Behavior / Cardiovascular Disease

Money, Medicine and Miracles

Image taken from http://weknowmemes.com/2014/08/where-we-donate-vs-diseases-that-kill-us-infographic/The extraordinary success of the ALS Ice Bucket Challenge is not without controversy, as the popularity of the fundraising endeavor has raised questions as to why we are more prone to give when there is a public aspect of the process. In other words– why not just donate to ALS Foundation? Why be motivated to act only when there is social media involved?  This aside, the Ice Bucket Challenge demonstrates another real health issue: lack of funding for disease prevention and treatment. The attached graph shows a large disconnect between some of our largest fundraising campaigns and the diseases that actually cause mortality and morbidity in the U.S.. For example,  we raise the most money for breast cancer with the Komen Race for the Cure (Think Pink!) yet the 5 year survival rate for breast cancer is 90% and 12.3% of women will be diagnosed with breast cancer over their lifetime. By contrast, heart disease, which is the top ranked cause of death for men and women, carries a substantially higher societal burden. About 40-50% of men and women living to the age of 50 will develop heart disease (although this statistic varies dramatically depending on the number of cardiovascular risk factors an individual has), and severe heart disease (i.e., heart failure) has a 5 year survival rate of less than 50%. Yet Jump Rope for the Heart, the top fundraiser for the American Heart Association, raises far less money than Race for the Cure. Now, certainly no one wants to detract from fundraising efforts for breast cancer. But with the issue at hand being that there just isn’t enough money to go around, I wanted to ask the question: Why do we give? What makes us choose to donate our time and/or money to a certain charity?

Turns out it’s complicated. Some research suggests that to a large extent we give based on our identity: who we are and how we identify ourselves. So, we are more likely to give to certain charities or events if they fit into our context of ourself. And, likely, this plays into the success of an adult fitness endeavor like Race for the Cure as opposed to a school-centered event like Jump Rope for the Heart. Another study demonstrated that we are more likely to find happiness through donation if the charitable giving involves social connection. Hence, again why races and walks are so popular, and perhaps a strong explanation underlying the social media explosion of the Ice Bucket Challenge. And then there’s the “magical thinking” hypothesis: our charitable giving appears influenced by how likely it is we think we’ll get a disease. For example, in research studies, people are more likely to give to a disease prevention campaign if they think they are likely to get the disease. Somehow, giving to the campaign spurs a sense of “disease protection” that is reassuring to the donor. This may play out in the fundraising discrepancy between cancer and heart disease campaigns, as cancer often seems random and uncertain (i.e., it seems as though everyone knows someone who was blindsided by a cancer diagnosis) whereas heart disease seems more predictable (with established risk factors such as obesity, physical inactivity, high blood pressure, and high cholesterol). Therefore, perhaps our willingness to participate in Race for the Cure comes from our own form of magical thinking about cancer and its impact on our lives.

Certainly, the point of this post isn’t to dissuade anyone from donating to charity, because money spent on disease prevention and treatment has a positive and beneficial impact regardless of where it goes, and donation is a personal choice. But understanding the psychology of donation– our own motivations and responses, for example– may help us more effectively match dollars to need over the course of a lifetime.

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