Social Vulnerability and Sickle Cell Disease Mortality in the US
Social determinants of health (SDOH) influence health outcomes, including those of sickle cell disease (SCD), despite advancements in treatments like disease-modifying therapies. To investigate the association of SDOH with SCD mortality rates from 2016 to 2020. This cross-sectional study combined co...
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| creator | Tan, Jia Yi San, Boon Jian Yeo, Yong-Hao Chan, Kok Hoe Shaaban, Hamid S Ezekwudo, Daniel E Idowu, Modupe |
| description | Social determinants of health (SDOH) influence health outcomes, including those of sickle cell disease (SCD), despite advancements in treatments like disease-modifying therapies.
To investigate the association of SDOH with SCD mortality rates from 2016 to 2020.
This cross-sectional study combined county-level data from the Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI) with SCD mortality data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database from January 1, 2016, to December 31, 2020. US counties were divided into 4 quartile (Q) models according to their SVI scores. Deaths from SCD in the US among patients of all ages were included. Data analysis occurred from March to April 2024.
SVI score.
Age-adjusted mortality rates (AAMRs) per 1 000 000 individuals were measured. Rate ratios (RRs) were obtained by comparing county-specific AAMRs of SVI-Q4 with SVI-Q1.
From 2016 to 2020, among a total population of 1 633 737 771 individuals, there were 2635 deaths from SCD (1289 male [49.1%] and 1336 female [50.9%]). There were 1480 deaths in Q4, 687 deaths in Q3, 344 deaths in Q2, and 114 deaths in Q1. Higher SVI was associated with 2.11 excess deaths per 1 000 000 individuals (RR, 4.90; 95% CI, 4.81-5.00). Similar trends were seen for both males (RR, 4.56; 95% CI, 4.44-4.69) and females (RR, 5.85; 95% CI, 5.68-6.03). Middle-aged patients with SCD had the highest mortality rate in Q4, with 3.45 excess deaths per 1 000 000 individuals (RR, 4.97; 95% CI, 4.85-5.09). Higher SVI was associated with 2.29 excess deaths per 1 000 000 individuals in African American individuals with SCD (RR, 1.24; 95% CI, 1.22-1.27]). In White individuals with SCD, higher SVI was associated with 0.12 excess deaths per 1 000 000 individuals (RR not available due to unreliable data in Q1). When stratifying by census region, the highest level of SCD-related mortality was in the Northeast, with higher SVI associated with 3.16 excess deaths per 1 000 000 individuals (RR, 8.02; 95% CI, 7.66-8.40).
In this cross-sectional study of the association of SVI with SCD mortality rates, higher SVI was associated with higher SCD mortality across US counties. These findings underscore the importance of addressing social determinants of health to improve mortality outcomes among patients with SCD. |
| doi_str_mv | 10.1001/jamanetworkopen.2024.40599 |
| format | Article |
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To investigate the association of SDOH with SCD mortality rates from 2016 to 2020.
This cross-sectional study combined county-level data from the Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI) with SCD mortality data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database from January 1, 2016, to December 31, 2020. US counties were divided into 4 quartile (Q) models according to their SVI scores. Deaths from SCD in the US among patients of all ages were included. Data analysis occurred from March to April 2024.
SVI score.
Age-adjusted mortality rates (AAMRs) per 1 000 000 individuals were measured. Rate ratios (RRs) were obtained by comparing county-specific AAMRs of SVI-Q4 with SVI-Q1.
From 2016 to 2020, among a total population of 1 633 737 771 individuals, there were 2635 deaths from SCD (1289 male [49.1%] and 1336 female [50.9%]). There were 1480 deaths in Q4, 687 deaths in Q3, 344 deaths in Q2, and 114 deaths in Q1. Higher SVI was associated with 2.11 excess deaths per 1 000 000 individuals (RR, 4.90; 95% CI, 4.81-5.00). Similar trends were seen for both males (RR, 4.56; 95% CI, 4.44-4.69) and females (RR, 5.85; 95% CI, 5.68-6.03). Middle-aged patients with SCD had the highest mortality rate in Q4, with 3.45 excess deaths per 1 000 000 individuals (RR, 4.97; 95% CI, 4.85-5.09). Higher SVI was associated with 2.29 excess deaths per 1 000 000 individuals in African American individuals with SCD (RR, 1.24; 95% CI, 1.22-1.27]). In White individuals with SCD, higher SVI was associated with 0.12 excess deaths per 1 000 000 individuals (RR not available due to unreliable data in Q1). When stratifying by census region, the highest level of SCD-related mortality was in the Northeast, with higher SVI associated with 3.16 excess deaths per 1 000 000 individuals (RR, 8.02; 95% CI, 7.66-8.40).
