In a study evaluating donor interest, researchers from The Johns Hopkins School of Medicine and Bloomberg School of Public Health found that African-American women were least willing to donate blood, with only 41 percent reporting they would. African-American men were least willing to become organ donors upon their deaths, with only 19 percent reporting they would. Study results are published in the February issue of the journal Medical Care.
Overall, African-American and white (59 percent) women were less likely to be willing to donate blood than white men (86 percent), and African-American women (38 percent) and men were less likely to donate organs than white men (65 percent).
Mistrust of hospitals and concerns about discrimination in hospitals explained most of the differences in willingness to donate blood, while religious beliefs explained most of the differences observed in willingness to donate organs among the four race and gender groups, says L. Ebony Boulware, M.D., M.P.H., lead author of the study.
"African-Americans have traditionally been leery of research settings, in part because of the ethical lapses in the Tuskegee experiment," Boulware says. "More work needs to be done to examine how to engender trust in the populations less willing to donate. Maybe by partnering with churches or other faith-based organizations we could better educate people about organ donation."
The finding that religious beliefs are related to organ donation may reflect the desire to be buried whole, despite the fact that in most organized religions, clergy support organ donation, Boulware says.
"Those seeking to increase blood and organ donation among African-American men and women should consider these potential donors' concerns regarding mistrust of and discrimination within hospitals, and their concerns about religion and spirituality when developing donor recruitment strategies," she says.
Shortages of donated blood products and solid organs pose a great public health challenge, particularly for minorities, Boulware says. For example, low blood donation rates by African-Americans have resulted in shortages of blood supply for illnesses where multiple transfusions result in difficult cross-matching, such as sickle cell disease.
For the study, researchers conducted 20-minute telephone interviews with 339 Baltimore residents ages 18 to 75, asking about their willingness to donate blood or become an organ donor after death, their trust in the health care system, religious involvement and prior medical care experience. One hundred fourteen of the respondents were African-American women, 46 were African-American men, 110 were white women and 69 were white men.
Overall, 199 respondents (59 percent) said they had donated blood. Of those who had donated, 64 (32 percent) were white women, 59 (30 percent) were white men, 46 (23 percent) were African-American women and 30 (15 percent) were African-American men.
One hundred fifty-seven people (46 percent) reported they had signed up to be organ donors on their driver's licenses. Of those, 65 (41 percent) were white women, 45 (29 percent) were white men, 39 (25 percent) were African-American women and eight (5 percent) were African-American men. Fifteen respondents (4 percent) did not have a driver's license.
The researchers also found that:
- African-American men and women were less trusting of hospitals than their white counterparts.
- African-American men and white women were more likely than others to report that they were afraid of hospitals.
- Most people in each race-gender group said rich patients get better care at hospitals than poor patients but few reported that men receive better care at hospitals than women.
- One-third of all respondents said they felt that white patients get better care at hospitals than people of other racial or ethnic groups.
The study was supported by the National Kidney Foundation of Maryland; the Health Resource and Services Administration; Robert Wood Johnson Scholars Program; and the National Institute of Diabetes and Digestive and Kidney Diseases. Other authors were Lloyd E. Ratner, M.D.; Lisa A. Cooper, M.D., M.P.H.; Julie Ann Sosa, M.D.; Thomas A. LaVeist, Ph.D., M.P.H.; and Neil R. Powe, M.D., M.P.H.
Boulware, L. Ebony et. al., "Understanding Disparities in Donor Behavior: Race and Gender Differences in Willingness to Donate Blood and Cadaveric Organs," Medical Care, Vol. 40, No. 2, pp. 85-95.
Related Web sites:
Johns Hopkins' Welch Center for Prevention, Epidemiology and Clinical Research
http://www.med.jhu.edu/welchcenter/
National Kidney Foundation
http://www.kidney.org
National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov
Johns Hopkins Medical Institutions' news releases are available on an EMBARGOED basis on EurekAlert at http://www.eurekalert.org and from the Office of Communications and Public Affairs' direct e-mail news release service. To enroll, call 410-955-4288 or send e-mail to bsimpkins@jhmi.edu.
On a POST-EMBARGOED basis find them at http://www.hopkinsmedicine.org.
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