Mark Igra – UW News

For the uninsured, crowdfunding provides little help in paying for health care and deepens inequities

Kim Eckart — Thu, 03 Feb 2022 21:02:16 +0000

Crowdfunding is sometimes touted as a “safety net” for people who can’t afford to pay their medical bills.

But new research from the ��Ӱ�Ӵ�ý, believed to be one of the first large-scale assessments of medical crowdfunding in the U.S., shows that people in states with higher medical debt and lower rates of insurance coverage are more likely to try to raise money but less likely to succeed.

This so-called safety net, researchers point out, isn’t much of one at all.

“We tend to think of crowdfunding as something that can help out anyone in hard times, but this data really indicates that where people need the most help paying for health care, crowdfunding provides the least help,” said , associate professor of nursing and health studies at UW Bothell.

The , published Feb. 3 in the American Journal of Public Health, collected data from more than 437,000 GoFundMe campaigns over a five-year period and analyzed, at the county and state level, crowdfunding use and outcomes. With the help of Census data and other information, Kenworthy and UW co-author , a graduate student in sociology, assessed how many campaigns were started, and how much money was raised, in areas with more or less income, medical debt and health insurance coverage.

See a in Scientific American.

The UW researchers have explored various angles of crowdfunding – who uses it, where they live and how successful their campaigns are. Last year, Igra and Kenworthy focused on crowdfunding during the first several months of the COVID-19 pandemic and found that campaigns were more successful in wealthier and more educated communities, a trend they attributed not just to financial resources available in such communities, but also to potentially wider – and wealthier – social networks. Igra and Kenworthy also found that 90% of campaigns, regardless of location, failed to meet their goals.

For this study, the researchers wanted to examine medical crowdfunding, and the extent to which it helps people who struggle to pay for health care in the U.S.On GoFundMe, which holds in the U.S., more than one-third of campaigns are related to health care. GoFundMe more than 250,000 campaigns to finance medical needs are started each year, raising more than $650 million.The UW study amassed one of the largest, publicly available datasets of GoFundMe campaigns in recent years, from 2016 through 2020, and demonstrated that more campaigns were started in low-income and under-insured communities, but campaigns in more affluent communities with higher rates of insurance coverage raise substantially more money. Among other findings:

Over that five-year period, the 437,596 campaigns in GoFundMe’s “medical, illness and healing” category raised more than $2 billion, with the median campaign earning just under $2,000
During that period, 16% of campaigns raised nothing, while less than 12% met their goal
Median numbers of donations and returns declined over time, hitting their lowest in 2020
In 2020, just under 18% of campaigns were started in areas with the highest household income bracket (between $73,000 and $130,000), but accounted for more than one-fourth of total money raised
That same year, 20% of campaigns were launched in the lowest income bracket ($19,000 to $47,000), accounting for 12% of total earnings. This is less than half of the earnings of the high-income bracket.
Similarly, there were more campaigns in states with higher percentages of people with medical debt and without insurance. Those campaigns raised less money than campaigns in other states. Mississippi, for example, has the highest percentage of the population with medical debt and is among the highest in percentage of uninsured, but crowdfunding campaigns there raised the least money of all 50 states.

In examining 2020 data — the last full year available — researchers said one statistic stood out: 33.8% of campaigns were unfunded. The percentage varied so much from that of previous years, when the portion ranged from zero to 4%, that researchers believe the pandemic alone wasn’t the cause. Rather, it appears more successful campaigns remain on the website longer, and thus previous years’ data may over-represent successful campaigns. In addition, unfunded campaigns appear to be removed from the site, either by the campaign creators or the website moderators, after one year, the researchers said.

“Because the campaigns people see on social networks are almost always the small subset that are shared widely, the public may have the impression that crowdfunding is more likely to be successful than it really is,” Igra said.

Greater transparency from all crowdfunding companies would allow more research and policymaking that could help address the very needs that crowdfunding purports to address, the researchers say. While thousands of people turn to crowdfunding to pay their medical bills, the study’s findings point to a more equitable and comprehensive solution: better health insurance coverage and social assistance programs.

“Relying on marketplace-based solutions only deepens already steep health inequalities. This research underscores the need for broader safety net programs that provide help to all those who need it,” Kenworthy said.

This study was funded by the National Science Foundation and the National Institute of Child Health and Human Development, through the UW Center for Studies in Demography & Ecology.

For more information, contact Igra at igra@uw.edu or Kenworthy at njk8@uw.edu.

