Study design and participants
This is a retrospective cross-sectional study of pediatric SCD patients
managed at Children’s of Alabama (the only free-standing pediatric
hospital in the state with a large pediatric SCD center) from 2012 to
2018. Clinical and socio-demographic data of the cohort were obtained
retrospectively from the electronic medical record throughout the
lifetime of each individual through an ongoing protocol approved by the
University of Alabama at Birmingham Institutional Review Board
(IRB-00000196). Area-level data were obtained by geocoding patients’
residential addresses to U.S. Census block groups (the smallest
geographic units for which U.S. Census data is available, used as
proxies for neighborhoods) and pairing them to existing area-level
measures as described further.