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Does Social Capital Explain Community-Level Differences in Organ Donor Designation?
Keren Ladin1,2, Rui Wang3, Aaron Fleishman4
1Tufts University.
The Milbank Quarterly
|September 10, 2015
Summary
Community social capital significantly influences organ donor designation rates, explaining over half the geographic variation. Tailoring interventions to local social contexts can improve organ donation efforts nationwide.
Area of Science:
- Public Health
- Sociology
- Health Policy
Background:
- The organ donor shortage is critical, with over 120,000 Americans awaiting transplants.
- Geographic disparities in organ availability persist despite national efforts and equitable allocation laws.
- Organ donor designation is a public health collective action problem influenced by individual willingness and community factors.
Purpose of the Study:
- To investigate the relationship between social capital and other community-level factors with organ donor designation rates.
- To understand geographic variations in organ donor designation within Massachusetts.
- To inform targeted interventions for increasing organ donation.
Main Methods:
- Utilized data from 3,281,532 registered drivers in Massachusetts (2010).
- Geocoded driver data and linked it to census blocks, US Census, and American Community Survey data.
- Employed spatial modeling and multivariate regression to analyze community characteristics, including social capital, and their association with organ donor designation rates.
Main Results:
- Higher social capital, racial homogeneity, income, workforce participation, owner-occupied housing, and a higher proportion of native-born and white residents were associated with increased organ donor designation rates (p < 0.001).
- These community-level factors collectively explained over half (R(2) = 0.52) of the geographic variance in organ donor designation.
- Key social capital indicators included residential segregation, voter registration/participation, residential mobility, and violent-death rates.
Conclusions:
- Community-level factors, particularly social capital, are strong predictors of organ donor designation rates.
- Interventions to increase organ donation should consider the community as the primary unit of action.
- Tailoring intervention strategies to the specific social context and social capital levels of communities is recommended.
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