Medically reviewed by Dr. Samuel Sarmiento, M.D., MPH on Oct. 4, 2023
A new study finds that Black patients have a lower life expectancy when living with sickle cell disease compared to Non-Blacks. This is despite being insured by Medicare and Medicaid, and might point to healthcare disparities requiring further investigation.
Sickle Cell Disease (SCD) affects about 100,000 individuals in the United States. However, this genetic disorder disproportionately affects people of African descent and other ethnic minorities. SCD predisposes individuals to wide-ranging life-threatening complications like stroke, severe anemia, chronic pain, and organ damage. Thus, these individuals require regular medical attention. Consequently, most of those living with the condition in the US are beneficiaries of Medicare and Medicaid. The present study, published in the journal Blood Advances, focused on the long-term survival of SCD patients with Medicare and Medicaid coverage.
Blacks Have Lower Life-Expectancy Than Non-Blacks
The study analyzed Medicare and Medicaid claims data between 2008 and 2016 for beneficiaries living with SCD, covering 50 states. The final data analysis included 94,616 individuals. The study confirmed that SCD patients have a life expectancy of 52.6 years. Moreover, the study also found that those with dual coverage of Medicare and Medicaid had worse survival, which is explained by the fact that these individuals live with more severe disease and its complications.
However, there were some surprising findings in the study that pointed to health disparities. The study additionally analyzed the life expectancy of Blacks vs. Non-Blacks when living with SCD. This secondary data analysis demonstrated that, at birth, the life expectancy of Black individuals living with SCD was 52.2 years vs. 55.1 years for Non-Black individuals.
The Bottom line
Though the study did not explicitly focus on health disparities, its data clearly indicate poor health outcomes and a lower life expectancy among Blacks despite adequate insurance coverage. This indicates that the reasons for worse health outcomes and disparities are not essentially related to poor access to healthcare alone. There could be other factors like worse care, poor communication, differences in managing the disease-related complications, and so on. Further, studies are needed to determine the causes for different outcomes and lower life expectancy of Blacks vs. Non-Blacks when living with SCD, since overcoming health disparities may significantly help enhance overall life expectancy for the population group.
Jiao, B., Johnson, K. M., Ramsey, S. D., Bender, M. A., Devine, B., & Basu, A. (2023). Long-Term Survival with Sickle Cell Disease: A Nationwide Cohort Study of Medicare and Medicaid Beneficiaries. Blood Advances, 7(13), 3276–3283. https://doi.org/10.1182/bloodadvances.2022009202