Neighborhood socioeconomic deprivation, racial segregation, and organ donation across 5 states

Sharad I. Wadhwani, Cole Brokamp, Erika Rasnick, John C. Bucuvalas, Jennifer C. Lai, Andrew F. Beck

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


One in 10 people die awaiting transplantation from donor shortage. Only half of Americans register as organ donors. In this cross-sectional study, we evaluated population-level associations of neighborhood socioeconomic deprivation and racial segregation on organ donor registration rates. We analyzed state identification card demographic and organ donor registration data from 5 states to estimate the association between a neighborhood socioeconomic deprivation index (range [0, 1]; higher values indicate more deprivation) and a racial index of concentration at the extreme (ICE) (range [−1, 1]; lower values indicate predominantly black neighborhoods, higher values indicate predominantly white neighborhoods) on organ donor registration rates within a specified geography (census tract or ZIP code tabulation area [ZCTA]). Among 26 720 738 registrants, 32% of the sample were registered organ donors. At the census tract level, with each 0.1 decrease in the deprivation index, the organ donor registration rate increased by 6.8% (95% confidence interval [CI]: 6.6%, 7.0%). With each 0.1 increase in the racial ICE, the rate increased by 1.5% (95% CI: 1.5%, 1.6%). These associations held true at the ZCTA level. Areas with less socioeconomic deprivation and a higher concentration of white residents have higher organ donor registration rates. Public health initiatives should consider neighborhood context and novel data sources in designing optimal intervention strategies.

Original languageEnglish
Pages (from-to)1206-1214
Number of pages9
JournalAmerican Journal of Transplantation
Issue number3
StatePublished - Mar 2021


  • disparities
  • donors and donation
  • health services and outcomes research
  • organ procurement and allocation
  • social sciences


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