Abstract Background Reducing inequalities among patients with inherited, chronic, and complex disorders requiring lifelong care remains a global public health priority. Despite medical advances, inequalities in healthcare access and quality persist for patients with β-thalassaemia. This study examined the associations between socio-economic indicators at the individual and country levels and clinical outcomes in β-thalassaemia patients using data from the International Thalassaemia Collaborative Assessment Patient Survey. Study design and methods Data from 971 patients across 45 countries were analysed. Individual-level socio-economic status (SES) was assessed through patients’ educational attainment and employment status, while country-level SES was represented by the Human Development Index and the World Bank Income classification. Clinical outcomes included pre-transfusion haemoglobin levels, serum ferritin concentration, cardiac T2* score, and liver iron concentration. Inequalities were quantified using the Slope Index of Inequality, representing absolute differences in outcomes between patients of lowest and highest SES. Results All SES indicators were positively associated with better clinical outcomes. Higher education and full-time employment corresponded to better levels of haemoglobin, ferritin, cardiac, and liver iron measures. Similarly, patients living in higher-income countries had better clinical measures compared to those living in lower-income countries. These findings indicate that socio-economic advantage is linked with improved disease management and monitoring quality. Discussion Socio-economic determinants influence the clinical outcomes of transfusion-dependent β-thalassaemia patients, which in turn affect their social integration and quality of life. Reducing these disparities requires investment in equitable healthcare systems, multidisciplinary care, and disease-specific public health policies.
Avraam et al. (Thu,) studied this question.