Socioeconomic deprivation, disease complications and access to preventive care in sickle cell disease in mainland France

Socioeconomic deprivation, disease complications and access to preventive care in sickle cell disease in mainland France | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Socioeconomic deprivation, disease complications and access to preventive care in sickle cell disease in mainland France Ondine Walter, Pierre Cougoul, Maryse Lapeyre-Mestre, Michelle Kelly-Irving, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7767414/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Several studies have assessed the impact of socioeconomic factors on the health of sickle cell patients, yielding heterogeneous results. We conducted a population-based study using a health-insurance database in France to investigate this association, using longitudinal data over a 9-year follow-up time. Socioeconomic factors were assessed using the validated French deprivation index, an area-level index of social disadvantage. The study population comprised 17,315 patients with a median age of 23 years and a median follow-up of 8.1 years. Patients living in the most disadvantaged areas were at greater risk of vaso-occlusive events (VOEs): 70.4% of patients with a median cumulative time of hospitalization of 33.5 days over the study period in the disadvantaged socioeconomic group, compared to 67.9% of patients and 29.9 days in the comparison group (p=0.035 and p<0.001). There was no difference regarding chronic complications, but a trend towards higher mortality in the disadvantaged group (HR: 1.13, 95% CI: 0.94 - 1.36). There was no difference between groups in access to preventive and curative care recommended in mainland France (vaccination, folic acid supplementation, antibiotic prophylaxis, hydroxycarbamide use). These underline the importance of socioeconomic disadvantage, independently of accessibility to healthcare, in the morbidity and mortality of sickle cell patients. Sickle cell disease Sickle cell anemia Epidemiology Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryMaterial.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 25 Nov, 2025 Reviews received at journal 25 Nov, 2025 Reviews received at journal 24 Nov, 2025 Reviews received at journal 12 Nov, 2025 Reviewers agreed at journal 08 Nov, 2025 Reviewers agreed at journal 07 Nov, 2025 Reviewers agreed at journal 15 Oct, 2025 Reviewers invited by journal 13 Oct, 2025 Editor assigned by journal 07 Oct, 2025 Submission checks completed at journal 07 Oct, 2025 First submitted to journal 02 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7767414","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":534022060,"identity":"e42e37de-438a-44be-be6d-e1b07444e21b","order_by":0,"name":"Ondine Walter","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/ElEQVRIie3NsUvDQBTH8V8p2OWw64Vi/oaTg8NCoP9KDiFT0U0ccwTSJdA1/S+EQqcOV4R2OXHNaBfniEuGDMakIAiXOjrcd3m8Bx8e4HL9y4ZxO8Yg3X7ZDb+HDFRrvPibhMBFd+bnCdN/JeywW7x9bOHzw8ueDqpApqOMlyXYvZUYqVT+Di7MXUQRRjIlRng52DS2EKGlSoiG3BRETOrwWaZ0LoYENbN9Ea9HldQNWedENF9awj9rMDspmi9oyBP9IWyCHjIrjmqVacqpmfMbRBFPyf7By5ideMtbXVY68McLc10gCK6Wo2RdVo92cor+PpwDLpfL5ertCyexUgVIBZs/AAAAAElFTkSuQmCC","orcid":"","institution":"Toulouse University Hospital","correspondingAuthor":true,"prefix":"","firstName":"Ondine","middleName":"","lastName":"Walter","suffix":""},{"id":534022061,"identity":"74364e32-c605-445c-9db5-f3c0c9a20211","order_by":1,"name":"Pierre Cougoul","email":"","orcid":"","institution":"Toulouse University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Pierre","middleName":"","lastName":"Cougoul","suffix":""},{"id":534022062,"identity":"eaa64a9a-125a-4fa0-882c-80af92258719","order_by":2,"name":"Maryse Lapeyre-Mestre","email":"","orcid":"","institution":"Toulouse University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Maryse","middleName":"","lastName":"Lapeyre-Mestre","suffix":""},{"id":534022063,"identity":"86a43419-ad09-4f2e-a669-06fa4be13a01","order_by":3,"name":"Michelle Kelly-Irving","email":"","orcid":"","institution":"Université Toulouse III - 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