# The Effect Of Structural Racism On Racial And Geographic Disparities In Deceased Organ Donation

> **NIH NIH F32** · JOHNS HOPKINS UNIVERSITY · 2024 · $97,364

## Abstract

PROJECT SUMMARY/ABSTRACT
Among the 12,000 deceased organ donors yearly in the US, there are racial disparities that have persisted
over decades, with the Black population most recently donating at 69% of the White population. Relatively
lower organ donation rates among racial minorities not only contribute to the organ shortage but also contribute
to racial disparities in waitlisted candidate’s access to transplantation, with some racial minorities having longer
wait times owing to difficult matching.
Historically, efforts to address racial disparities in deceased organ donation have examined inpatient medical
facility deaths, using inpatient death counts to estimate the potential organ donor pool, to benchmark
successful organ recovery, and to target interventions. While only individuals who die in an inpatient medical
facility can have their organs recovered for transplantation, the focus on this highly selected population is
limiting. Structural racism, a determinant of racial disparities in health, affects healthcare resource availability,
with Black individuals being 40% less likely than White individuals to have a usual source of healthcare in
racially segregated neighborhoods. To date, healthcare resource availability has not been examined as a
potential mediator of racial and geographic disparities in deceased organ donation.
To better understand the impact of structural racism on deceased donor rates, we will perform novel linkages
with three nationally representative datasets (Scientific Registry of Transplant Recipients, CDC WONDER, and
National Health and Nutrition Examination Survey) to study the following aims: (1) To examine county-level risk
factors for inpatient and outpatient death under medical conditions consistent with organ donation; (2) To
examine the relationship between structural racism and the potential organ donor rate; and (3) To examine
whether healthcare access mediates the relationship between structural racism and the potential organ donor
rate.
We hypothesize that structural racism affects inpatient facility death distribution, and subsequent organ
donation rates, through its differential effects on healthcare access according to race and across geographies.
If the proposed aims are achieved, we will directly inform national healthcare access and organ allocation
policy, and population-level structural interventions to eliminate racial disparities in transplantation.

## Key facts

- **NIH application ID:** 10860992
- **Project number:** 5F32DK132832-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Lawrence Brown
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $97,364
- **Award type:** 5
- **Project period:** 2022-07-14 → 2025-07-13

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10860992

## Citation

> US National Institutes of Health, RePORTER application 10860992, The Effect Of Structural Racism On Racial And Geographic Disparities In Deceased Organ Donation (5F32DK132832-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10860992. Licensed CC0.

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