Racial and gender disparities among highly successful medical crowdfunding campaigns

Davis, Aaron Renee; Elbers, Shauna K.; Kenworthy, Nora

doi:10.1016/j.socscimed.2023.115852

Cited by 12 publications

(7 citation statements)

References 33 publications

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“…The role of medical crowdfunding in the widening of social and racial disparities is well documented, particularly through limited fundraising success. 6 , 7 , 10 , 11 We add to this literature with further evidence on widening racial disparities in medical fundraising based on clinical need and ability, particularly among Black organizers, using a comprehensive set of national crowdfunding platforms. Our data focus on a specific type of medical fundraiser, organ transplantation, which allows us to define a measure of fundraising need based on a clearly defined metric of medical need (WLAs), which is challenging when analyzing medical crowdfunding in general.…”

Section: Discussionmentioning

confidence: 99%

“…16 While the existence of crowdfunding platforms (CFPs) may offer an opportunity to overcome these barriers to access, evidence shows that not all campaigns reach their monetary goal 3 , 11 and that crowdfunding favors individuals with larger social networks of more affluent individuals, as well as those who are able to engage with online tools and tell a compelling story. 3 , 6 , 10 , 17-20 Additionally, the link between crowdfunding and health insurance is not clear. One would expect to see more crowdfunding in geographical areas with lower insurance or underinsurance rates among populations with similar levels of clinical need; however, there is mixed evidence on the association between Medicaid expansion under the Affordable Care Act (ACA) and higher levels of medical crowdfunding.…”

Section: Introductionmentioning

confidence: 99%

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The role of race and ethnicity in health care crowdfunding: an exploratory analysis

Machado,

Perez,

Papanicolas

2024

Health Affairs Scholar

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Medical crowdfunding is a key source of finance for individuals facing high out of pocket costs, including organ transplant candidates. However, little is known about racial disparities in campaigning activity and outcomes, or how these relate to access to care. In this exploratory nationwide cross-sectional study, we examined racial disparities in campaigning activity across states and the association between U.S. campaigners’ race and ethnicity and crowdfunding outcomes using a novel database of organ-transplant related campaigns, and an algorithm to identify race and ethnicity based on name and geographic location. This analysis suggests that there are racial disparities in individuals’ ability to successfully raise requested funds, with Black and Hispanic campaigners fundraising lower amounts and less likely to achieve their monetary goals. We also find that crowdfunding among White, Black, and Hispanic populations exhibit different patterns of activity at the state level, and in relation to race specific uninsurance and wait list additions, highlighting potential differences in fundraising need across the three groups. Policy efforts should consider not only how inequalities in fundraising ability for associated costs influences accessibility to care, but also how to identify clinical need among minorities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of race and ethnicity in health care crowdfunding: an exploratory analysis

Machado,

Perez,

Papanicolas

2024

Health Affairs Scholar

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“…Our findings are consistent with earlier research in medical crowdfunding that suggests campaigns raising money for racial minorities and women experience systematic inequities in online crowdfunding success. 32,33 LGBTQ+ crowdfunding studies outside of a cancer context have primarily focused on access to high-cost gender-affirming care that is often not covered by health insurance. 34 Such studies have revealed that while crowdfunding may provide financial access to needed care for some transgender individuals it may also perpetuate existing inequities.…”

Section: Further Our Sensitivity Analysis Findings Indicate Thatmentioning

confidence: 99%

LGBTQ+ inequity in crowdfunding cancer costs: The influence of online reach and LGBTQ+ state policy

Waters,

Easterly,

Turner

et al. 2024

Cancer Medicine

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BackgroundEmerging literature suggests that LGBTQ+ cancer survivors are more likely to experience financial burden than non‐LGBTQ+ survivors. However, LGBTQ+ cancer survivors experience with cost‐coping behaviors such as crowdfunding is understudied.MethodsWe aimed to assess LGBTQ+ inequity in cancer crowdfunding by combining community‐engaged and technology‐based methods. Crowdfunding campaigns were web‐scraped from GoFundMe and classified as cancer‐related and LGBTQ+ or non‐LGBTQ+ using term dictionaries. Bivariate analyses and generalized linear models were used to assess differential effects in total goal amount raised by LGBTQ+ status. Stratified models were run by online reach and LGBTQ+ inclusivity of state policy.ResultsA total of N = 188,342 active cancer‐related crowdfunding campaigns were web‐scraped from GoFundMe in November 2022, of which N = 535 were LGBTQ+ and ranged from 2014 to 2022. In multivariable models of recent campaigns (2019–2022), LGBTQ+ campaigns raised $1608 (95% CI: −2139, −1077) less than non‐LGBTQ+ campaigns. LGBTQ+ campaigns with low (26–45 donors), moderate (46–87 donors), and high (88–240 donors) online reach raised on average $1152 (95% CI: −$1589, −$716), $1050 (95% CI: −$1737, −$364), and $2655 (95% CI: −$4312, −$998) less than non‐LGBTQ+ campaigns respectively. When stratified by LGBTQ+ inclusivity of state level policy states with anti‐LGBTQ+ policy/lacking equitable policy raised on average $1910 (95% CI: −2640, −1182) less than non‐LGBTQ+ campaigns from the same states.Conclusions and RelevanceOur findings revealed LGBTQ+ inequity in cancer‐related crowdfunding, suggesting that LGBTQ+ cancer survivors may be less able to address financial burden via crowdfunding in comparison to non‐LGBTQ+ cancer survivors—potentially widening existing economic inequities.

