Friday, July 30, 2010

Racial disparities in organ donation

Image description: A black and white drawing of an enlarged kidney.

There’s a lot of evidence that rather than heading towards a post-racial society, racial gaps in the US are actually widening - in wealth, in test scores, and in organ donation. And recent studies have shown that white supremacy extends to whose life is and is not extended by organ donation (80% of which are kidney donations). According to the Madison Capital Times:
"There is an increasing gap between African-Americans and white patients," says nephrologist Byran Becker "Our health care system is heading the wrong way, and we should think of how to change that."..

A Capital Times analysis of data compiled by state and federal health agencies, private researchers, and the United Network for Organ Sharing, the organization that oversees this country's organ donations, found disparities at every step of the transplant process, from the prevalence of diseases leading to renal failure to the numbers of donors and recipients to death rates. 
To begin with, African-Americans are several times more likely to develop diseases like hypertension and diabetes that lead to kidney failure, according to countless studies. New research suggests this group is hit hard in part because of a genetic predisposition to the disorders; many African-Americans also lack the regular access to decent health care that can keep such conditions under control. 
African-Americans also make up a disproportionate share of the 354,000 people in this country - including 5,000 in Wisconsin - who need to go on dialysis. While only 13 percent of the country's population, blacks make up 40 percent of those on dialysis and a third of patients waiting for a renal transplant. Some of them will need to wait a long time. According to UNOS data, 39 percent of African-American patients who registered for a transplant seven years ago are still waiting or have died, nearly twice the proportion of white patients who suffered those fates.
Our health care system is deeply fucked up; it’s kyriarchal on just about every axis imaginable. This is one more indication that the medical industry values some lives more than others, and that ours is not a post-racial society.


  1. Could this be because of cultural or religious reasons that would prevent African Americans from donating their organs? Some religions have rules against this.

  2. It's totally possible that some of the disparity is based around this (for example, Jehovah's Witnesses would prevent organ donation, and in many areas the JW community is black by a huge majority).

    OTOH, many of the other religions I can think of besides JW that would stand in the way of organ donation are largely white (Christian Science, for example, at least in my experience).

    I'm wondering personally if it's also due to a disparity in health insurance coverage. They mention this in terms of African-American/black people NEEDING organs (eg, they aren't getting proper preventative care, thus their liver and kidneys are failing) but I'm also wondering if lack of proper health care is keeping the organs from being donated.

    Granted, you can always sign the back of your driver's license, but I'm guessing that most organ donors are familial and not people who die in car accidents. Therefore, if someone in your family is ignoring all the signs of kidney failure because they can't afford surgery or dialysis, you're probably also not seeing if YOU have a spare kidney to give away because you're (a)not in the hospital with them and (b)not able to afford surgery.

    Tangential. But I know I'm uninsured and I won't go to the doctor unless I'm risking brain death (literally: I'm an epileptic and seizures are the only occasion under which I approach a hospital, and increasingly less often then) so I assume that other people feel the same way I do: doctors mean bills, bills mean things I can't pay, things I can't pay means bad credit and risking not being able to get what I need and people harrassing me on the phone.

  3. I realize this is an old post ubt I wanted to comment.

    There's also some science issues in this. Because of the way organ donation studies have progressed, matching is harder for non-white people. (The blood factors that are apparently the most important, according to current knowledge, are different for people of mixed race due to the higher degree of genetic heterozygosity and variety in the population, apparently, and African Americans have what is apparently MUCH more diversity than your average western-european-blend white American.)

    The studies are, like all studies, likely skewed towards the white and male (in an attempt to remove variability in subjects), but they're what we have. I'm NOT saying this is good- it's just what it is. We need more work on it. There's also apparently a big lag in organ donation (particularly posthumous donation?) in non-white communities, which may be an education (privlege?) issue, but it also means less matchy factors and cases to study to work with.

    I'm not an expert on this at all- I've watched a couple documentaries. :P But I do think it's a factor that maybe you've not considered as much on the transplant thing? I think kyriarchy is probably a problematic factor here, I'm NOT saying it's not, I'm just saying it may not be the largest factor.


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