Interrelated Topics and Contributing Factors of African-American Disparities Identified Within Race-Related Sickle Cell Literature

Abstract

Background: Sickle cell disease is a predominately African-American disease that affects more than 100,000 people in the United States. Unfortunately, these patients are subject to many healthcare disparities and issues pertaining to race are often overlooked or marginalized in sickle cell literature.

Objectives:The purpose of this integrative literature review was to expose trending topics amongst race-related sickle cell literature, identify the factors that are found to contribute to sickle cell disease healthcare disparities and report whether or not race was found to affect the management of sickle cell disease.

Method:An integrative literature review was used.

Results:The four most common topics amongst sickle cell literature that addressed race were: pain management, provider attitudes, acute care facility utilization and perceived race-related discrimination or racism. Within those topics, the following four factors were commonly identified as having an effect on sickle cell disease healthcare disparities: patient mistrust of the healthcare system, lack of objective findings in SCD manifestation, lack of a SCD pain management protocol, and poor patient-provider communication.

Conclusions:The majority of the studies concluded that race is not the sole contributing factor to the healthcare inequalities experienced by SCD patients. Only one study objectively identified race as a contributing factor to SCD disparities and it stressed the need for provider education and the implementation of medical protocols in order to change providers’ attitudes.

Key Words:disparities, race; racism; sickle cell disease