Social Determinants of Severity in Sickle Cell Disease

This chapter argues that biological and genetic factors, as well as good medical care, can impact on sickle cell disorders (SCD) and how the condition is experienced. We adopted a ‘social determinants of health’ (SDH) lens to understand and explain sociocultural, environmental, economic and political factors which can worsen the impact of SCD for people. We start the chapter by explaining what SCD are, why severity is a particular issue and how the SDH perspective might offer us some solutions. We then give an overview to highlight what we feel would be the main factors that would impact on severity of SCD: (1) environmental; 2) socio-political and economic; (3) physiological; (4) psychosocial; (5) structural; (6) trauma; and (7) physical violence. As SDH align with the WHO's One Health agenda of ensuring universal healthcare for all people, this chapter proposes ways of working with inter-disciplinary and cross-sectoral actors to provide person-centred management of SCD that meets the needs of different people while increasing accessibility to care for SCD.