Population income and longitudinal trends in living kidney donation in the US

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http://www.ncbi.nlm.nih.gov/pubmed/25035519

Population income and longitudinal trends in living kidney donation in the United States.
Gill J1, Dong J2, Gill J3.
J Am Soc Nephrol. 2015 Jan;26(1):201-7. doi: 10.1681/ASN.2014010113. Epub 2014 Jul 17.

Abstract
Living kidney donation is declining in the United States. We examined longitudinal trends in living donation as a function of median household income and donor relation to assess the effect of financial barriers on donation in a changing economic environment. The zip code-level median household income of all 71,882 living donors was determined by linkage to the 2000 US Census. Longitudinal changes in the rate of donation were determined in income quintiles between 1999 and 2004, when donations were increasing, and between 2005 and 2010, when donations were declining. Rates were adjusted for population differences in age, sex, race, and ESRD rate using multilevel linear regression models. Between 1999 and 2004, the rate of growth in living donation per million population was directly related to income, increasing progressively from the lowest to highest income quintile, with annualized changes of 0.55 (95% confidence interval [95% CI], 0.14 to 1.05) for Q1 and 1.77 (95% CI, 0.66 to 2.77) for Q5 (P<0.05). Between 2005 and 2010, donation declined in Q1, Q2, and Q3; was stable in Q4; and continued to grow in Q5. Longitudinal changes varied by donor relationship, and the association of income with longitudinal changes also varied by donor relationship. In conclusion, changes in living donation in the past decade varied by median household income, resulting in increased disparities in donation between low- and high-income populations. These findings may inform public policies to support living donation during periods of economic volatility.

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Per US Census 2010 data as reported on http://en.wikipedia.org/wiki/Household_income_in_the_United_States#Distribution_of_household_income_in_2010_according_to_US_Census_data, the mean household national average income quintiles in 2010 were:

Q1: $20,260 and below.   
Q2: $20,260-$38,515
Q3: $38,515-$62,434
Q4: $62,434-$101,577
Q5: $101,577 and up.

  Assuming your quintile in 2010 was your quintile when you donated, and you're in Q1, 2, or 3, you bucked the trend since 2005. The disincentive/incentive conversation is directly relevant to you. What are your thoughts? I donated in 2003, and was on the path from 2001, so I prefer to hear from those who've lived the experience since, when Q4 stabilized and Q1, 2, & 3 started to decline.