Pandemic-era crowdfunding more common, successful in affluent communities

Kim Eckart — Wed, 16 Jun 2021 20:19:25 +0000

During the first several months of the pandemic — when communities locked down, jobs were lost, PPE was scarce and store shelves were cleared — thousands of people turned to online crowdfunding to meet their needs.

But a new ��Ӱ�Ӵ�ý analysis of requests and donations to the popular crowdfunding site GoFundMe, along with Census data, shows stark inequities in where the money went and how much was donated.

A published June 15 in Social Science & Medicine found more than 175,000 COVID-19-related GoFundMe campaigns in the U.S., raising more than $416 million, from January through July 2020. Researchers found that affluent and educated communities created more fundraising campaigns, and received more in return, than other communities with fewer resources.

What’s more, researchers found that campaign success, overall, was hard to come by. Some 43% of campaigns didn’t receive a single donation. More than 90% of campaigns didn’t meet their goals.

Researchers say the study reveals the challenges inherent to online crowdfunding, as well as its capacity to reinforce existing socioeconomic divides.

“Our study shows that even though COVID-19 had an impact across the country, the places that benefitted most from crowdfunding were the places that already had the most resources available,” said the study’s lead author, , a graduate student in sociology at the UW.

While some results may not be surprising from an economic standpoint — people in wealthier communities likely have more money to donate to charitable causes — researchers say the results highlight other factors contributing to campaign success. For example, people in more educated communities are likely better able to tap into existing social networks to raise money — whereas in communities where education is lower the needs may be greater, but residents may have fewer connections to affluent donors, and fewer campaigns reach their goals.

Other recent research has explored finding that campaigns are common, but often unsuccessful, in communities where health care resources and insurance coverage are lacking. This study is believed to be the first to examine online crowdfunding as a broader crisis response, and its impacts on inequality.

In examining COVID-19-related fundraising campaigns that mentioned a need associated with the pandemic, such as a lost job and a need for food or rent money, researchers eliminated those that were part of a GoFundMe program providing matching funds for businesses, leaving about 164,000 campaigns to sort through. Because demographic data about crowdfunding users is hard to come by, researchers analyzed campaign data at a county level and compared it with other county-level socioeconomic characteristics using U.S. Census data. Among their findings:

The median campaign goal was $5,000, with a median of two donations and only $65 raised.
The top 1% of campaigns received nearly one-quarter of all the money raised.
As COVID-19 cases and unemployment rose in a variety of communities, more fundraising campaigns were created in communities with higher education and income levels.
Counties where 35% of residents are college graduates can expect about 50% more campaigns than counties where only 12% are graduates.
Counties with a median household income of at least $130,000 raised nearly $150 million, almost three times as much as counties with a median income of $19,000 to $47,000, even though the populations of those counties are about the same.
A keyword search of GoFundMe campaign requests found that those identifying business and medical needs yielded more donations than those campaigns that mentioned personal financial needs.

GoFundMe’s approach of highlighting and promoting certain campaigns, whether those tied to a high-profile person or those that are gaining attention and growing at a faster rate, means success begets success, researchers said.

These bar charts show differences in crowdfunding campaign creation, among other differences, according to counties’ median household income. Photo: Igra et al., 2021, Social Science & Medicine

Co-author , an associate professor of nursing and health studies at UW Bothell, said the study shows who’s able to leverage resources in a crisis, and that the nature of online crowdfunding as a social media platform exacerbates the dynamics of a crisis.

“During the pandemic, there’s been a lot of talk of communities supporting communities, but we need to ask, where does that happen, for whom, and who gets left out?” said Kenworthy. “The more we rely on social media platforms to shape that community response, the more we are blinded to where help is not happening and who’s not getting assistance.”

That’s not to say crowdfunding doesn’t serve a valuable purpose, the authors point out. It’s more a sign “that we shouldn’t shy away from more structural solutions,” Kenworthy said, such as government-run programs that could cast a wider net than crowdfunding can cover.

“People’s fundamental needs for health and well-being shouldn’t be dependent on such an unpredictable source of funds. It’s really a question of what is our shared commitment to the things people should have, regardless of whether they can be successful at crowdfunding,” Igra said. “It’s a good thing that people are helping, but people who aren’t being helped aren’t visible.”

The study was funded by the National Science Foundation, the Center for Studies in Demography & Ecology at the UW, and the School of Nursing and Health Studies at UW Bothell. Additional co-authors were Cadence Luchsinger of the UW Department of Health Services and Jin-Kyu Jung of the School of Interdisciplinary Arts and Sciences at UW Bothell.

For more information, contact Igra at igra@uw.edu or Kenworthy at njk8@uw.edu.