• L Ebony Boulware, Lloyd E Ratner, Lisa A Cooper, Julie Ann Sosa, Thomas A LaVeist, and Neil R Powe.
• Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
• Med Care. 2002 Feb 1; 40 (2): 85-95.

BackgroundRecent efforts to recruit blood and organ donors have only marginally improved demographic disparities in willingness to donate. Few studies have examined which factors are most important in explaining race and gender disparities in willingness to donate.ObjectivesTo assess race and gender differences in willingness to donate blood and cadaveric organs, and to determine the extent to which several factors (including sociodemographic characteristics and attitudes about religion and mistrust of hospitals) might explain differences in willingness to donate.Research DesignCross-sectional telephone survey of Maryland households contacted via random-digit dialing.MeasuresPast blood donation, organ-donor status on driver's license, and measures of medical mistrust and religious and spiritual salience.SubjectsPersons age 18 to 75 living in the Baltimore, Maryland metropolitan area.ResultsOf 385 respondents (84% of randomized households), 114 were black females, 46 were black males, 110 were white females, and 69 were white males. Before adjustment, black females were least willing to donate blood (41%), and black males were least willing to become cadaveric donors (19%) among all race-gender groups. Adjustment for respondent concerns about mistrust of hospitals and discrimination in hospitals explained most differences in willingness to donate blood, whereas adjustment for respondents' beliefs regarding the importance of spirituality and religion explained most differences in willingness to donate cadaveric organs.ConclusionsBoth race and gender are important identifiers of those less willing to donate. To maximize efficiency, donor recruitment efforts should focus on race-gender groups with lowest levels of willingness. Potential donor concerns regarding mistrust in hospitals and religion/spirituality may serve as important issues to address when developing programs to improve donation rates.

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