Study: US neighborhoods with less ‘socioeconomic deprivation’ have more organ donors
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Study results demonstrated that, in several states across the country, neighborhoods with less “socioeconomic deprivation” and a greater concentration of white residents have higher organ donor registration rates.
“Our data provide evidence that neighborhood socioeconomic deprivation and racial segregation influence the decision to register as an organ donor,” Sharad I. Wadhwani, MD, MPH, University of California, San Francisco, and colleagues wrote.
According to the researchers, as only half of Americans register as organ donors and one in 10 patients with kidney disease die awaiting transplantation, it is important to identify groups with low rates of organ donor registration.
“[This] may enable tailored public health initiatives to increase registration rates,” they suggested.
The researchers included 26,720,738 residents from five states (New York, Oregon, Tennessee, Vermont and Wisconsin) who had a driver’s license and state identification. They found 32% of this sample were registered organ donors.
They considered associations between neighborhood socioeconomic deprivation index scores. According to the researchers, the index “is composed of six measures from the U.S. Census Bureau’s 2015 5-year American Community Survey (ACS): median household income, and fraction of the population below the federal poverty level, adults with a high school education, households receiving public assistance, population with no health insurance and housing units that are vacant.” Higher values indicated more deprivation. They also analyzed racial concentrations and organ donor registration rates within a specified geography (census tract or ZIP code tabulation area [ZCTA]).
At the census tract level, results showed that with each 0.1 decrease in the deprivation index, the organ donor registration rate increased by 6.8% and with each 0.1 increase in the racial index of concentration at the extreme, the rate increased by 1.5%. The researchers noted these associations were also observed at ZCTA level.
Wadhwani and colleagues suggested these results highlight a larger, systemic issue demonstrated in a previous study, which showed bystanders were less likely to initiate cardiopulmonary resuscitation in poor, Black neighborhoods vs. wealthy, white neighborhoods.
“Our findings may be driven by similar root causes, reasons that are likely multifactorial and may include diminished trust in the health care system, misperceptions about organ donation, and alienation from the society to which they are donating,” they elaborated.
“Future studies evaluating why people from more deprived, segregated neighborhoods are less likely to register for organ donation may identify opportunities for interventions to improve registration rates,” the researchers wrote. “If we are to seek increased registration rates for organ donation that extend across populations, we must also demand that the health system build trust with and unravel generations of inequities felt by marginalized groups.”
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