Sickle cell disease and climate change affects Black and minoritised ethnic communities disproportionately – the connection must be recognised to fight effectively for equity.
Despite Sickle Cell Disease (SCD) being the UK’s most common genetic blood disorder, it remains under recognised, and its treatment is chronically underfunded (NHS Race & Health Observatory, 2025).
Sickle Cell Disease principally affects people from Black communities. It’s sad, yet unsurprising, that it represents yet another site of health and race inequity, with those living with the disease often experiencing substandard care. The NHS screened 660,000 pregnant women and 617,000 newborns for sickle cell, thalassaemia, and related conditions in 2019-2020. One in 2,517 were diagnosed with a significant sickle cell condition and one in 78 were carriers. The screening picked up possible cases in about 7 out of every 1,000 Black African newborns, far higher than the national average of less than 1 in 1,000 babies.(Gov.uk, 2022)
Sickle Cell Disease is where health and climate inequity are inextricably linked. Negative climate change effects, such as increased toxic air and pollutants, disproportionately affect Black and minoritised ethnic communities, who are over-represented in regions facing the worst weather and pollution extremes. These environmental stressors, driven by the climate crisis, significantly exacerbate Sickle Cell Disease symptoms. Changing rainfall patterns, windstorm intensity and toxic air pollution, can each trigger painful episodes for people with the disease. Rapid temperature shifts driven by climate change, can cause rapid skin cooling which can lead to painful blockages in blood flow that create sickle cell crises. Meanwhile, a London-based study found that high levels of ground-level ozone (O₃), a pollutant that forms from a chemical reaction when emissions react with sunlight on hot days, has been linked to spikes in hospital admissions for sickle cell pain (Yallop et al., 2007)
Such pollution has been shown to produce harmful effects on the lungs, and researchers believe the respiratory stress it provokes worsens crises for people with SCD. Research in London and Paris also found that weather conditions like wind speed and rainfall were particularly associated with a spike in hospital admissions for child sufferers of Sickle Cell Disease (Piel et al., 2017)
The inequitable experience of climate change is concerning in itself, with Black communities in London, for instance, disproportionately exposed to toxic air. (Race Equality Foundation, 2023)
To understand that this is compounded by a genetic disease which affects Black communities in greater numbers, being undertreated, under researched, underdiagnosed, and its symptoms exacerbated by a climate crisis which also disproportionately affects such communities, is intolerable. We know Sickle Cell Disease is inherited, but the inequities experienced are a result of systemic structures that neglect the health of certain communities. To effectively dismantle both health and environmental inequity, they must be examined as interconnected issues. Sickle Cell Disease is a glaring example as to why.
SCD should remind us that the fight for health equity doesn’t just concern healthcare systems and policy. It’s also about building environments where everyone can live, breathe, and heal. Too often, the development of health and environmental systems has overlooked the needs of people from Black communities. It’s important that community advocates have the evidence and knowledge on how such issues intersect to organise and self-advocate effectively, and policymakers can construct systems which mitigate against climate change and systemic racism compounding to affect the most vulnerable.
In addition, environmental, health and urban planning institutions must continue to strive to build trust with Black and minoritised ethnic communities, in order to meaningfully engage and support them. Blood donations from Black donors are urgently needed for sickle cell care, as the rare Ro blood subtype needed is more common among people from Black communities. Furthermore, people with Sickle Cell Trait are not only eligible to donate blood, but are more likely to provide the necessary closely matched blood for patients with SCD. Yet barriers persist, from mistrust in medical institutions and misinformation, to restrictive eligibility rules, that make donating more difficult.
As with all inequities, it’s not enough to be aware if nothing changes. Let’s fight by not only giving blood, if able, but also pushing for systems that establish clean air as a right for all.
To campaign with Health Equals and raise awareness of the unequal impacts of toxic air, visit https://healthequals.org.uk/is-that-fair/
To learn more about blood donation, visit: https://www.blood.co.uk/
