Jada Bascom Foundation
3
30-35 minutes

Health Disparities & Donor Diversity

Examine systemic factors contributing to disparities in donor matching and explore public health approaches to equity.

Learning Objectives

  • Analyze data on match rates across different population groups
  • Identify systemic factors that contribute to disparities in donor registries
  • Evaluate potential approaches to improving health equity
  • Connect donor diversity to broader public health principles

Materials

  • Match rate data (provided below)
  • Note-taking materials

Lesson Content

The Data: Match Rates by Ancestry (8 min)

Approximate probability of finding a well-matched (8/8) adult donor in the US registry, by patient ancestry. Source: NMDP / Be The Match, "Likelihood of finding a matching donor" (data as of 2024); see also Gragert et al., NEJM 2014.
Patient BackgroundMatch Rate (US Registry)
White/Caucasian~77%
Hispanic/Latino~46%
Asian/Pacific Islander~41%
Black/African American~29%
MultiracialVariable, often lower
  • "These numbers represent the probability of finding at least one well-matched donor in the registry (Source: NMDP, 2024)."
  • "The disparity is stark: nearly 80% for white patients, under 30% for Black patients."
  • "This is not because of biology—all humans can potentially be donors. It's about representation."
  • "These figures move as registries diversify; check the NMDP source link for the current numbers."

Understanding the Causes (10 min)

1. Registry Composition

  • Historically, registries were built primarily from certain communities
  • Recruitment efforts often focused on college campuses and workplace drives
  • Communities with less access to these settings were underrepresented

2. Historical Medical Distrust

  • Past medical abuses (e.g., the US Public Health Service Syphilis Study at Tuskegee, 1932-1972) created justified distrust (Source: CDC, "The Tuskegee Timeline").
  • Some communities have experienced exploitation in medical research
  • Trust must be rebuilt through transparent, respectful engagement

3. Genetic Diversity

  • Populations with greater genetic diversity (e.g., African-descent) have more HLA variety
  • More variety means more registered donors are needed to find matches
  • Mixed-heritage individuals may have very rare combinations

4. Socioeconomic Factors

  • Awareness and access to registration events vary by community
  • Healthcare access disparities affect who learns about registries
  • Time and resource constraints affect participation

Approaches to Equity (7 min)

  • Targeted recruitment: Registry organizations now actively recruit in underrepresented communities.
  • Community partnerships: Working with trusted community organizations, churches, historically Black colleges.
  • Addressing barriers: Improving accessibility, providing clear information, building trust through transparency.
  • Education: Curriculum like this—providing factual information that empowers informed decisions.
  • Research: Developing haploidentical transplant techniques that allow half-matches to be used.

Health Equity Principles (3 min)

  • "Health equity means everyone has a fair opportunity to be as healthy as possible."
  • "Equity ≠ equality. Equity recognizes that different people may need different resources to achieve the same outcome."
  • "In this case, achieving equity means ensuring all patients have similar chances of finding matches."

Closing (2 min)

  • "Understanding disparities is the first step toward addressing them."
  • "Solutions require systemic change, not just individual action."
  • "Next lesson: We'll explore ethics, advocacy, and your role as future citizens."

Activity: Data Analysis Discussion

Small Group Discussion Questions:

  1. Look at the match rate data. What patterns do you observe? What surprises you?
  2. Of the four causes discussed, which do you think has the largest impact? Why?
  3. What would need to change for match rates to become equal across all groups?
  4. How does this issue connect to other health disparities you've learned about?

After small group discussion, share key insights with the class.

Health Disparity
A preventable difference in health outcomes between population groups, often linked to social, economic, or environmental factors.
Health Equity
The principle that everyone should have a fair opportunity to attain their full health potential.
Social Determinants of Health
The conditions in which people are born, grow, live, and work that affect health outcomes.
Underrepresentation
When a group is present in smaller proportion than their share of the population.
Systemic Factors
Structural elements of systems (policies, institutions, practices) that produce unequal outcomes.

Discussion Questions

  • Is it fair that someone's chances of finding a donor depend on their ancestry? How should society respond?
  • What role should historical context play in current public health efforts?
  • How might you explain the disparity data to someone who says "it's just biology"?

Optional Extension

Research another health disparity (e.g., maternal mortality, diabetes rates) and analyze its causes. Compare the systemic factors involved to those affecting donor registries.

Sources