A cross-sectional study of social inequities in medical crowdfunding campaigns in the United States

Abstract

Americans are increasingly relying on crowdfunding to pay for the costs of healthcare. In medical crowdfunding (MCF), online platforms allow individuals to appeal to social networks to request donations for health and medical needs. Users are often told that success depends on how they organize and share their campaigns to increase social network engagement. However, experts have cautioned that MCF could exacerbate health and social disparities by amplifying the choices (and biases) of the crowd and leveraging these to determine who has access to financial support for healthcare. To date, research on potential axes of disparity in MCF, and their impacts on fundraising outcomes, has been limited. To answer these questions, this paper presents an exploratory cross-sectional study of a randomized sample of 637 MCF campaigns on the popular platform Gofundme, for which the race, gender, age, and relationships of campaigners and campaign recipients were categorized alongside campaign characteristics and outcomes. Using both descriptive and inferential statistics, the analysis examines race, gender, and age disparities in MCF use, and tests how these are associated with differential campaign outcomes. The results show systemic disparities in MCF use and outcomes: non-white users (and black women in particular) are under-represented; there is significant evidence of an additional digital care labor burden on women organizers of campaigns; and marginalized race and gender groups are associated with poorer fundraising outcomes. Outcomes are only minimally associated with campaign characteristics under users' control, such as photos, videos, and updates. These results corroborate widespread concerns how technology fuels health inequities, and about how crowdfunding may be creating an unequal and biased marketplace for those seeking financial support to access healthcare. Further research and better data access are needed to explore these dynamics more deeply and inform policy for this largely unregulated industry.

Donor Financial Capacity Drives Racial Inequality in Medical Crowdsourced Funding

“…Berliner and Kenworthy (2017) are concerned that network access and social media literacy create barriers for marginalized populations. In recent work, Kenworthy et al (2020) use a sample of 637 hand-coded campaigns to confirm that nonwhite users are indeed underrepresented on the site. Kenworthy also demonstrates that nonwhite recipients receive fewer donations than Whites, and Black recipients receive significantly smaller average donations.…”

Crowdfunding Medical Care: A Comparison of Online Medical Fundraising in Canada, the United Kingdom, and the United States

“…In another study of 637 randomly sampled US MCF campaigns from GoFundMe, non-white beneficiaries were also significantly under-represented, constituting only 19% of the sample while this group represents 27% of the US census. 27 Within our sample, females and black beneficiaries raised approximately $4,000 and $1,700 less than their male and non-black counterparts, respectively. Similarly, in a US study of 850 campaigns for organ transplantation, females had raised 27% less than males after multivariable adjustment.…”

“I Invest by Following Lead Investors!” The Role of Lead Investors in Fundraising Performance of Equity Crowdfunding

“…In particular, scholars have mainly focused on the signals of project quality and individual (entrepreneur) quality when investigating the success factors of fundraising performance of crowdfunding (Kuppuswamy and Bayus, 2018). Mollick (2014), for instance, found that personal networks and underlying project quality are associated with the success of crowdfunding efforts. Zheng et al (2014) demonstrated that an entrepreneur's social network ties, obligations to fund other entrepreneurs, and the shared meaning of the crowdfunding project between the entrepreneur and the sponsors positively impact crowdfunding performance.…”

“…We control for the crowdfunding goal and duration of the funding campaign because both variables could exert influence on the fundraising performance (Mollick, 2014;Zheng et al, 2014). The crowdfunding goal is measured by the total amount of money that an entrepreneur aims to raise for a particular project.…”

“…The World Bank believes that crowdfunding could account for over $300 billion in cumulative transactions by 2025 (Meyskens and Bird, 2015). By definition, crowdfunding refers to the efforts by entrepreneurial individuals and groups to fund their ventures by drawing on relatively small contributions from a large number of individuals using the Internet, without standard financial intermediaries (Mollick, 2014). Primarily, there are four forms of crowdfunding: donation-based, reward-based, debt-based, and equity-based crowdfunding (Bi et al, 2017).…”