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<p>Several studies have assessed the impact of socioeconomic factors on the health of sickle cell patients, yielding heterogeneous results. We conducted a population-based study using a health-insurance database in France to investigate this association, using longitudinal data over a 9-year follow-up time. Socioeconomic factors were assessed using the validated French deprivation index, an area-level index of social disadvantage. The study population comprised 17,315 patients with a median age of 23&#xa0;years and a median follow-up of 8.1&#xa0;years. Patients living in the most disadvantaged areas were at greater risk of vaso-occlusive events (VOEs): 70.4% of patients with a median cumulative time of hospitalization of 33.5&#xa0;days over the study period in the disadvantaged socioeconomic group, compared to 67.9% of patients and 29.9&#xa0;days in the comparison group (p = 0.035 and p &lt; 0.001). There was no difference regarding chronic complications, but a trend towards higher mortality in the disadvantaged group (HR: 1.13, 95% CI: 0.94—1.36). There was no difference between groups in access to preventive and curative care recommended in mainland France (vaccination, folic acid supplementation, antibiotic prophylaxis, hydroxycarbamide use).</p>

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Socioeconomic deprivation, disease complications and access to preventive care in sickle cell disease in mainland France

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月26日

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  • Ondine Walter,
  • Pierre Cougoul,
  • Maryse Lapeyre-Mestre,
  • Michelle Kelly-Irving,
  • Margaux Lafaurie,
  • Guillaume Moulis.

摘要

Several studies have assessed the impact of socioeconomic factors on the health of sickle cell patients, yielding heterogeneous results. We conducted a population-based study using a health-insurance database in France to investigate this association, using longitudinal data over a 9-year follow-up time. Socioeconomic factors were assessed using the validated French deprivation index, an area-level index of social disadvantage. The study population comprised 17,315 patients with a median age of 23 years and a median follow-up of 8.1 years. Patients living in the most disadvantaged areas were at greater risk of vaso-occlusive events (VOEs): 70.4% of patients with a median cumulative time of hospitalization of 33.5 days over the study period in the disadvantaged socioeconomic group, compared to 67.9% of patients and 29.9 days in the comparison group (p = 0.035 and p < 0.001). There was no difference regarding chronic complications, but a trend towards higher mortality in the disadvantaged group (HR: 1.13, 95% CI: 0.94—1.36). There was no difference between groups in access to preventive and curative care recommended in mainland France (vaccination, folic acid supplementation, antibiotic prophylaxis, hydroxycarbamide use).