In this cross-sectional study of the association of SVI with SCD mortality rates, higher SVI was associated with higher SCD mortality across US counties. These findings underscore the importance of addressing social determinants of health to improve mortality outcomes among patients with SCD.</description><identifier>ISSN: 2574-3805</identifier><identifier>EISSN: 2574-3805</identifier><identifier>DOI: 10.1001/jamanetworkopen.2024.40599</identifier><identifier>PMID: 39348116</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Adolescent ; Adult ; Anemia, Sickle Cell - mortality ; Child ; Child, Preschool ; Cross-Sectional Studies ; Disease control ; Female ; Hematology ; Humans ; Infant ; Male ; Middle Aged ; Mortality ; Online Only ; Original Investigation ; Sickle cell disease ; Social Determinants of Health - statistics & numerical data ; Social Vulnerability ; United States - epidemiology ; Young Adult</subject><ispartof>JAMA network open, 2024-09, Vol.7 (9), p.e2440599</ispartof><rights>2024. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright 2024 Tan JY et al. .</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-a347t-58c8c110158a8a5edc630f5a30167806e5f40d96eb9cff5bc3bdf344eb6f124b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,781,785,865,886,27928,27929</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39348116$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tan, Jia Yi</creatorcontrib><creatorcontrib>San, Boon Jian</creatorcontrib><creatorcontrib>Yeo, Yong-Hao</creatorcontrib><creatorcontrib>Chan, Kok Hoe</creatorcontrib><creatorcontrib>Shaaban, Hamid S</creatorcontrib><creatorcontrib>Ezekwudo, Daniel E</creatorcontrib><creatorcontrib>Idowu, Modupe</creatorcontrib><title>Social Vulnerability and Sickle Cell Disease Mortality in the US</title><title>JAMA network open</title><addtitle>JAMA Netw Open</addtitle><description>Social determinants of health (SDOH) influence health outcomes, including those of sickle cell disease (SCD), despite advancements in treatments like disease-modifying therapies.
To investigate the association of SDOH with SCD mortality rates from 2016 to 2020.
This cross-sectional study combined county-level data from the Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI) with SCD mortality data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database from January 1, 2016, to December 31, 2020. US counties were divided into 4 quartile (Q) models according to their SVI scores. Deaths from SCD in the US among patients of all ages were included. Data analysis occurred from March to April 2024.
SVI score.
Age-adjusted mortality rates (AAMRs) per 1 000 000 individuals were measured. Rate ratios (RRs) were obtained by comparing county-specific AAMRs of SVI-Q4 with SVI-Q1.
From 2016 to 2020, among a total population of 1 633 737 771 individuals, there were 2635 deaths from SCD (1289 male [49.1%] and 1336 female [50.9%]). There were 1480 deaths in Q4, 687 deaths in Q3, 344 deaths in Q2, and 114 deaths in Q1. Higher SVI was associated with 2.11 excess deaths per 1 000 000 individuals (RR, 4.90; 95% CI, 4.81-5.00). Similar trends were seen for both males (RR, 4.56; 95% CI, 4.44-4.69) and females (RR, 5.85; 95% CI, 5.68-6.03). Middle-aged patients with SCD had the highest mortality rate in Q4, with 3.45 excess deaths per 1 000 000 individuals (RR, 4.97; 95% CI, 4.85-5.09). Higher SVI was associated with 2.29 excess deaths per 1 000 000 individuals in African American individuals with SCD (RR, 1.24; 95% CI, 1.22-1.27]). In White individuals with SCD, higher SVI was associated with 0.12 excess deaths per 1 000 000 individuals (RR not available due to unreliable data in Q1). When stratifying by census region, the highest level of SCD-related mortality was in the Northeast, with higher SVI associated with 3.16 excess deaths per 1 000 000 individuals (RR, 8.02; 95% CI, 7.66-8.40).
In this cross-sectional study of the association of SVI with SCD mortality rates, higher SVI was associated with higher SCD mortality across US counties. These findings underscore the importance of addressing social determinants of health to improve mortality outcomes among patients with SCD.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anemia, Sickle Cell - mortality</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cross-Sectional Studies</subject><subject>Disease control</subject><subject>Female</subject><subject>Hematology</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Sickle cell disease</subject><subject>Social Determinants of Health - statistics & numerical data</subject><subject>Social Vulnerability</subject><subject>United States - epidemiology</subject><subject>Young Adult</subject><issn>2574-3805</issn><issn>2574-3805</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUtPwzAQhC0EohX0L6AILlxadmM7Dy6AylMq4lDK1XJch7pN42InIP496QNUevJK_ma0s0PIKUIPAfBiKuey1NWXdTO70GUvhJD1GPA03SPtkMesSxPg-1tzi3S8nwJACEjTiB-SFk0pSxCjNrkeWmVkEbzVRamdzExhqu9AluNgaNSs0EFfF0Vwa7yWXgfP1lVyRZgyqCY6GA2PyUEuC687m_eIjO7vXvuP3cHLw1P_ZtCVlMVVlycqUYiAPJGJ5HqsIgo5lxQwihOINM8ZjNNIZ6nKc54pmo1zypjOohxDltEjcrX2XdTZvJHrsnKyEAtn5tJ9CyuN-P9Tmol4t58CkTFKOW0czjcOzn7U2ldibrxq4jX3tLUXFBFDiAHTBj3bQae2dmWTr6FYyNOQxUvqck0pZ713Ov_bBkEsyxI7ZYllWWJVViM-2c7zJ_2thv4A-tOVJg</recordid><startdate>20240903</startdate><enddate>20240903</enddate><creator>Tan, Jia