Skip to main content
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2006 May;98(5):695–703.

Many facets of reluctance: African Americans and the decision (not) to donate organs.

Susan E Morgan 1
PMCID: PMC2569263  PMID: 16749644

Abstract

Although the body of research on African Americans and organ donation continues to grow, the literature still suffers from a lack of reliance on theory to guide research as well as a surfeit of advanced statistical analytical strategies. A more sophisticated approach to understanding the barriers and facilitating factors that African Americans experience in the process of making the decision to become potential organ donors would yield more sound campaign strategies to increase donation. In this study, a sample of 310 African-American adult members of the NAACP was surveyed about their attitudes, knowledge and beliefs about organ donation. Logistic regression demonstrated that the level of knowledge, attitudes, social norms and altruism resulted in correct classification of organ donor card status in 69.3% of cases. When variables such as medical mistrust, bodily integrity and religiosity were added, an even more powerful model resulted, with 73.2% of the cases correctly classified according to organ donor card status. Recommendations for campaigns targeting African Americans' willingness to donate organs are offered.

Full text

PDF
698

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arnason W. B. Directed donation. The relevance of race. Hastings Cent Rep. 1991 Nov-Dec;21(6):13–19. [PubMed] [Google Scholar]
  2. Braun K. L., Nichols R. Death and dying in four Asian American cultures: a descriptive study. Death Stud. 1997 Jul-Aug;21(4):327–359. doi: 10.1080/074811897201877. [DOI] [PubMed] [Google Scholar]
  3. Callender C. O., Bey A. S., Miles P. V., Yeager C. L. A national minority organ/tissue transplant education program: the first step in the evolution of a national minority strategy and minority transplant equity in the USA. Transplant Proc. 1995 Feb;27(1):1441–1443. [PubMed] [Google Scholar]
  4. Callender C. O. Organ donation in blacks: a community approach. Transplant Proc. 1987 Feb;19(1 Pt 2):1551–1554. [PubMed] [Google Scholar]
  5. Creecy R. F., Wright R. Correlates of willingness to consider organ donation among blacks. Soc Sci Med. 1990;31(11):1229–1232. doi: 10.1016/0277-9536(90)90128-f. [DOI] [PubMed] [Google Scholar]
  6. Davidson M. N., Devney P. Attitudinal barriers to organ donation among black Americans. Transplant Proc. 1991 Oct;23(5):2531–2532. [PubMed] [Google Scholar]
  7. DeJong W., Franz H. G., Wolfe S. M., Nathan H., Payne D., Reitsma W., Beasley C. Requesting organ donation: an interview study of donor and nondonor families. Am J Crit Care. 1998 Jan;7(1):13–23. [PubMed] [Google Scholar]
  8. Gordon E. J. Patients' decisions for treatment of end-stage renal disease and their implications for access to transplantation. Soc Sci Med. 2001 Oct;53(8):971–987. doi: 10.1016/s0277-9536(00)00397-x. [DOI] [PubMed] [Google Scholar]
  9. Hall L. E., Callender C. O., Yeager C. L., Barber J. B., Jr, Dunston G. M., Pinn-Wiggins V. W. Organ donation in blacks: the next frontier. Transplant Proc. 1991 Oct;23(5):2500–2504. [PubMed] [Google Scholar]
  10. Harrington B. The Black Task Force--a community group empowered to make a difference. Transplant Proc. 1995 Feb;27(1):1447–1449. [PubMed] [Google Scholar]
  11. Hong B. A., Kappel D. F., Whitlock M., Parks-Thomas T., Freedman B. Using race-specific community programs to increase organ donation among blacks. Am J Public Health. 1994 Feb;84(2):314–315. doi: 10.2105/ajph.84.2.314. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Horton R. L., Horton P. J. A model of willingness to become a potential organ donor. Soc Sci Med. 1991;33(9):1037–1051. doi: 10.1016/0277-9536(91)90009-2. [DOI] [PubMed] [Google Scholar]
  13. Horton R. L., Horton P. J. Knowledge regarding organ donation: identifying and overcoming barriers to organ donation. Soc Sci Med. 1990;31(7):791–800. doi: 10.1016/0277-9536(90)90174-q. [DOI] [PubMed] [Google Scholar]
