“Missing minorities” in blood donation: Rethinking blood procurement in Europe as a citizenship regime

Abstract

Although European blood collection organizations are currently obtaining sufficient and safe blood from the majority population, they report having difficulty recruiting first and second-generation immigrants from non-European countries. Most existing studies on these underrepresented groups, who have been coined the “ missing minorities” in blood donation, have adopted an instrumental approach that focuses on the development of targeted recruitment strategies to overcome specific barriers to donation faced by members of these minorities. Although this approach does offer several short-term benefits, our central argument is that it is one-sided in its questioning of the non-participation of ethnic minorities. The literature currently lacks research on how the blood procurement system is failing to include minorities. Drawing on recent social theory, we seek a broader sociological understanding of minority under-representation in blood donor populations by shifting the analytic focus toward a critical examination of the main pillars of the procurement system within the European context. This paper advances a novel analytical framework based on two general propositions. First, we apply the literature on “citizenship regimes” to argue that blood donation is part of one specific institutionalization of citizenship and solidarity. We then reconceptualize the “problem” of missing minorities in European blood donation as an application for social change, suggesting avenues related to blood collection as a way of renegotiating minority-majority relations of solidarity.

Insights into the diversity of blood donation practice across Asia: How blood collection agencies adapt donor criteria and processes to their population

“…The recruitment and retention of eligible blood donors are central to meeting the demand, and this is impacted by global immigration and travel, which have altered the ethno‐racial characteristics of many populations. A number of European countries and the United States have recognized the difficulty of recruiting blood donors from immigrant populations, termed the ‘missing minorities’ [20] or ‘minority donors’ [21]. Thus, all BCAs must continually review their approaches to dynamically adapt their collection approaches to meet the current and future blood supply needs.…”

The importance of need‐altruism and kin‐altruism to blood donor behaviour for black and white people

“…It has been argued that a stronger preference for kin-altruism among Black people, as well as people from ethnic minorities, is one reason for reduced levels of voluntary blood donation observed in these communities. [12][13][14][15][16][17][18][19] Indeed, Tran et al 16 in their discussion of Black people in Montreal, state: 'The gift of blood … is normally destined to a stranger. But … the preferred figure of the receiver might not be that of a complete stranger but that of a community member" [p. 522], with community members often referring to close family.…”

“…12,13,16 Perceived discrimination leads to a focus on family and community, as does reduced trust in healthcare and the government 7 and supports a stronger preference for kin. 16,17,19 Hamilton's rule r > c b where r = the genetic relatedness between individuals [ranging from 0 for no degree of relatedness, (i.e., stranger) to 1 (i.e., identical twins)], and c b is the cost-benefit ratio (where c = the cost to the helper and b = the benefit to the recipient), indicates that to choose to help someone, r must exceed the cost-benefit ratio c b . 20,21 One implication is that people are willing to pay a higher cost, relative to benefits, to help a relative (r is higher) than a stranger (r is lower).…”

“…The hypothesis that people from Black communities have a stronger preference for kin-altruism is based on qualitative evidence, [12][13][14][15][16][17][18][19] that crucially has not considered the role of need-altruism across different communities or wider motivations and barriers to donation.…”

“…Furthermore, it has been reported that Black people demonstrate a stronger preference for kin-altruism than White people, with the assumption that this preference for kin-altruism acts as a potential barrier to VNRBD. [12][13][14][15][16][17][18][19] We test the hypothesis that the expression of kin-altruism is higher in Black people compared to White people (H2). We do this by exploring preferences for kin-and need-altruism across people from different ethnicities and how kinand need-altruism are related to (i) blood donor status (current, lapsed, non-donor) and (ii) willingness-to-donate.…”