€Œmaking Ends Meetâ€�: Poverty As a Predictor for the Well-Being of Youth Diagnosed with Sickle Cell Disease

Background: The literature has documented the potentially negative outcomes of living in poverty, which disproportionately impact African American children (Goosby, 2007). Sickle cell disease (SCD), a chronic illness that is largely diagnosed among African Americans, is also accompanied with adverse outcomes such as poor psychosocial functioning (Barakat et al., 2012). However, documentation examining the potential outcomes of youth living in poverty who are diagnosed with SCD is scarce. Moreover, studies often neglect to include a theoretical model. Using a conceptual framework on the effects of poverty on child and youth mental, emotional, and behavioral health (Yoshikawa et al., 2012), the aim of this study is to: (1) investigate whether poverty predicts the HRQOL of youth diagnosed with SCD and (2) analyze the mediating role of parenting stress. Findings provide implications for social work, as social workers are often tasked with managing the psychosocial functioning of this population.

Methods: A total of 150 youth, ages 8-17 years old, diagnosed with SCD and their parents were included in this study. The Pediatric Quality of Life Scale (PedsQL)3.0 and the parental stress scale gathered HRQOL and parental stress data, respectively. A demographic questionnaire was used to collect patient and parent variables. Using linear regression, this study investigated whether poverty predicted the HRQOL of youth diagnosed with SCD and whether parental stress served as a mediator. Next, the study presents findings using the conceptual framework on the effects of poverty on child and youth mental, emotional, and behavioral health. Lastly, implications for social work are discussed.

Results: Poverty served as a predictor for poor HRQOL in this sample (p = .05) and the mediating role of parenting stress was also significant (p < .001). In relation to the study findings and supplemental literature, we will present Yoshikawa and colleague’s (2012) conceptual framework on the effects of poverty on child and youth mental, emotional, and behavioral health. This model highlights potential mediating factors associated with the mental, emotional, and behavioral outcomes of youth living in poverty. Participants will see how this model applies to the current study and understand implications for social work.

Implications: Youth diagnosed with SCD who live below the poverty threshold are at risk poor psychosocial functioning. Parenting stress was shown to play a mediating role in child outcomes, which underscores the need for the advancement of social work policy, practice, and education in this area. For social work policy, study findings shift the focus from treating the downstream issue of poverty among youth with SCD to the upstream problem of what places youth and families at risk for falling into poverty. With study findings showing poverty as a predictor for HRQOL, along with the mediating effect of parenting stress, social workers in the practice setting may find it beneficial to gather sociodemographic details of their patients and provide resources for patients when appropriate. Lastly, the results of the current study emphasize the need for advancing social work healthcare curriculums to include the role of poverty on youth with chronic illness.