Racial disparities in preferences and perceptions regarding organ donation

OBJECTIVES: To identify reasons for lower organ donation rates by African Americans, we examined knowledge and attitudes about brain death, donation, and transplantation and trust in the health care system. METHODS: Data were collected from 1,283 subjects in Ohio using a random digit dial telephone survey. Items were developed based on focus group results. Willingness-to-donate indicators included a signed donor card and willingness to donate one's own and a loved one's organs. RESULTS: Compared with whites, African-Americans had lower rates of signing a donor card (39.1% vs 64.9%, P <.001), and willingness to donate their own organs (72.6% vs 88.3%, P <.0011 or a loved one's organs (53.0%vs 66.2%, P <.001). African Americans had lower scores on the Trust in the Health Care System scale (mean scores +/- SD, 9.43 +/- 3.05 vs 9.93 +/- 2.88, P <.01) and were more likely to agree that "if doctors know I am an organ donor, they won't try to save my life" (38.6% vs 25.9%, P <.001), the rich or famous are more likely to get a transplant (81.9% vs 75.7%, P <.05), and less likely to agree that doctors can be trusted to pronounce death (68.2% vs 82.9. P <.001). African Americans were also more likely to agree that families should receive money for donating organs (45.6% vs 28.0%, P <.001) and funeral expenses (63.1% vs 46.6%, P <. 001). CONCLUSIONS: African Americans reported greater mistrust in the equity of the donation system and were more favorable about providing tangible benefits to donor families than white respondents.