The Social and Cultural Context of Coping with Sickle Cell Disease: I. A Review of Biomedical and Psychosocial Issues

Sickle cell disease (SCD) is widely conceived in the United States as a group of blood disorders that principally affect African Americans. Although pain is its principal feature, strokes, lung problems, sepsis, anxiety, depression, impaired social functioning, and maladjustment at work are frequent concomitants. This article selectively reviews biomedical and psychosocial aspects of SCD related to pain assessment, medical treatment, genetic counseling, education, and employment. The strongest support exists for claims of social deficits among adolescents and depression and work-related problems among adults. The social context of SCD, including issues related to socioeconomic status (SES), urbanicity, ethnicity, cultural values, and racial stigmatization, are important to include in empirical assessments and theoretical analyses of the effects of SCD on children and their families. The adverse psychosocial functioning often described as an effect of SCD might indeed be a consequence of these factors acting alone or in concert with the strains of SCD.