Thursday, June 03, 2010

On population aging and Newfoundland's blood supplies

The aging of populations has any number of consequences in any number of countries for any number of reasons. One consequence that I hadn't imagined at all was a falling number of potential blood donors in Newfoundland and Labrador.

Statistics Canada's latest demographic projection singled out Newfoundland and Labrador as the province with the fastest aging population.

As well, under a low-growth scenario, Newfoundland and Labrador is the only province that could see its population decline over the next 25 years.

"As this demographic shift happens, it will have a two-fold effect on our blood supply," said Sharon Bala, a communications official with the Canadian Blood Services in St. John's.

"First, we'll need more blood and then second, there'll be fewer donors available to donate, so that's why it's really important for us to engage younger people to pick up the torch."

In 2009, the median age of blood donors in Newfoundland was 41, meaning that half of the people who gave blood were older than that.

Bala said Canadian Blood Services has launched a new campaign targeting teens. She said organizers want to recruit donors at a younger age and to foster donation habits that will last for years.

In Canada, as in many other countries, blood is frequently in short supply. Part of this is because (circa 2008)a third of committed donors did not showing up, but as one source notes the demographics of blood donors are become less and less favourable.

Currently, despite the fact that almost everyone will need to use donor blood at some point in their life, less than 4% of eligible donors give blood.

By examining the records from the Canadian Blood Services, several patterns were observed. Firstly, the 15-24 age group showed the strongest likelihood to be donors, whilst those of working age (25-54) were the least likely to be donors. The authors predict that due to an ageing population this reliance on the younger generation will be unsustainable.

The study also showed positive ties between level of education and ability to speak English with donation likelihood, whilst immigrants and the wealthy were less likely to donate. The paper shows that those living in a big city were much less likely to donate blood than those living in smaller cities or towns, coining the phrase "the stingy big-city effect". According to Páez, "The fact that those who possessed a higher level of education were more likely to donate lends weight to the assertion that, with 25% of Canadians thinking there are some risks in donating blood, educating the public would help expand the donor database".

This last may be a consequence of fears dating back to the early and mid-1980s, when many people believed that they could become infected with HIV not only by receiving blood products but by donating blood. Older people with more commitments just find it difficult to set aside the time necessary.

Saberton et al's very extensive and highly recommended study suggests that, in Canada the proportion of blood donors as such doesn't very much by region, with (as noted above) fluency in English and residency in small towns playing more of a role. Newfoundland's very badly off in this regard, with underserviced rural areas and a most unfavourable age pyramid, with low completed fertility compounded by mass emigration of the young and working-age population.

What goes for Newfoundland probably also goes for other countries facing similar demographic issues. Where will the blood needed for surgeries come from in the future? Perhaps the blood could be manufactured. (But how?) Perhaps the blood could be imported. (But the memory of the tainted blood scandals common to most of the developed world will surely prevent this.) It's the sort of conundrum that doesn't seem to have been considered, honestly. Maybe it should.


Anonymous said...

Currently, despite the fact that almost everyone will need to use donor blood at some point in their life

From what I understand, most donated blood goes to a relatively small number of recipients. For example, 100 units of donated blood don't end up being given to 100 recipients, one per person. It's more likely that one person will get 95 units (and probably will die anyhow), while five people get one each.


Scott said...

Another factor to consider is the eligibility of potential donors to actually donate blood. Simply having to take certain medications can disqualify you, as well has having had health issues in the past such as cancer. Also, people who have simply traveled to certain countries particularly in Africa are considered ineligible, at least in the US.

This limits the potential supply of donor blood in the US significantly.