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Member Research & Reports

Member Research & Reports

Saint Louis University: Spatial Analysis used to Explain Variation in Organ Donation Rates

The shortage of organs is a burgeoning issue. The number of people on waiting lists continues to grow while available donors and transplants aren’t enough to support the demand. Currently there are more than 100,000 people waiting to receive an organ. In 2017, approximately 34,000 organ transplants were performed and around 16,000 donors recovered with transplants occurring for each of the most common types of organ transplants: kidney, liver, heart, and lung.

A recent study by Dr. Enbal Shacham, associate professor of Behavioral Science and Health Education, at the Saint Louis University College for Public Health and Social Justice evaluated registration rates for organ donations. Dr. Shacham and colleagues in the Department of Epidemiology and Biostatistics used spatial techniques to help examine sociodemographic differences in organ donor registration rates in Missouri. Spatial analysis is used to visually examine, compare and quantify patterns within an area, such as a neighborhood within a specific zip code or schools within a city. Color tones are often used to highlight unique characteristics of an area or elements within an area. They reported on potential reasons why people aren’t gifting their organs at a rate that is adequate for the demand. The findings are published in the American Journal of Transplantation.

The researchers examined organ donor registration data from 173 licensing (DMV) offices in Missouri. Sociodemographic characteristics describing areas serviced by the individual DMV offices within specific zip-codes were obtained using survey data from the United States Census Bureau.

Organ registration rates across all DMV locations ranged from 19 percent to 63 percent.  Female-head of households, individuals who were unemployed, and people living below the poverty threshold were all found significantly less likely to gift an organ. They also found that people living in areas with high concentrated disadvantage were not likely to gift an organ. However, individuals with at least a four-year degree were more likely to gift an organ. Furthermore, Dr. Shacham and colleagues suggest that race does not play a significant role in the variation in donor registration rates.  They point to concentrated disadvantage because they found that it had the most consistent relationship with organ donor registration rates.

If their basic needs aren’t being met, individuals are not likely to consider being an organ donor.  Whether individuals are presented with the idea of being an organ donor,  other life stressors in addition to having to meet basic needs can overshadow being an organ donor.  Dealing with the stress associated with long waits, crowded environments, and questionable customer service, people cannot respond in a way that is thoughtful and meaningful in the context of a DMV.  The researchers also acknowledge that in low socioeconomic areas there might be low utilization of the DMV due to the lack of car ownership and identified a need for innovative methods to registering for organ donations.