  Americans are increasingly relying on crowdfunding to pay for the costs of
healthcare. In medical crowdfunding, online platforms allow individuals to
appeal to social networks to request donations for health and medical needs.
Users are often told that success depends on how they organize and share their
campaigns to increase social network engagement. However, experts have
cautioned that MCF could exacerbate health and social disparities by amplifying
the choices and biases of the crowd and leveraging these to determine who has
access to financial support for healthcare. To date, research on potential axes
of disparity in MCF, and their impacts on fundraising outcomes, has been
limited. This paper presents an exploratory cross-sectional study of a
randomized sample of 637 MCF campaigns on the popular platform Gofundme, for
which the race, gender, age, and relationships of campaigners and campaign
recipients were categorized alongside campaign characteristics and outcomes.
Our analyses examine race, gender, and age disparities in MCF use, and tests
how these are associated with differential campaign outcomes. The results show
systemic disparities in MCF use and outcomes: non-white users are
under-represented. There is significant evidence of an additional digital care
labor burden on women organizers of campaigns, and marginalized race and gender
groups are associated with poorer fundraising outcomes. Outcomes are only
minimally associated with campaign characteristics under users' control, such
as photos, videos, and updates. These results corroborate widespread concerns
how technology fuels health inequities, and about how crowdfunding may be
creating an unequal and biased marketplace for those seeking financial support
to access healthcare. Further research and better data access are needed to
explore these dynamics more deeply and inform policy for this largely
unregulated industry.
