Emerging Economic Coping Strategies amidst a Growing Market for Human Blood Plasma

Background and Purpose: This study examines the experiences of people who are paid plasma donors and the extent to which relying on this practice to earn income is a consequence of poverty and inequality. As biotechnological innovation has expanded therapeutic uses of human blood plasma, the demand for this precious fluid has skyrocketed. This has resulted in the growth of the for-profit market for human blood plasma in the U.S., where people can earn hundreds of dollars each month by giving blood plasma up to twice per week. This study asks: how and why have millions of Americans come to rely on exchanging their blood plasma for money to generate income? Findings reveals that paid plasma donation serves as an economic coping strategy for low to middle income Americans coping with growing inequality.

Methods: This mixed methods study incorporates survey and interview analysis to evaluate the factors that motivate donors to engage in the for-profit blood plasma market. I collected 300 survey responses and conducted 36 semi-structured interviews with paid plasma donors. Analysis of this data provides insight on the conditions that influence people's decisions to give plasma, how the money earned is used, the side effects donors experience, how the process of giving plasma works, how the industry’s framing of plasma donation as a “donation” shapes the donor’s perception of the transaction, and the extent to which donors view plasma donation as a job. Participants were recruited using various strategies, including in-person recruitment at plasma centers, referrals, and online recruitment through Facebook. Interview participants were selected from the survey respondent pool. All interviews were conducted via Zoom by the researcher in English or Spanish.

Results: Findings indicate that people across all income groups, from households earning less than $10,000 for per year (21.7% of respondents) to over $100,000 per year (20% of respondents), the two largest income groups represented in the study, commonly expressed that financial hardship and/or the “bad economy,” characterized by inflation and the high cost of food, gas, rent, student debt, and other basic living expenses, motivated their decision to give plasma. Low to middle-income Americans, nearly half of which work full-time, view paid plasma donation as an income-generating strategy akin to a second job. While donors routinely experience side effects, ranging from blackouts, nausea, fatigue, and bruising, and worry about long-term health effects, they continue giving plasma because they need the money.

Conclusion and Implications: This work contributes to our understanding of the consequences of growing economic inequality. This is the first study to reveal that the demographics of paid donors is changing—while paid plasma donation has traditionally been viewed as a practice reserved for low-income people, my findings show that people from moderate-income households are increasingly engaging in paid plasma donation as well. This study brings a conversation on the ethical implications of the for-profit blood plasma industry to the forefront and integrates social work practice by calling on policymakers to re-examine whether existing policies adequately protect donors from unintended health outcomes and exploitation.