Healthy donor effect and satisfaction with health

Abstract

The objective of this paper is to quantify selection effects related to blood donation behavior and their impact on donors' perceived health status. We rely on data from the 2009 and 2010 survey waves of the German socio-economic panel (N = 12,000), including information on health-related, demographic and psychographic factors as well as monetary donation behavior and volunteer work. We propose a propensity score matching approach to control for the healthy donor effect related to the health requirements for active blood donations. We estimate two separate models and quantify selection biases between (1) active and inactive blood donors and (2) active donors and non-donors. Our results reveal that active donors are more satisfied with their health status; after controlling for selection effects, however, the differences become non-significant, revealing selection biases of up to 82% compared with non-donors. These differences also exist between active and inactive donors, but the differences are less distinct. Our methodological approach reveals and quantifies selection biases attributable to the healthy donor effect. These biases are substantial enough to lead to erroneous statistical artifacts, implying that researchers should rigorously control for selection biases when comparing the health outcomes of different blood donor groups.

Associations of health status with subsequent blood donor behavior—An alternative perspective on the Healthy Donor Effect from Donor InSight

“…The HDE has been elegantly quantified by Shehu et al in their 2015 study. [ 25 ] They quantified the overall effect of the HDE on donation-related health outcomes. Their estimation was that up to 82% of the health differences between donors and non-donors were due to the HDE rather than to actual health effects of donation.…”

“…By the means of a propensity score matching, Shehu et al have demonstrated a way forward in an attempt to adjust for the HDE (both the HDSE and the HDCE). [ 25 ] The study also expresses its limitations on using self-reported health data as an indicator for the donor health status, as well as an inability to account for the motivational factors (for donation) among blood donors. Another recent study on blood donation and blood donor mortality found an inverse relationship between donation frequency and mortality.…”

Who donates? Cross‐country and periodical variation in blood donor demographics in Europe between 1994 and 2014

“…Large‐scale quantitative research is scarce. When performed, it is mostly based on single‐country, single‐period samples . In these studies, the typical donor is male, well educated, healthy, white, married with children, and has a rare blood type .…”

“…When performed, it is mostly based on single-country, single-period samples. 4,18,[20][21][22][23][24][25][26] In these studies, the typical donor is male, well educated, healthy, white, married with children, and has a rare blood type. 4,6,26 In addition, within the overall population of donors, different donor profiles have been distinguished on the basis of gender, age, socioeconomic status, and ethnicity, 9,11,16,20,[27][28][29] with the frequency of blood donation being significantly higher for male, older, white, and educated individuals.…”

The association between population density and blood lipid levels in Dutch blood donors

“…There are, however, other possible explanations as to why no association was found between population density and blood lipid levels. Our study population was relatively healthy, with respect to both blood lipid levels and physical activity, which is probably the result of donor selection based on eligibility criteria and self-selection [53–56]. Beneficial effects of repeated blood donation on blood lipid profiles have been suggested in the literature [57, 58].…”