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

Author

Listed:
  • Nora Kenworthy
  • Zhihang Dong
  • Anne Montgomery
  • Emily Fuller
  • Lauren Berliner

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: people of color (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 with how technology fuels health inequities, and 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.

Suggested Citation

  • Nora Kenworthy & Zhihang Dong & Anne Montgomery & Emily Fuller & Lauren Berliner, 2020. "A cross-sectional study of social inequities in medical crowdfunding campaigns in the United States," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-23, March.
    • Handle: RePEc:plo:pone00:0229760
    DOI: 10.1371/journal.pone.0229760
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    References listed on IDEAS

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    1. Igra, Mark & Kenworthy, Nora & Luchsinger, Cadence & Jung, Jin-Kyu, 2021. "Crowdfunding as a response to COVID-19: Increasing inequities at a time of crisis," Social Science & Medicine, Elsevier, vol. 282(C).
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    3. Yalin Wang & Yaokuang Li & Juan Wu & Li Ling & Dan Long, 2023. "Does digitalization sufficiently empower female entrepreneurs? Evidence from their online gender identities and crowdfunding performance," Small Business Economics, Springer, vol. 61(1), pages 325-348, June.
    4. Davis, Aaron Renee & Elbers, Shauna K. & Kenworthy, Nora, 2023. "Racial and gender disparities among highly successful medical crowdfunding campaigns," Social Science & Medicine, Elsevier, vol. 324(C).

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