Contributed by Anna Cronin de Chavez
Sickle cell disease (SCD)  is one of the health conditions most susceptible to harm from exposure to cold. Keeping warm at home for people with SCD is not just a question of comfort – it is vital to prevent pain attacks and the potential for lifelong or life-threatening consequences of an SCD crisis.
SCD is an inherited form of anemia, a condition in which a person does not maintain enough healthy red blood cells to carry adequate oxygen throughout his or her body. Normally, red blood cells are flexible and round, and move easily through blood vessels. In SCD, red blood cells are misshapen – more like sickles or crescent moons, hence the name – and become rigid and ‘sticky’. With these characteristics, they can get stuck in small blood vessels, ultimately slowing or completely blocking the flow of blood and the oxygen it carries.
Reducing the flow of blood supplies in the extremities is one natural mechanism the body uses to conserve body heat in the core. It is why our hands and feet get cold first. But for people with SCD, that reaction to cold temperatures can trigger a sickle crisis that is so painful, even pain management therapy in hospital cannot provide relief.
Yet people with SCD are often more at risk of fuel poverty than the general population. Because the condition leads to frequent hospitalisation and periods of illness, it affects the education of those afflicted and undermines their ability to obtain and sustain a job and earn a regular income. In the United Kingdom, people with low incomes are more likely to have an energy debt and are therefore forced to have a prepayment meter installed for electricity and/or heating. Thus, despite having a condition that makes cold a health risk, if they run out of cash, they simply cannot heat their homes until they get some again.
In some cases, the blockage of blood vessels associated with an SCD crisis can cause complications in other parts of the body, including stroke, organ failure and bone death. More detailed analysis of the situation for SCD sufferers highlights the long-term impacts and the reason immigrant populations are at higher risk.
Cold temperatures at home can trigger a range of health crises. As noted in other articles (see menu in sidebar), people who are chronically cold often pick up other infections or viruses more easily and are prone to other health problems. They may also have high levels of stress associated with trying to cope with limited financial resources to meet their basic needs.