Overcoming barriers to access and utilization of hospice and palliative care services in African-American communities.
While there is ample evidence to support the need for hospice and palliative care services for African Americans, only 8% of patients who utilize those services are from African-American communities. The underutilization of end-of-life and palliative care can be attributed to several barriers to service access including incompatibility between hospice philosophy and African-American religious, spiritual, and cultural beliefs; health care disparities; distrust of the medical establishment; physician influence; financial disincentives, and hospice admission criteria. Suggestions for dismantling barriers to care access include developing culturally competent professionals in the health and human services, expanding the philosophy of hospice to include spiritual advisors from client communities, and funding national initiatives to promote improved access to health care at all stages in the life cycle of members of all underserved communities.
Winston
Carole A
CA
University of North Carolina at Charlotte, College of Health and Human Services, Department of Social Work, 9201 University City Boulevard, Charlotte, NC 28223, USA. cwinston@email.uncc.edu
Leshner
Paula
P
Kramer
Jennifer
J
Allen
Gillian
G
D001291:Attitude of Health Personnel; D001293:Attitude to Death; D044383:Black People / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D017051:Hospice Care / Q000706:statistics & numerical data*; D006801:Humans; D008020:Life Support Care; D010166:Palliative Care / Q000706:statistics & numerical data*; D011287:Prejudice; D012067:Religion; D035502:Trust; D001741:Black or African American