  14. Kankam M. K., Ktsanes V. K., Moore R. M., Jr, Kaczmarek R. G., Jeng L. L. Knowledge in relation to cadaveric kidney donation in urban blacks. J Health Care Poor Underserved. 1990 Winter;1(3):297–304. doi: 10.1353/hpu.2010.0176. [DOI] [PubMed] [Google Scholar]
  15. Kappel D. F., Whitlock M. E., Parks-Thomas T. D., Hong B. A., Freedman B. K. Increasing African American organ donation: the St Louis experience. Transplant Proc. 1993 Aug;25(4):2489–2490. [PubMed] [Google Scholar]
  16. LaVeist T. A., Nickerson K. J., Bowie J. V. Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients. Med Care Res Rev. 2000;57 (Suppl 1):146–161. doi: 10.1177/1077558700057001S07. [DOI] [PubMed] [Google Scholar]
  17. Lange S. S. Psychosocial, legal, ethical, and cultural aspects of organ donation and transplantation. Crit Care Nurs Clin North Am. 1992 Mar;4(1):25–42. [PubMed] [Google Scholar]
  18. McNamara P., Guadagnoli E., Evanisko M. J., Beasley C., Santiago-Delpin E. A., Callender C. O., Christiansen E. Correlates of support for organ donation among three ethnic groups. Clin Transplant. 1999 Feb;13(1 Pt 1):45–50. doi: 10.1034/j.1399-0012.1999.t01-2-130107.x. [DOI] [PubMed] [Google Scholar]
  19. Morgan Susan E., Cannon Thomas. African Americans' knowledge about organ donation: closing the gap with more effective persuasive message strategies. J Natl Med Assoc. 2003 Nov;95(11):1066–1071. [PMC free article] [PubMed] [Google Scholar]
  20. Plawecki H. M., Freiberg G., Plawecki J. A. Increasing organ donation in the black community. ANNA J. 1989 Aug;16(5):321–324. [PubMed] [Google Scholar]
  21. Reitz N. N., Callender C. O. Organ donation in the African-American population: a fresh perspective with a simple solution. J Natl Med Assoc. 1993 May;85(5):353–358. [PMC free article] [PubMed] [Google Scholar]
  22. Sanner M. A. Exchanging spare parts or becoming a new person? People's attitudes toward receiving and donating organs. Soc Sci Med. 2001 May;52(10):1491–1499. doi: 10.1016/s0277-9536(00)00258-6. [DOI] [PubMed] [Google Scholar]
  23. Sanner M. Attitudes toward organ donation and transplantation. A model for understanding reactions to medical procedures after death. Soc Sci Med. 1994 Apr;38(8):1141–1152. doi: 10.1016/0277-9536(94)90229-1. [DOI] [PubMed] [Google Scholar]
  24. Siminoff L. A., Arnold R. Increasing organ donation in the African-American community: altruism in the face of an untrustworthy system. Ann Intern Med. 1999 Apr 6;130(7):607–609. doi: 10.7326/0003-4819-130-7-199904060-00023. [DOI] [PubMed] [Google Scholar]
  25. Siminoff L. A., Arnold R. Increasing organ donation in the African-American community: altruism in the face of an untrustworthy system. Ann Intern Med. 1999 Apr 6;130(7):607–609. doi: 10.7326/0003-4819-130-7-199904060-00023. [DOI] [PubMed] [Google Scholar]
  26. Siminoff L. A., Chillag K. The fallacy of the "gift of life". Hastings Cent Rep. 1999 Nov-Dec;29(6):34–41. [PubMed] [Google Scholar]
  27. Spigner C., Weaver M., Pineda M., Rabun K., French L., Taylor L., Allen M. D. Race/ethnic-based opinions on organ donation and transplantation among teens: preliminary results. Transplant Proc. 1999 Feb-Mar;31(1-2):1347–1348. doi: 10.1016/s0041-1345(98)02022-3. [DOI] [PubMed] [Google Scholar]
  28. Thompson Hayley S., Valdimarsdottir Heiddis B., Winkel Gary, Jandorf Lina, Redd William. The Group-Based Medical Mistrust Scale: psychometric properties and association with breast cancer screening. Prev Med. 2004 Feb;38(2):209–218. doi: 10.1016/j.ypmed.2003.09.041. [DOI] [PubMed] [Google Scholar]
  29. Wittig D. R. Organ donation beliefs of African American women residing in a small southern community. J Transcult Nurs. 2001 Jul;12(3):203–210. doi: 10.1177/104365960101200304. [DOI] [PubMed] [Google Scholar]
  30. Yuen C. C., Burton W., Chiraseveenuprapund P., Elmore E., Wong S., Ozuah P., Mulvihill M. Attitudes and beliefs about organ donation among different racial groups. J Natl Med Assoc. 1998 Jan;90(1):13–18. [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES