Donor Financial Capacity Drives Racial Inequality in Medical Crowdsourced Funding

Abstract

In 2018, over 250,000 American families found themselves unable to pay for medical care and turned to the online “crowdfunding” service GoFundMe to raise money online. The $650 million dollars raised from these medical campaigns appear to have filled a sizable hole in the American social safety net. Yet crowdfunding is at heart a network process, and a large body of research shows that social networks can reproduce inequality. In this paper I show that medical crowdfunding indeed replicates patterns of racial, ethnic, and geographic income stratification as predicted by network theory. Using 2,618 GoFundMe campaigns hand-coded for perceived race and ethnicity of the recipient, I show that Black and Hispanic beneficiaries receive substantially less money via their networks than White and Asian beneficiaries. Hierarchical linear models show that social network access via online sharing does not vary by race and ethnicity. Instead I find that unequal mobilization in terms of the number and size of donations accounts for unequal returns. Variations in the number of donations can largely be explained by differences in expected network financial capital, but variations in donation size are not fully accounted for even in models including proxies for network income. In a preliminary analysis, probabilistic estimates of donor race and ethnicity indicate that donors of all races and ethnicities tend to give White recipients the largest donations and Black recipients the smallest. Overall, I demonstrate the use of “crowd insurance” in place of sufficient medical insurance reproduces existing patterns of inequality.

Struggling, helping and adapting: Crowdfunding motivations and outcomes during the early US COVID‐19 pandemic

“…Given a relatively small sample size and lack of significance testing for differences between racial groups, we caution against drawing overly strong conclusions about these results. However, these findings do generally align with other research which documents substantial racial disparities in crowdfunding outcomes (Igra, 2021; Kenworthy et al., 2020).…”

“…Despite public support for causes such as hospital and health worker aid, nutrition and PPE, campaigns for individuals and basic needs far outnumbered other purposes. These outcomes lend further credence to observations that crowdfunding is most successful and visible among higher income, better educated and more resourced populations, and less successful among those who need it most (Igra, 2021; Igra et al., 2021; Kenworthy & Igra, 2022; Lukk et al., 2018; van Duynhoven et al., 2019).…”

“…We developed codes for campaign purpose and objectives, intended beneficiaries, how much the campaign was motivated by COVID‐19 needs and whether the campaign involved a death from COVID‐19. Given previous research indicating structural and interpersonal racism impacts campaign success (Igra, 2021; Kenworthy et al., 2020), we assessed the race of both organisers and beneficiaries whenever there was enough information provided to do so. Three team members coded the same 50 campaigns and then reviewed errors and discrepancies.…”

Impacts of news media coverage on Canadian medical crowdfunding campaigns

“…The relative success of these campaigns is likely due to a number of factors other than news media coverage. Based on earlier analyses of medical crowdfunding campaign outcomes, these factors include the relative wealth of the crowdfunding campaigner's community and their educational attainments, race, and social connections (Igra, 2021; van Duynhoven et al, 2019). The findings of the current analysis suggest that news media coverage is among these factors of success.…”

Like a Grinding Stone: How Crowdfunding Platforms Create, Perpetuate, and Value Health Inequities

“…Due to the challenges of collecting robust data from private platforms, only a handful of studies have empirically documented this phenomenon. Studies in both the United States and Canada have found that crowdfunders seek funds to fill common holes in the social safety net, and that campaigns for older people, people of color, and transgender users tend to perform more poorly (Barcelos 2019; Berliner and Kenworthy 2017;Igra 2020;Kenworthy et al 2020;Lukk et al 2018). Duynhoven and colleagues (2019) found that Canadian cancer campaigns were more common in wealthier, better educated, urban areas.…”