The Color of Blood: Red Cross Reflects on its Blood Collection History

As a humanitarian organization, the American Red Cross is committed to listening to and learning from our valued colleagues and community members as we reflect on the legacy of racism and systemic discrimination in the U.S.

For more than 80 years, the Red Cross has helped to collect and distribute lifesaving blood. During that time, our work has been propelled by brilliant medical experts, dedicated employees, community leaders and generous volunteers of all races and backgrounds. In 1942, the Red Cross made the regrettable decision to segregate blood based on race, accommodating cultural norms of the time rather than relying on scientifically based facts —resulting in civil rights organizations boycotting the Red Cross and blood donation. 

Shortly after the policy was enacted and throughout World War II, the Red Cross hosted ongoing meetings with Black community leaders to discuss such segregation policies and ways the organization could engage the Black community in its mission work. These conversations were necessary to bringing down racial barriers that resulted in increased employment of African Americans and the eventual end of segregation within the Red Cross.  

We applaud the Black leaders who were at the table, boldly and courageously addressing these concerns and working to advance collaborative opportunities for the Red Cross and the communities it served. In 1948, the Red Cross discontinued the practice of segregating blood, as we determined that there was no scientific or medical basis to do so. With the policy discontinued, civil rights organizations ended their boycotts and later partnered with blood collection organizations like the Red Cross to encourage the Black community to donate blood over the years.

We acknowledge that this donation policy was hurtful and recognize these actions contributed to continued mistrust and pain for Black communities, where health disparities continue to be felt disproportionately. We remain grateful to the community leaders who have held us accountable and who continue to do so while supporting and advocating for our humanitarian mission. Today, the Red Cross stands firm in its dedication to diversity and inclusivity, and resoundingly rejects hate, racism and bigotry of any kind.

Blood Compatibility Advancements

With scientific advancements, we have learned a great deal about blood and its many unique characteristics. While the race of blood donors and blood recipients typically do not matter as long as their blood types are compatible, some individuals who are Black (including African American or other individuals of African descent) have unique protein structures on their red blood cells that can make it difficult to find a compatible unit of blood in other donor populations.

Beyond the well-known blood types of A, B, O and AB, there are more than 600 known antigens for red blood cells, and some antigens are unique to specific racial and ethnic groups. For example, Ro is a Rh antigen, or haplotype. This haplotype is more than 10 times more likely to be in individuals who are Black or of African descent than individuals who are white. This information is important in meeting the transfusion needs of patients with sickle cell disease, who, in the U.S., are mostly individuals who are Black. If a patient has this haplotype, we are more likely to find the most compatible blood product match from a Black donor.

Sickle Cell Blood Needs

In our current health system in the U.S., patients who are Black continue to face racial inequities in the fight against sickle cell disease. Unlike other diseases, there have been fewer health resources available to help those suffering from sickle cell disease in comparison to similar diseases, a troubling legacy of neglect for diseases that primarily affect individuals who are Black. Today, blood transfusion for patients with sickle cell disease remains as one of the primary treatments to help alleviate the pain of this disease.

Blood transfused to patients with rare blood types, like those with sickle cell disease, must be matched very closely to reduce the risk of complications. These patients are more likely to find a compatible blood match from a blood donor of the same race or ethnicity. While the science of blood antigens can be complicated, the simple fact is, individuals who are Black often have unique antigens on their red blood cells that must be closely matched for patients with sickle cell disease.  

That is why the Red Cross has made increasing blood donations from individuals who are Black a priority:

• We work closely with diverse community leaders and pre-eminent organizations within the Black community to address blood-related medical concerns prevalent in Black populations, such as sickle cell disease, as well as to help increase blood drives in Black communities.
• For a limited time, we are offering sickle cell trait screening on all donations from self-identified multiracial and Black or African American donors. This additional screening will help the Red Cross identify compatible blood types more quickly to help sickle cell patients and provide these specific donors an additional health insight during a time when health information has never been more important.
• We recognize the COVID-19 pandemic and ongoing public health disparities have compounded the challenges for patients with sickle cell disease as they continue to face concerns around availability of care and access to needed blood products for their treatment. One treatment a patient should not have to worry about is the availability of a closely matched blood product to ease their pain.
   

The Red Cross is committed to ensuring blood is available for any patient who may need it, and that the most compatible blood match is available for all patients in need.

A Diverse, Inclusive Future

As we work to inspire and build a more inclusive future for our nation and the world, it is important the Red Cross reflects on all aspects of our past, honors the historic pain caused by racial discrimination and understands current challenges to meet the needs of all patients equitably. Establishing trust and maintaining transparency with those we serve is critical to alleviating human suffering.

Everyone is welcome and needed in this mission to provide blood to patients in need, and we invite you to join us. Together, this is a need we can and must address today.

Editor’s Note: This news release was originally published September 8, 2021, and was updated February 7, 2023, for additional context and comprehensiveness. It was also updated Aug. 7, 2023, to reflect the expansion of sickle cell trait screening to include multiracial donors as well as Black or African American donors.