title: Fear of dying in an ethnically diverse society: cross-sectional studies of people aged 65+ in Britain.
abstract: OBJECTIVE
  To examine fears about dying in an ethnically diverse population sample, and a more homogeneous population sample, aged 65 and over.
  
  
  METHODS
  Personal interviews with people aged 65+ living at home responding to two Office for National Statistics Omnibus Surveys in Britain, and two Ethnibus Surveys of ethnically diverse populations in Britain.
  
  
  RESULTS
  Ethnically diverse respondents were more likely than British population respondents to express fears about dying on all measures used. Respondents in both samples with better, compared with worse, quality of life had significantly reduced odds of having extreme fears of dying (ethnically diverse sample, OR 0.924 (95% CI 0.898 to 0.951); British population sample, OR 0.981 (95% CI 0.966 to 0.996); both p<0.001). In the latter sample only, older age was protective (OR 0.957; 95% CI 0.930 to 0.985; p<0.001), whereas in the Ethnibus sample, having a longstanding illness (OR 2.024; 95% CI 1.158 to 3.535; p<0.05) and having more relatives to help them (OR 1.134; 95% CI 1.010 to 1.274; p<0.05) increased fears about dying.
  
  
  CONCLUSIONS
  Enabling older people to express fears about dying is likely to be important when planning supportive end-of-life care. Practitioners should not assume that fears about dying are the same in different social groups, or that extensive family support is protective against such anxiety. Older people from ethnic minorities had more anxieties about dying than others, and were more likely to express fears the more extensive their family support. These findings have implications for commissioners and practitioners of primary and secondary care.
authors.affiliation: Department of Primary Care and Population Health, University College London, Royal Free Campus, London NW3 2PF, UK. a.bowling@ucl.ac.uk
authors.forename: Ann
authors.initials: A
authors.lastname: Bowling
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.forename: Anthony
authors.initials: A
authors.lastname: Kessel
authors.forename: Irene J
authors.initials: IJ
authors.lastname: Higginson
mesh_terms: D000368:Aged; D001208:Asia / Q000208:ethnology; D001293:Attitude to Death / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005239:Fear; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011788:Quality of Life; D012044:Regression Analysis; D006113:United Kingdom / Q000453:epidemiology; D014900:West Indies / Q000208:ethnology