AbstractSickle cell anemia (SCA) negatively impacts the ability to achieve educational and occupational goals increasing vulnerability to socioeconomic challenges. In a cross‐sectional analysis of 332 SCA adults, we investigated whether the distressed community index (DCI) was associated with SCA‐related complications and nutritional status. More patients with higher DCI had Medicaid insurance. A higher DCI was independently associated with tobacco use and lower body mass index, serum albumin, and vitamin D 25‐OH levels after adjusting for insurance status but was not associated with SCA‐related complications. Future studies investigating access to healthy foods may help improve health equity in patients with SCA.