S4 Ep5: Do we give more to charity after we've been sick?

Episode Summary

Executive Summary: This episode examines “altruism born of suffering” (ABS): whether severe health shocks make people more charitable. Using US panel data on cancer, stroke, and heart attacks, Sarah Smith explains that health shocks do not make non-donors start giving; instead, they redirect existing donors away from non-health causes toward health charities, with no rise in total giving and only limited persistence over time.

Main Topics: Defining altruism born of suffering (Priority: 5/5): The episode frames ABS as a behavioral response in which personal suffering motivates helping others, but asks whether this is new generosity or a reallocation of existing charitable intent. Research design and data (Priority: 5/5): The study uses the US Panel Study of Income Dynamics to track the same individuals before and after unexpected serious health shocks, focusing on cancer, strokes, and heart attacks. Shift in charity type, not total generosity (Priority: 5/5): Findings show that health shocks increase donations to health charities while reducing donations to other non-religious causes, leaving total giving broadly unchanged. Who changes behavior after a shock (Priority: 4/5): The effect comes from people who already gave to charity before the shock; those who were non-donors generally do not begin giving afterward. Religion as a separate category (Priority: 4/5): Religious giving is analyzed separately because it is unusually important in the US and may respond differently to health shocks and changes in observance. Persistence and time pattern (Priority: 4/5): The biggest effect occurs in the year after the health shock, with smaller but still positive effects two to three years later. Implications for fundraising and competing causes (Priority: 4/5): The discussion links the findings to broader fundraising dynamics, including COVID-era support for health institutions and evidence that large campaigns can raise total donations rather than simply crowding out other causes.

Key Arguments: Health shocks trigger a redirection of charitable giving rather than a net increase in generosity. People who had already been donors are the ones most likely to shift toward health charities after a shock. There is no evidence that previously non-giving individuals suddenly begin donating because of a health shock. The strongest response occurs in the year immediately after the shock, suggesting salience and emotional proximity matter. Religious giving is largely unaffected, implying the main reallocation is between health charities and other non-religious, non-health causes. Charitable fundraising matters: campaigns can alter overall donation levels, while individual shocks mostly change the composition of giving.

Data Points: US donors reporting any giving in the last year: just under 70% - Used to describe how common charitable giving is in the United States. Charitable donations in the US as share of GDP: about 1.4% - Shows the United States is the most generous among countries discussed by this measure. Next-best country donations as share of GDP: about 0.7% - Compared with the US, the next highest country—New Zealand—is about half as high. Baseline share giving to health charities: around 30% - The pre-shock level of donors contributing to health charities. Increase in health-charity giving after shock: +11 percentage points - Largest effect in the year after the health shock. Post-shock health-charity giving level: about 40% - Approximate increase from a 30% baseline after a health shock. Health shock persistence: positive through 2–3 years - The effect attenuates but remains above baseline beyond the first year. Health conditions studied: 3 main conditions - Cancer, stroke, and heart attack were the focal severe health shocks.

Pivotal Quotes: "What we saw is that people who had given to charity switch from giving to a whole range of different charitable causes towards giving more towards health charities." — Sarah Smith: Core finding on reallocation of donations after a health shock. "So it really causes people to redirect their giving rather than causing them to start giving in the first place." — Sarah Smith: Clarifies that ABS changes the target of giving, not the decision to give at all. "There is no change in total giving, but that comes through the other non-religious, non-health charities." — Sarah Smith: Explains the trade-off between health and non-health charitable giving.

Implications: Health shocks can reshape philanthropy by shifting donations toward health-related causes, especially soon after the event. For charities, this means fundraising competition matters and cause-specific campaigns may move money rather than create entirely new donors.