Tackling the Health Care Inequity Problem

The good news is that the waiting list for a lifesaving organ has decreased by 10% over the past five years. This is a glowing testament to those who say yes to donation and the wonderful demonstration of the generosity of so many.

But while we rejoice in all that has been accomplished, there is still much work to be done as more than 107,000 Americans wait for a donor.  This includes 21,000 Californians and a disproportionate number of African Americans who, according to the US Department of Health and Human Services, comprise the largest single group in need of an organ transplant.  We know that the opportunity to donate and to receive a lifesaving transplant knows no sexual orientation and has no national, racial, ethnic nor religious boundaries. However:

• The need for donation and transplantation is greatest in communities of color where higher rates of diabetes, high blood pressure and heart disease put patients at risk for organ failure. African Americans are almost four times more likely than white Americans to have kidney failure.

• Nearly 60% of the Americans waiting for a transplant are persons of color and African Americans disproportionately make up 29% of the list, while only 13% of the population.  

• While 28% of the waiting list, African Americans received only 21% of transplants; despite the fact that list ranking is based on medical need, likelihood of transplant survival, and time waiting.

• Although African Americans comprised 24% of potential organ donors, African Americans made up only 12.5 percent of organ donors in 2019 as donor authorization rates in the African American community are some 13 percentage points lower than the U.S. average.

Each of these statistics are evidence of healthcare inequities in access to, reliance on, and benefits from the U.S. healthcare system among communities of color – inequities brought to the forefront by the COVID-19 pandemic.  And as these data show, the imbalance that exists in organ and tissue transplant rates is an equally troubling, yet far less talked about issue.

These and other health disparities are the result of a multitude of issues, including a multi-generational distrust of the medical system, traditional beliefs around death and dying, the false presumption that the organ transplant system discriminates, and underlying co-morbidities that make transplantation and donation more challenging due in large part to sociologically-driven disparities.  

Fortunately, today there are many organizations here in Los Angeles – including Black-owned businesses along with numerous others – who are working to make a meaningful impact in our community and help heal the wounds of healthcare inequalities that have stained our nation for far too long.  OneLegacy is proud to join in that effort.  Here are some of the things we are doing:

• In 2020 we launched a series of virtual Town Halls (which are continuing this year) featuring hosts and guests of diverse backgrounds, including African American owned businesses. The goal of these Town Halls is to bring heightened awareness to donation and transplantation in diverse communities and to bridge the gap between the demand for organ transplants and the supply of donated organs.

• We are actively engaged in a social media outreach campaign to share facts and figures about health care access and disparities among diverse communities.  While our charter concerns organ and tissue donation, we recognize that the issue of health disparities stretches far broader and only by acknowledging the totality of the problem can true progress be made.

• We’ve produced public service announcements highlighting health resources available for African Americans, Hispanics, Asians and Native Americans in Southern California. Through this effort we are encouraging communities of color to seek appropriate health care whenever needed and to register to be an organ and tissue donor. By doing so we can create healthier communities through the generous gift of life and transplantation, an action that looks beyond race and ethnicity to simply help those in greatest need.

• We are working with partner organizations with whom we can share ideas and resources to further reach into communities of color with our message of donation.  As an example, earlier this year we joined with Zeta Phi Beta – an international, historically African American sorority – and LifeStream Blood Bank at Arrowhead Regional Medical Center in Colton to encourage blood donation and, at the same time, register people to be organ and tissue donors.  We invite other organizations, including African American-owned businesses here in Los Angeles, to join us in this effort.

Los Angeles is home to the most diverse region in the nation boasting 185 distinct languages and cultures (OneLegacy’s seven-county service area is comprised of 69% Hispanic, Asian and Black as compared to 31% White population). Included in this are many Black-owned businesses which are cultural hubs, economic engines and vital parts of the communities they serve.  This multi-cultural and multi-ethnic community makes it imperative that every business do all that it can to foster diversity and equality, to embrace all cultures and influences and to fully appreciate why Black business matters.  

Tom Mone is chief executive officer of OneLegacy, a nonprofit organization dedicated to saving lives through organ, eye and tissue donation in seven counties in Southern California.  For more information, visit OneLegacy.org, like the organization on Facebook, or follow it on Twitter and Instagram. To register to become an organ, eye or tissue donor, visit OneLegacy.org/Register.


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