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Blood donation is straightforward, but its history - and the numbers on who donates - is not

Blood donation
Posted at 8:52 AM, Jan 18, 2022

ATLANTA — You’ll find few places more sterile than a Red Cross center for donating blood.

The tubes, the bulbs, even the blood: it all runs the same. If any place was to be free of bias and inequity, it would be this.

And yet, it's there.

It's a familiar subject for Tiereny Bell.

"I get all the time, ‘But you don't look sick!’" Bell said. "And it’s like, ‘Well, thank you that I don't look sick, but I am.’”

Bell was born with sickle cell anemia. She’s one of roughly 100,000 Americans with the disorder. Most are Black.

“I've had multiple surgeries. I've had my spleen removed, my gallbladder removed," she said with a sigh and a laugh. "So much."

Sickle cell anemia keeps oxygen from the body. It limits physical activity. It starts at birth and stays for life. And it requires a transfusion of blood every month. Per the Red Cross, "Blood transfused to patients with sickle cell disease must be matched very closely to reduce the risk of complications. Therefore, these patients are more likely to find a compatible blood match from a blood donor of the same race or similar ethnicity."

But in America, a tapestry of diversity, the vast majority of blood donors are white. Black Americans make up more than 12% of the population and less than 3% of donors.

Of course, it’s never just about numbers.

Red Cross officials are the first to point out a lack of donation spots in Black communities, a lack of direct appeals to Black communities, and a history of mistrust in which they admit their part. When the federal government and Red Cross established the National Blood Donor Service in 1941, they excluded Black donors. A year later they changed course, but they segregated donations by race.

“We have not always welcomed diverse communities, and that’s a fact," said Dr. Yvette Marie Miller, the Red Cross' current executive medical director.

The segregation policy drew backlash and boycotts. It went away soon after the war, but it set a tone that remains hard to shake.

“Some of those health disparities and some of those access issues and inclusivity still remains today," Dr. Miller said. "So, even though the past informs the present, it is the present that is really part of the issue. You commonly hear people say, when they’re asked, ‘Why haven’t they donated blood?’ they’ll say, ‘Well, nobody ever asked me.’”

And that wariness, that frequent mistrust of the system, extends beyond blood.

“In college, it was a little difficult to find a hospital that treated sickle cell patients and knew about sickle cell disease," Bell said. “We have a joke in a sickle cell community: If a doctor comes in and asks you how long you've had sickle cell disease, then get up and get out. You're born with it."

Today, the Red Cross runs an entire initiative devoted to finding sickle cell blood donors.

For the most part, blood is blood. Race is irrelevant. Donation is safe – and sterile. But for Tiereny Bell, the lack of Black donors – and the implications for those with her disease – spur her to speak.

“You know, it's an invisible disease," Bell said. "So, a lot of people don't believe you're in pain, and doctors still have a hard time managing pain for sickle cell patients. It makes me think, like, at what point will I go to the hospital and not have the blood there?”

For more on blood donation, here is the Red Cross' web site.