AABB2025: Closing the Divide in Blood Donation

Historical mistrust, misinformation and socioeconomic barriers remain significant obstacles that continue to affect donor engagement and eligibility. In the Monday morning session, “Closing the Divide: Pathways to Engaging Underrepresented Communities in Blood Donation,” presenters explored the multifaceted challenges underrepresented communities face in accessing and participating in blood donation.  

Yvette Marie Miller, MD, ABIHM, executive medical officer of the American Red Cross in North Carolina, opened the presentation with a sobering look at the history of American Red Cross’s segregated blood donation practices in the United States. Miller displayed a 1941 letter written by Sylvia Tucker, who recounted her experience of being barred from donating blood due to her race. In her letter, Tucker questioned how Black soldiers injured in battle would receive transfusions if Black donors were excluded. 

“She must have felt devastated and disrespected,” Miller told attendees. She noted that this historical event helps explain why marginalized communities remain hesitant to donate blood today. 

“When trauma and pain like this are inflicted on a community, it becomes part of their collective psyche, and that trauma is passed from generation to generation,” Miller said. 

Miller acknowledged the impact of Red Cross’s past policies on marginalized communities and emphasized the Red Cross’s commitment to equitable access to blood transfusions through its initiatives and programs. “Understanding where we’ve come from helps us understand why health inequities persist, and what it will take to truly achieve equitable access to transfusion and care,” Miller said. “Part of our work is to alleviate human suffering.” 

Rim Abadallah, MD, from Vitalant, focused on the importance of donor diversity, particularly among underrepresented ethnic groups. She engaged the audience with polling questions about blood donation. Her data revealed that 62% of the U.S. population is eligible to donate, with only 3% actually donating, and 12.2% of active donors come from underrepresented communities.  

Abadallah identified several key barriers to blood donation, including mistrust, historical racism, medical exploitation, limited access, fear, safety concerns and knowledge gaps, especially among older adults regarding eligibility and donation process. She also highlighted Vitalant’s ongoing initiatives to diversify the donor pool, such as its "Strength of Us" campaign, which aims to educate and recruit more donors from the Black community to help patients with sickle cell disease (SCD). Additional efforts include continued partnerships with religious minorities, such as the Colorado Muslim Society, and with the LGBTQ+ community.

“All of these factors are interconnected. When we maintain a balanced inventory, we build a stronger, more resilient blood supply... one that can better withstand seasonal shortages,” Abadallah said. “Ultimately, this supports patient safety, promotes equitable access to care, and benefits everyone. SCD is a powerful example, as it disproportionately affects certain ethnic groups.” 

Jenni Gasbarro, who leads American Red Cross’s Sickle Cell Initiative, discussed the organization’s diverse donor program and its focus on increasing blood donor diversity, particularly among Blacks, Latinos, and LGBTQ+ individuals. The program aims to meet the high demand for type O blood and support patients with SCD.  

“With a declining national blood donor base, we must build a sustainable blood supply. That means engaging newly eligible donors, including through LGBTQ+ engagement, and addressing the ongoing high demand for type O blood, particularly in light of changing demographics,” she said.  

Gasbarro emphasized the importance of collaboration and engaging diverse communities to meet the high demand for blood types needed for patients with SCD. According to Gasbarro, the Red Cross’s Sickle Cell Initiative has seen a 60% increase in active Black donors and has provided more than 300,000 sickle cell trait screenings since January 2021.  

Gasbarro concluded her presentation with a video of a young sickle cell warrior, highlighting the vital role of blood transfusions throughout his journey. “Stories like Jaylen’s remind us why this work matters,” she told the audience. “We want sickle cell warriors to share their stories about the impact and critical importance of blood donation, and for the American Red Cross to serve as a platform that shines a spotlight on those who are affected.”  

Attendee Naghena Ghulam, BS SBB(ASCP)CM, immunohematology reference lab manager at One Blood, stated, “This session was truly engaging and enlightening. It’s going to help me bring new practices back to my lab, because I work with patients with SCD. It was incredibly insightful. I learned so much more than I expected, and now I feel equipped with valuable information to apply in my practice.”