Blood Veins for Hire: Social Inequality and the Blood Plasma Industry

Background and Purpose: The United States sources 70% of the world’s blood plasma. This may be the case because unlike in most countries where plasma collection is restricted to an altruistic, non-remunerated exchange, U.S. regulations allow donors to be paid twice per week. In 2021, 43.8 million blood plasma collections occurred in the U.S., where today there are nearly 1,200 for-profit plasma collection centers. These centers are overrepresented in high poverty areas where racial and ethnic minorities are more likely to reside.

Evidence suggests that blood plasma donation, as the practice of exchanging blood plasma for money has been coined, has become a widespread practice among people experiencing economic adversity. This is concerning because there is limited research on the health effects of frequent plasma extraction and because vulnerable populations are already prone to negative health outcomes. Yet, no study has empirically examined the experiences of people who give plasma, or the extent to which relying on this practice to earn income is a consequence of poverty and inequality. As such, this study asks what role does blood plasma donation play in the lives of plasma donors?

Methods: This mixed methods project draws on spatial analysis of the location of US plasma centers, plus survey and interview data analysis. I join data on the location of US plasma centers with demographic data from the American Community Survey 5-year estimates to examine the demographic characteristics of the locations where centers have expanded to since 2017. I supplement spatial analysis with 300 survey responses and 30-40 interviews of plasma donors to understand their economic well-being, their rationale for giving plasma, and how compensation is spent. In-person recruitment at plasma centers and online recruitment using social media is employed for this study.

Results: Based on preliminary survey results and ongoing interviews, most respondents are primarily motivated to give plasma for the money. They use funds for a variety of reasons but in most cases, funds are used to cover necessary expenses, such as food, rent, and clothes for children. Respondents often describe experiencing short-term health side effects and question whether emerging health issues may be related to giving plasma. The frequency with which people give plasma is associated with their degree of financial hardship, their connection to the labor market, and access to government transfers. Moreover, ongoing data collection on the location of plasma centers shows that the number of centers in the US has nearly doubled since 2017 and that centers are now in almost every state in the continental US.

Conclusion and Implications: Reliance on blood plasma donation as an income generating tool is a consequence of poverty and inequality. Advocacy, a key component of social work practice, is needed to raise awareness to the lengths that cash-strapped Americans are going to make ends meet, to ensure the blood plasma industry doesn't exploit vulnerable individuals, and to call on policymakers to revisit plasma collection regulations in the US to ensure that plasma donors are not inadvertently putting their health at risk.