Yi</creator><creator>San, Boon Jian</creator><creator>Yeo, Yong-Hao</creator><creator>Chan, Kok Hoe</creator><creator>Shaaban, Hamid S</creator><creator>Ezekwudo, Daniel E</creator><creator>Idowu, Modupe</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240903</creationdate><title>Social Vulnerability and Sickle Cell Disease Mortality in the US</title><author>Tan, Jia Yi ; San, Boon Jian ; Yeo, Yong-Hao ; Chan, Kok Hoe ; Shaaban, Hamid S ; Ezekwudo, Daniel E ; Idowu, Modupe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a347t-58c8c110158a8a5edc630f5a30167806e5f40d96eb9cff5bc3bdf344eb6f124b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anemia, Sickle Cell - mortality</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cross-Sectional Studies</topic><topic>Disease control</topic><topic>Female</topic><topic>Hematology</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Online Only</topic><topic>Original Investigation</topic><topic>Sickle cell disease</topic><topic>Social Determinants of Health - statistics & numerical data</topic><topic>Social Vulnerability</topic><topic>United States - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tan, Jia Yi</creatorcontrib><creatorcontrib>San, Boon Jian</creatorcontrib><creatorcontrib>Yeo, Yong-Hao</creatorcontrib><creatorcontrib>Chan, Kok Hoe</creatorcontrib><creatorcontrib>Shaaban, Hamid S</creatorcontrib><creatorcontrib>Ezekwudo, Daniel E</creatorcontrib><creatorcontrib>Idowu, Modupe</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JAMA network open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tan, Jia Yi</au><au>San, Boon Jian</au><au>Yeo, Yong-Hao</au><au>Chan, Kok Hoe</au><au>Shaaban, Hamid S</au><au>Ezekwudo, Daniel E</au><au>Idowu, Modupe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Social Vulnerability and Sickle Cell Disease Mortality in the US</atitle><jtitle>JAMA network open</jtitle><addtitle>JAMA Netw Open</addtitle><date>2024-09-03</date><risdate>2024</risdate><volume>7</volume><issue>9</issue><spage>e2440599</spage><pages>e2440599-</pages><issn>2574-3805</issn><eissn>2574-3805</eissn><abstract>Social determinants of health (SDOH) influence health outcomes, including those of sickle cell disease (SCD), despite advancements in treatments like disease-modifying therapies.
To investigate the association of SDOH with SCD mortality rates from 2016 to 2020.
This cross-sectional study combined county-level data from the Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI) with SCD mortality data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database from January 1, 2016, to December 31, 2020. US counties were divided into 4 quartile (Q) models according to their SVI scores. Deaths from SCD in the US among patients of all ages were included. Data analysis occurred from March to April 2024.
SVI score.
Age-adjusted mortality rates (AAMRs) per 1 000 000 individuals were measured. Rate ratios (RRs) were obtained by comparing county-specific AAMRs of SVI-Q4 with SVI-Q1.
From 2016 to 2020, among a total population of 1 633 737 771 individuals, there were 2635 deaths from SCD (1289 male [49.1%] and 1336 female [50.9%]). There were 1480 deaths in Q4, 687 deaths in Q3, 344 deaths in Q2, and 114 deaths in Q1. Higher SVI was associated with 2.11 excess deaths per 1 000 000 individuals (RR, 4.90; 95% CI, 4.81-5.00). Similar trends were seen for both males (RR, 4.56; 95% CI, 4.44-4.69) and females (RR, 5.85; 95% CI, 5.68-6.03). Middle-aged patients with SCD had the highest mortality rate in Q4, with 3.45 excess deaths per 1 000 000 individuals (RR, 4.97; 95% CI, 4.85-5.09). Higher SVI was associated with 2.29 excess deaths per 1 000 000 individuals in African American individuals with SCD (RR, 1.24; 95% CI, 1.22-1.27]). In White individuals with SCD, higher SVI was associated with 0.12 excess deaths per 1 000 000 individuals (RR not available due to unreliable data in Q1). When stratifying by census region, the highest level of SCD-related mortality was in the Northeast, with higher SVI associated with 3.16 excess deaths per 1 000 000 individuals (RR, 8.02; 95% CI, 7.66-8.40).
In this cross-sectional study of the association of SVI with SCD mortality rates, higher SVI was associated with higher SCD mortality across US counties. These findings underscore the importance of addressing social determinants of health to improve mortality outcomes among patients with SCD.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>39348116</pmid><doi>10.1001/jamanetworkopen.2024.40599</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Anemia, Sickle Cell - mortality Child Child, Preschool Cross-Sectional Studies Disease control Female Hematology Humans Infant Male Middle Aged Mortality Online Only Original Investigation Sickle cell disease Social Determinants of Health - statistics & numerical data Social Vulnerability United States - epidemiology Young Adult |
| title | Social Vulnerability and Sickle Cell Disease Mortality in the US |
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