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“…Successful medical crowdfunding requires a certain sophistication in understanding and describing medical terms and the effect of illness on the individual, which often results from education and health literacy. Davis et al [ 30 ] suggested that the 827 most successful medical crowdfunding campaigns in 2020 represent higher rates of White populations and reflect the types of illnesses and accidents that most frequently affect these populations. Using visually appealing, well-crafted storytelling, these campaigns reflect educational privilege and garner higher donation amounts.…”

Section: Introductionmentioning

confidence: 99%

“…Whereas some authors hypothesize that narratives of deservingness or simple interpersonal racial discrimination play a role in these disparities [ 24 , 30 ], others propose that racial and ethnic differences in donor network financial capacity play a considerable role in differences in campaign success [ 31 , 32 ]. During the COVID-19 pandemic, people from wealthier counties with higher levels of education, compared with people living in areas with lower income and education, were not only more likely to start new campaigns when they experienced health and economic crises but also received more funding [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

Investigating Racial Disparities in Cancer Crowdfunding: A Comprehensive Study of Medical GoFundMe Campaigns

Zhang,

Wang,

Lane

et al. 2023

J Med Internet Res

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Background In recent years, there has been growing concern about prejudice in crowdfunding; however, empirical research remains limited, particularly in the context of medical crowdfunding. This study addresses the pressing issue of racial disparities in medical crowdfunding, with a specific focus on cancer crowdfunding on the GoFundMe platform. Objective This study aims to investigate racial disparities in cancer crowdfunding using average donation amount, number of donations, and success of the fundraising campaign as outcomes. Methods Drawing from a substantial data set of 104,809 campaigns in the United States, we used DeepFace facial recognition technology to determine racial identities and used regression models to examine racial factors in crowdfunding performance. We also examined the moderating effect of the proportion of White residents on crowdfunding bias and used 2-tailed t tests to measure the influence of racial anonymity on crowdfunding success. Owing to the large sample size, we set the cutoff for significance at P<.001. Results In the regression and supplementary analyses, the racial identity of the fundraiser significantly predicted average donations (P<.001), indicating that implicit bias may play a role in donor behavior. Gender (P=.04) and campaign description length (P=.62) did not significantly predict the average donation amounts. The race of the fundraiser was not significantly associated with the number of donations (P=.42). The success rate of cancer crowdfunding campaigns, although generally low (11.77%), showed a significant association with the race of the fundraiser (P<.001). After controlling for the covariates of the fundraiser gender, fundraiser age, local White proportion, length of campaign description, and fundraising goal, the average donation amount to White individuals was 17.68% higher than for Black individuals. Moreover, campaigns that did not disclose racial information demonstrated a marginally higher average donation amount (3.92%) than those identified as persons of color. Furthermore, the racial composition of the fundraiser’s county of residence was found to exert influence (P<.001); counties with a higher proportion of White residents exhibited reduced racial disparities in crowdfunding outcomes. Conclusions This study contributes to a deeper understanding of racial disparities in cancer crowdfunding. It highlights the impact of racial identity, geographic context, and the potential for implicit bias in donor behavior. As web-based platforms evolve, addressing racial inequality and promoting fairness in health care financing remain critical goals. Insights from this research suggest strategies such as maintaining racial anonymity and ensuring that campaigns provide strong evidence of deservingness. Moreover, broader societal changes are necessary to eliminate the financial distress that drives individuals to seek crowdfunding support.

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Racial and gender disparities among highly successful medical crowdfunding campaigns

Cited by 12 publications

References 33 publications

The role of race and ethnicity in health care crowdfunding: an exploratory analysis

The role of race and ethnicity in health care crowdfunding: an exploratory analysis

LGBTQ+ inequity in crowdfunding cancer costs: The influence of online reach and LGBTQ+ state policy

Investigating Racial Disparities in Cancer Crowdfunding: A Comprehensive Study of Medical GoFundMe Campaigns

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