269829 Do social capital and residential segregation predict organ donation?

Sunday, October 28, 2012

Keren Ladin, MSc , Health Policy, Harvard University/ Beth Israel Deaoness Medical Center, Boston, MA
Rui Wang , Harvard Medical School, Boston, MA
Douglas Hanto, MD PhD , Transplant Institute, Beth Israel Deaoness Medical Center, Boston, MA
James Rodrigue, PhD , Transplant Institute, Beth Israel Deaoness Medical Center, Boston, MA
Public policy initiatives have aimed to increase donor registration, most recently, through changing defaults (opt-in), incentives, and educational initiatives. Despite these efforts, donation rates remain low in many areas, especially among minorities, for reasons that are poorly understood. Social inequality, particularly community-level racial heterogeneity (racial segregation), have been shown to be important predictors of pro-social altruistic behavior. Social inequality, measured at the census tract, has also been negatively correlated with prosocial altrusitic behavior, such as charitable giving and voting. Using a unique dataset from the Massachusetts Department of Motor Vehicles that contains geographically-coded donor registration data, we use census tract and individual variables to understand which social factors, including social capital, predict donor registration rates. GIS and univariate regression analyses confirmed that higher income, workforce participation, owner-occupied housing, native-born, percentage white residents, higher social capital, and less racial heterogeneity at the census tract-level were positively correlated with donation registration (p<0.0001). These factors (race, isolation and segregation indices, residential stability, native-born, workforce participation, income per capita, and percent owner-occupied housing) remained significant in the multivariate model. Importantly, this model explained much of the variance in donor registration (R-squared=0.64). The findings suggest that donor registration rates are higher in tracts that with a greater white population or in tracts with a homogeneous white population. Conversely, this also suggests higher donation rates when black/other minority populations are less isolated, suggesting that higher rates of altruism and donation occur when the minority population is well-integrated.

Learning Areas:
Administer health education strategies, interventions and programs
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Review and evaluate the latest research related to disparities in transplantation, particularly pertaining to disparities in donation rates between racial and ethnic groups Examine how GIS methods can be used to better understand disparities Improve clinical interventions aimed at improving equity in transplantation and donation rates across all racial and ethnic groups

Keywords: Health Disparities, Geographic Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee and direct ethics and health policy research at the Transplant Institute and all studies presented.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.