How plasma donation centers can make cities safer

Financial incentives for donating blood, plasma, or other biological tissues are controversial. On one hand, paying donors could lead to exploitation of people who are financially vulnerable. On the other hand, it’s clear that financial rewards motivate donation and that, at least for plasma donation, donor screening and limits protect their health. A compelling new study reveals that there may be additional, unexpected positive benefits to paid plasma donation—reduction in crime levels. 

For years, Dr. Mario Macis of Johns Hopkins University has been committed to understanding how financial incentives shape blood donation behavior. One of his experiments, randomly assigned incentives across the country, demonstrated a clear relationship: higher rewards led to higher donation rates. His subsequent research on economic rewards revealed something equally important—that financial incentives didn't undermine donors’ altruism but rather worked as complements to it. Perhaps most tellingly, Macis found no differences across income groups; people from all economic backgrounds responded similarly to donation incentives. He also found throughout this study that adding a financial incentive had no impact on donor health and safety either positively or negatively.

While Macis's research established that paid donation systems effectively increase blood supply without compromising donor motivations, it opened a larger question: What other societal impacts might these compensation models have beyond the healthcare system itself? 

The new research reveals that when a plasma center opens in a city, the crime rate in that city drops by 12%. This unexpected finding comes from a study conducted by Dr. Brendon McConnell (University of London), Dr. Mariyana Zapryanova (Smith College), and Samuel Kang (University of St. Gallen), and suggests an innovative approach to crime prevention hiding in plain sight within our healthcare infrastructure.

Using a sophisticated within-city design, the researchers discovered large crime drops specifically in neighborhoods close to newly opened plasma centers. This localized impact indicates that the benefits concentrate in areas surrounding the facilities. As McConnell noted, the study found “no evidence of crime shifting within cities” but rather "a city-wide reduction in crime at the city level following the opening of a plasma center." This means crime isn’t simply moving elsewhere.

The research examined an extensive range of criminal activity to reach these conclusions. The crime reduction effect is particularly pronounced in property and drug-related offenses. 

"We mainly consider broad crime categories—property crime, violent crime, drugs supply, drugs possession, other crime—although the richness of our data allows us to be more specific with crime types—theft, vehicle crime, fraud for property crime, and possession of specific drug types," McConnell explained. This comprehensive approach strengthens the study's findings across multiple offense categories.

The mechanism behind this crime reduction appears directly tied to the financial incentives plasma donation provides. Plasma centers offer donors up to $400 in monthly income for under four hours of time per week, creating a legitimate income source for economically vulnerable individuals, without risking their safety or health in the process, as studies have shown. The United States stands out in this regard, as McConnell pointed out. "The United States is one of the few Organization for Economic Co-operation and Development (OECD) countries to pay individuals to donate blood plasma and is the most generous in terms of remuneration, " he said.

According to the researchers, the crime-reducing effect stems from "a combination of income effects and drug requirements." Each donation center performs a health screening to determine eligibility and automatically defers a donor if they have taken drugs within the last three months. There was no evidence to suggest that individuals formerly committing crimes simply have less time to do so once they begin donating plasma. The income component appears most significant, suggesting that providing accessible financial opportunities through plasma donation serves as an effective crime prevention strategy, particularly for economically motivated offenses.

The timing of this research carries particular significance given the expansion of plasma donation infrastructure across the United States. The number of plasma centers has surged from fewer than 300 in 2005 to over 900 in 2020. This growth trajectory means these facilities have increasing power to transform neighborhoods, and since the pandemic, centers have opened in a broader range of types of neighborhoods than before. 

Perhaps most remarkably, the crime reduction appears to compound over time. "These effects are relatively long term," McConnell observed. "We find that the crime-reducing effect of a plasma center opening takes a few years to build–the medium-run effect (7 years post-opening) is considerably larger than the short-run effects (1-2 years post-opening)." 

This research reveals an unexpected relationship between healthcare infrastructure and public safety that challenges conventional thinking about crime prevention. 

McConnell summarized "Our research highlights a notable public benefit from a ‘being paid for plasma donation’ model. The financial benefits of being a donor may lead some individuals to disengage from gaining income from property crime and drug-related crime, making cities with blood plasma centers safer than they would have been in the absence of the plasma center. There is nothing in our research to suggest that this finding would not replicate in other settings where paid-for-donation was introduced."