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.