SDoH, Financial Hardship Exacerbate Distress in Individuals With Hemophilia

A cross-sectional study aimed to examine hemophilia-related distress (HRD) based on race and ethnicity, as previous research has shown that HRD is higher among individuals with lower educational attainment, according to researchers.

Researchers analyzed data from the hemophilia-related distress questionnaire (HRDq) validation study, involving adults with hemophilia A or B. Participants were recruited from 2 hemophilia treatment centers between July 2017 and December 2019.

The HRDq scores ranged from 0 to 120, with higher scores indicating higher levels of distress. The self-reported race/ethnicity categories were grouped as Hispanic, non-Hispanic White, and non-Hispanic Black. Unadjusted and multivariable linear regression models were used to examine the relationship between race/ethnicity and HRDq scores, as well as potential mediators.

Out of 149 participants enrolled, 143 completed the HRDq and were included in the analyses. Among the participants, approximately 17.5% were non-Hispanic Black, 9.1% were Hispanic, and 72.0% were non-Hispanic White. 

The mean HRDq score was 35.1 (standard deviation (SD) = 16.5), with scores ranging from 2 to 83. The average HRDq scores were significantly higher among non-Hispanic Black participants (mean = 42.6, SD = 20.6) compared to non-Hispanic White participants (mean = 33.2, SD = 14.9). However, there was no significant difference in HRDq scores between Hispanic participants (mean = 33.8, SD = 16.7) and non-Hispanic White participants.

When adjusting for inhibitor status, severity, and target joint, the differences in HRDq scores between non-Hispanic Black and non-Hispanic White participants remained statistically significant. However, after adjusting for household income, the differences in HRDq scores between non-Hispanic Black and non-Hispanic White participants were no longer significant. The analysis indicated that household income mediated the higher distress scores observed in non-Hispanic Black participants compared to non-Hispanic White participants.

These findings underscore the importance of understanding social determinants of health and financial hardship in individuals with hemophilia, researchers said. Addressing financial challenges and improving access to resources may help alleviate hemophilia-related distress, particularly among individuals from marginalized racial and ethnic groups, the authors concluded.

Reference:
Fedewa SA, Buckner TW, Parks SG, et al. Racial and Ethnic Differences in Distress, Depression, and Quality of Life in people with hemophilia. J Racial Ethn Health Disparities. Published online May 3, 2023. 2023;10.1007/s40615-023-01616-3. doi:10.1007/s40615-023-01616-3