Sickle Cell Disease: Babies, Migrants, & Mental Health

Imagine that you have been experiencing frequent episodes of excruciating pain since the age of six. Imagine having a condition that not many people, including physicians, understand.  Imagine not expecting to live to see your 50^th birthday.  Unfortunately, these are realities for many people living with sickle-cell disease (also known as sickle-cell anemia).  Based on the limited literature and data available on the disease, it seems to be an understudied and often misunderstood condition that has serious health consequences.  Globally, nearly 5% of the population carries the trait genes for haemoglobin disorders like sickle cell anemia (World Health Organization (WHO), 2011).  Sickle-cell disease is linked to a variety of global health concerns, including: infant and child mortality, migration, and mental health.  

Sickle-cell disease causes the disfigurement of the red blood cells, resulting in restricted blood flow and blockages to all parts of the body (WHO, 2011).  Individuals living with sickle-cell disease are susceptible to chronic pain, tissue death, and serious bacterial infections (WHO, 2011).  The life expectancy for an adult with sickle-cell disease is 42 to 48 years of age (Platt, Rosse, Milner, Castro, Steinberg, & Klug, 1994).  Sickle-cell disease can only be cured by a bone marrow transfusion (Chakrabarti & Bareford, 2004).  Unfortunately, for a variety of reasons, this is not a feasible option for many sickle-cell disease patients (Chakrabarti & Bareford, 2004).  

 

Infant & Child Mortality

Infant and child mortality continues to be a major global health concern, especially in low- and middle-income countries (see WHO, 2014).  More than 300,000 babies are diagnosed with serious haemoglobin disorders like sickle-cell disease every year (WHO, 2011).  Most of these babies are born in low- and middle-income countries (WHO, 2011).  According to WHO, 50% to 80% of the infants in low- and middle- income countries who are born with sickle-cell disease die before they reach 5 years of age.

Migration

Even though sickle-cell disease is most prevalent in tropical regions, it is estimated to affect 90,000 Americans.  It is most common in Black or African-Americans.  In fact, 1 out of 500 Blacks or African-Americans are born with sickle-cell disease (Centers for Disease Control and Prevention (CDC), 2011).  It is said that the disease was spread to most countries by migration (WHO, 2011).  I think this is interesting based on our class discussions on migration.  This seems to be a unique example of how migration can affect subgroups within a host country.  Sickle-cell disease could be a result of forced migration from the slave trade or voluntary migration.

Mental Health

Similar to other chronic conditions, sickle-cell disease not only affects an individuals physical health, it can also greatly affect his or her mental health.  Studies have found that sickle-cell disease causes painful episodes, deteriorated vision, anemia, and depression (Jenerette, Funk, & Murdaugh, 2005).  One major reason for this is that others often stigmatize individuals living with the illness, including physicians (Jenerette, Funk, & Murdaugh, 2005).  I think sickle-cell disease offers us another illustration of why patients would benefit from the integration of physical and mental health.

There seems to be a great opportunity to build on the research on sickle-cell disease.  As I mentioned earlier, this appears to be a very understudied topic.  Additionally, it raises questions about who decides which health conditions are important.  I think it also provides evidence that a focus on global health is essential because health issues can breach geographic boundaries and international borders.

Works Cited

Centers for Disease Control and Prevention. (2011, September 16). Sickle Cell Disease (SCD). Retrieved December 4, 2014, from Centers for Disease Control and Prevention: http://www.cdc.gov/ncbddd/sicklecell/data.html

Chakrabarti, S., & Bareford, D. (2004). Will developments in allogeneic tranplantation influence treatment of adult patients with sickle cell disease? Biology of Blood & Marrow Transplantation , 10 (1), 23-31.

Jenerette, C., Funk, M., & Murdaugh, C. (2005). Sickle cell disease: A stimatizing condition that may lead to depression. Issues in Mental Health Nursing , 26, 1081-1101.

Platt, O. S., Rosse, D. J., Milner, W. F., Castro, P. F., Steinberg, M. H., & Klug, P. P. (1994). Mortality in sickle cell disease. Life expectancy and risk factors for early death. New England Journal of Medicine , 330 (23), 1639-1644.

World Health Organization. (2011, January). Media centre: Sickle-cell disease and other haemoglobin disorders. Retrieved Dec 4, 2014, from World Health Organization: http://www.who.int/mediacentre/factsheets/fs308/en/