How Housing Affects Patients with Sickle Cell Disease

By: Caitlin Correa , Spring 2019 HeLP Legal Services Clinic Intern

In the HeLP Clinic, we receive several cases each semester involving children with sickle cell disease. While many individuals with sickle cell disease may be eligible for disability benefits from the Social Security Administration, many attorneys and patients alike do not realize the potential remedies available for a housing issue as it relates to a sickle cell patient.

Patients with sickle cell disease have abnormal hemoglobin production. As a result, these individuals’ blood cells form a “sickle” shape instead of a rounded shape, and these sickled cells are more prone to clumping while travelling through certain areas of the body. This clumping is what leads to a pain crisis. These pain crises involve swelling and extreme pain in areas where cells have clumped.

Usually, sickle cell disease starts to manifest its symptoms in a patient’s first year of life. The earliest signs can be in children as young as five months old, and symptoms only worsen with time. Treatment options can include undergoing a blood transfusion or administration of high-powered pain medications. However, physicians commonly warn patients with sickle cell disease to try to avoid crises before they begin. In this regard, a pain crisis can be triggered by multiple causes, one of which is exposure to extreme heat or cold. For these reasons, Georgia summers provide a serious hazard to patients with sickle cell disease. This risk highlights the importance of understanding housing rights in Georgia, particularly for those renting an apartment or home.

First, as with all legal issues, every situation is different and sometimes the rights and remedies for one situation may not directly match up to another. However, as a general rule, if a landlord offers air conditioning in his or her rental units, he or she has a legal duty to keep these air conditioning units in good repair. If the landlord fails to fix units or lets units fall into disrepair, then the tenant has a duty to notify the landlord of the issue. This notification allows the landlord to have a reasonable amount of time to pay for the repairs and potentially take remedial measures.

Specifically for patients with sickle cell, who may have a pain crisis triggered by the lack of air conditioning, these remedial measures are particularly important. Such measures include the potential to ask the landlord to reduce the next month’s rent in proportion to the weeks spent without air conditioning. In addition, if the landlord actively chooses not to repair the air conditioning, and the sickle cell patient continues to suffer pain crises due to the heat, the tenant-patient also potentially has the ability to vacate the dwelling in something called a “constructive eviction.”

However, this constructive eviction option should only be used as a last resort, and as with all interactions between a tenant and a landlord, communication is key. Thus, a patient with sickle cell disease should communicate (preferably in writing) how fixing the air conditioning is a vital part of their health and well-being. Hopefully with this kind of communication between tenants and landlords, and the presence of legal rights and remedies, sickle cell patients will not continue to suffer pain crises due to fixable housing issues.