How Do Home Socioeconomic Environment Factors Affect SCD Care for Patients?

Medical anthropologist Hamda Khan, MA, is a clinical research associate in Hematology at St. Jude Children’s Research Hospital in Memphis, Tennessee. She spoke with Heme Today about the study she led on the effect of socioeconomic environment factors on health of pediatric patients with sickle cell disease (SCD), recently published in Blood Advances.

The study was conducted within a larger, lifetime longitudinal cohort study underway at St. Jude in the Sickle Cell Clinical Research and Intervention Program (SCCRIP). Patients in SCCRIP are followed from pediatric into adult SCD care, with a wide array of data retrospectively and prospectively collected.

Ms. Hamda’s study investigated how access to food, and other socioeconomic factors, affect the results of patients’ SCD care. These factors were quantified using indices of publicly available, census-level data about the patients’ home communities.

“We want people to start looking at the granularity of how every single thing that is associated to a person can ultimately determine how well they’re going to live,” Ms. Hamda explained.

As she conducted her study within SCCRIP, Ms. Hamda was able to include a multidisciplinary collaboration of experts in social and environmental determinants of health, a type of collaboration she found largely absent from the studies uncovered by her initial literature search.

Within SCCRIP, her study also had access to plentiful, nuanced data, enabling an evaluation of which personal or environmental factors have the strongest impact on health care outcomes. Senior study author Jason Hodges, PhD, MA, director of research and clinical studies in Hematology at St. Jude, noted they could even control for the specific type of treatment patients were receiving at St. Jude and gauge how home environment factors affect the success of that care.

“If they come out of a neighborhood that is showing higher rates of deprivation or higher rates of vulnerability, or lower rates of food access, does that impact those health outcomes above and beyond the treatment that they’re getting?” Dr. Hodges commented.

The authors stressed that even as patients receive high quality care, they continue to be affected by home environment factors which drive or exacerbate the clinical issue.

“Our goal is to not just generate data and increase the knowledge that’s out there, but, at the same time, also provide awareness that we should start addressing things in a more holistic way if we want to actually create something that’s more unique and more long lasting,” Ms. Hamda concluded.