This award is funded under the American Recovery and Reinvestment Act of 2009 (Public Law 111-5).
Securing a high and stable supply of blood and blood components is indispensable not only to face emergencies such as accidents and surgeries, but also to meet the increasing demand for blood for chronic diseases and certain types of cancer. The over 16 million units of blood annually collected in the United States, however, are not able to guarantee the emergence of frequent situations of blood supply shortage. Quite strikingly, while the majority of the adult population is eligible to supply blood, only 5% of the eligible population donates. Just like the eligibility requirements to be a donor do not explain this low donation rate in the population, so a lack of information on the importance of blood donations and on the frequent situations of supply shortage is not a plausible explanation, given the widespread ad campaigns by numerous organizations and public agencies, and the fact that a large share of individuals have had or will have a blood transfusion. If poor health conditions and lack of awareness are not plausible causes of the low level of blood supply, then other explanations, such as high opportunity costs, low ability to commit and low motivation appear as alternative explanations. If these causes are relevant, then economic incentives may increase the number and frequency of donations by the eligible population. While recent empirical research suggests economic incentives could be effective, several scholars and observers have argued against offering explicit (e.g. financial) incentives to stimulate the supply of blood (and it remains illegal for some organizations such as the American Red Cross to pay for blood). Providing material incentives, it is argued, would reduce the overall quality of the supplied blood, as it would attract bad types of donors, and might also crowd out the intrinsic motivations of people to undertake pro-social activities. The project studies the impact of material incentives on the quantity, frequency and quality of blood donation, through a series of field experiments on multiple blood drives, in collaboration with the North East Ohio Chapter of the American Red Cross. The project examines: a) whether the provision of material incentives to blood donors leads to an increase in potential donors and effective units collected; b) whether the presence of incentives at a given point in time has a habit-formation effect, whereby individuals repeat their donation even when incentives are no longer present; c) whether the presence of incentives attracts blood donors of lower quality; and d) what is the shape of the supply of blood for different levels of material incentives. The analyses not only focus on the immediate effects of incentives, but also focus on aggregate effects by examining whether the presence of incentives at a given location and time increases the overall donations in a geographical area, or instead incentives shift donors from drives without incentives to drives with incentives, and delays donations to later drives in the same locations without incentives. After accounting for spatial and temporal substitution (and crowding) effects, the total effect of the incentives in a given site may be substantially smaller or even negative.
This project is the largest and most comprehensive study to date on incentives for blood donations, and more generally one of the largest studies of the effects of incentives on the performance of pro-social behavior and provision of public goods. Through the use of controlled experiments over a large and representative population, and the use of promotions similar to the ones already in place, this study offers results that are both well-identified and generalizable to other contexts. The current empirical evidence is largely based on laboratory experiments, small-scale field experiments (or experiments targeted to narrow questions), and publicly available data sources. This study has the potential to provide more grounded answers to the effects of incentives on pro-social behavior. The size and variety of the sample also allows testing a wide series of incentives, varying in type and size, and will allow testing for habit formation as well as for substitution effects.
Broader Impacts: This study helps design mechanisms to encourage blood donation and reduce the recurrent situations of shortage, in the US and elsewhere, while at the same time safeguarding blood quality. The study also informs policy makers, companies and non-profit organizations on the role of material incentives for the performance of pro-social activities and the provision of public goods.
