Predictors of Employment Status Among African Americans with Sickle Cell Disease

Individuals with sickle cell disease (SCD) are less likely to look for a job when they see their condition as a limitation.

Sickle cell disease (SCD) affects an estimated 80,000 Americans; 40 percent to 60 percent of the SCD population is unemployed; although SCD patients can experience severe pain and other health problems, it is unlikely that these symptoms are the root cause of unemployment.

This study pursued psychosocial explanations for unemployment among African-Americans with SCD (SCD patients in the U.K. had previously identified fears of being judged by employers as a barrier to employment). The authors examined data from the Cooperative Study of Sickle Cell Disease (CSSCD). Participants reported their perceptions of how SCD affected their social relationships and emotions; a survey question assessed the extent that SCD interfered with work or school; other measures included self-esteem, depression, perceived control over the disease (locus of control), assertiveness and employment status.

Key Findings:

  • Women with SCD were nearly three times as likely as men with SCD to be employed.
  • SCD patients who considered themselves more self-assertive were more likely to be employed; assertiveness was associated with higher self-esteem and less depression.
  • Forty-seven percent of participants had a high school education or less; however, employment was not influenced by education level.

A greater proportion of the population suffering from SCD is unemployed than suffer severe physical symptoms; therefore, it is unlikely that the pain caused by SCD is the only cause of unemployment. Among African-Americans, it is possible that men, facing pressure to conform to masculine stereotypes, are hesitant to disclose their condition to employers; also, employment opportunities for African-American men may already be limited.