Food insecurity and housing instability are 2 social determinants of health linked with poorer diet quality in children with sickle cell disease (SCD), according to a recent investigation published in Pediatric Blood & Cancer.

The authors found that children with SCD who lived in environments with food insecurity and housing instability consumed more dairy and pizza and less whole grains. Moreover, they reported an association between housing instability alone and higher dairy intake in children with SCD.

“Screening families of children with SCD for food insecurity and housing instability may identify those with potential nutrition-related social needs,” the authors said.

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The study enrolled 100 participants (mean age, 10.6 ± 5.6 years, 53% black and 43% Hispanic) from 1 pediatric SCD center. Most (70%) indicated less than or equal to 1 measure of economic instability, with 40% reporting housing instability alone, and 30% reporting both food insecurity and housing instability. Most (80%) participants received at least 1 federal food assistance benefit.

Fernández et al used validated US instruments and a food frequency questionnaire to measure food insecurity, housing instability, and dietary quality. The better dietary quality was defined by the US dietary guidelines.

Social determinants of health are known to affect economically unstable and under-resourced US communities, therefore affecting children with SCD who live in such communities.

In contrast, in high-income countries, children with SCD present with better outcomes and live well into adulthood, although their overall survival rates are inferior to that of the general population.


Fernández CR, Licursi M, Wolf R, Lee MT, Green NS. Food insecurity, housing instability, and dietary quality among children with sickle cell disease: assessment from a single urban center. Pediatr Blood Cancer. Published online November 22, 2021. doi:10.1002/pbc.29463