225384 Mortality from sickle cell disease: Geographic and ethnic variation within the United States

Monday, November 8, 2010 : 2:45 PM - 3:00 PM

Maria del Pilar Aguinaga, PhD, DLM, ASCP , Department of Obstetrics and Gynecology/Sickle Cell Center, Meharry Medical College, Nashville
Green A. Ekadi, PhD, MS , School of Graduate Studies and Research, Meharry Medical College, Nashville, TN
Barbara Kilbourne , Center for Health Research, Tennessee State University, Nashville, TN
Maureen Sanderson, PhD , Department of Obstetrics and Gynecology, Meharry Medical College, Nashville, TN
Robert S. Levine, MD , Department of Family & Community Medicine, Meharry Medical College, Nashville, TN
Background: Sickle Cell Disease Sickle (SCD), an inherited hemoglobinopathy characterized by a chronic hemolytic anemia and frequent painful vaso-occlusive episodes, is a major health problem in the United States (US) that affects primarily minority populations. It yields significantly decreased life expectancy, with a devastating burden of disease on the patient and family. SCD is the most common genetic disorder identified at birth by newborn screening in the US. Little is known about geographic and ethnic variations in US mortality due to SCD. Objective: Describe mortality from SCD among blacks according to Hispanic ethnicity and state for the years 1999-2006. Methods: Mortality data was from the Centers for Disease Control and Prevention Compressed Mortality File available on the Wonder web site. Results: US mortality from SCD among black Hispanics (0.2 per 100,000, 95% confidence interval [CI] 0.13-0.29) was 6.5 times lower than that among non-Hispanic blacks (1.3 per 100,000, 95% CI 1.27-1.36). Among 28 states with reliable mortality rates, there was a two-fold ethnic difference between the lowest rate (0.9 per 100,000 in Connecticut, Maryland, and Massachusetts) and the highest rate (1.8 per 100,000 in South Carolina and Wisconsin). Variations in mortality were slight across US regions, and there was no correlation between mortality from SCD with and without crisis. Conclusions: Further study is required to determine whether observed variations in SCD mortality among blacks by ethnicity and state is due to artifact, variations in disease severity, or variations in access and utilization of health care.

Learning Areas:
Assessment of individual and community needs for health education
Chronic disease management and prevention
Clinical medicine applied in public health
Other professions or practice related to public health
Program planning

Learning Objectives:
Explain why sickle disease is a major problem in the US Describe variations in black mortality due to sickle cell disease according to ethnicity and place within the US Discuss the benefits of further study of observed variations in sickle cell disease

Keywords: Minority Health, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present I am a professor in the Dept. of OB/GYN and Director of, and Researcher in, the Meharry Sickle Cell Center
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.