with sickle cell disease (SCD) face the burdens of chronic illness and often racial disparities, both of which may increase vulnerability to adverse social determinants of health (SDoH).

Uncovering new therapeutic targets for airway inflammation in sickle cell disease
A new study by De, Agrawal, Morrone et al, challenges the common notion that airway in-flammation in Sickle Cell Disease (SCD) is secondary to asthma, even though the two disor-ders often coexist.

Researchers develop new method to rapidly, reliably monitor sickle cell disease
Researchers have developed a rapid and reliable new method to continuously monitor sickle cell disease using a microfluidics-based electrical impedance sensor.

Sickle cell disease needs more attention
Article signed by researchers affiliated with institutions in the US, UK, Ghana and Brazil highlights recent progress in diagnosis and treatment but warns that more screening of newborns is needed.

New genetic weapons challenge sickle cell disease
Researchers advancing gene-editing techniques to help patients with sickle cell disease discover an unexpected boost in fetal hemoglobin production, which mutes the effect of the disease.

Read More: Sickle Cell Disease News and Sickle Cell Disease Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to