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The burden of poverty in children with haemoglobinopathies presenting to a London tertiary referral centre
  1. G Hann1,
  2. M Roberts-Harewood2,3,
  3. A Yardumian3,
  4. O Wilkey1
  1. 1Paediatric Department, North Middlesex University Hospital NHS Trust, London, UK
  2. 2Paediatric Haematology Department, Great Ormond Street Hospital, London, UK
  3. 3Haematology Department, North Middlesex University Hospital NHS Trust, London, UK

Abstract

Background The burden of poverty and its impact on children with sickle cell disease has been documented in the United States of America where healthcare is accessed via health insurance programs. In the UK, there are few references in the literature to the impact of poverty on sickle cell disease or the extent of poverty within the sickle cell population. However, there has been media coverage of children with sickle cell disease, entering the country illegally, being deported to countries with inadequate healthcare provisions.

Objectives We aim to show the demographics of children attending a tertiary haemoglobinopathy referral centre, and the locations of their respective domiciles to examine the burden of poverty and deprivation within the areas of residence.

Methods The postcodes of 256 paediatric haemoglobinopathy patients were plotted on a map of the boroughs served by the hospital. The deprivation and poverty indices of each borough were then analysed. The highest areas of poverty within each borough were located and compared to where the children were resident.

Results 49% of children attending the hospital lived in the borough of Enfield, ranked 15th highest out of 32 London boroughs for child poverty. Enfield is ranked as the 74th most deprived borough in the country out of 354 boroughs. 35% of children lived in the borough of Haringey ranked as the 5th most deprived London borough with the 4th highest level of child poverty in London. Haringey is the 18th most deprived borough in England. The children from both Enfield and Haringey lived in the most deprived areas of those boroughs.

Conclusions There is a strong link between poverty and haemoglobinopathies based on the findings from this study. 84% of the children with a haemoglobinopathy lived in two of the most deprived boroughs in the country with high levels of child poverty. 3% of the children were on a child protection plan and many more had social problems including problems with immigration. The impact of this poverty to their health is yet undetermined but further studies are planned by the authors of this paper.

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