title: Racial differences in end-of-life planning: why don't Blacks and Latinos prepare for the inevitable?.
abstract: I evaluate the extent to which ethnic disparities in advance care planning reflect cultural and religious attitudes and experience with the painful deaths of loved ones. Data are from a sample of 293 chronically ill older adults who are seeking care at one of two large medical centers in urban New Jersey. Blacks and Hispanics are significantly less likely than Whites to have a living will, a durable power of attorney for health care (DPAHC), and to have discussed their end of life treatment preferences. Multivariate analyses reveal that the Black-White gap in advance care planning is largely accounted for by Blacks' belief that God controls the timing and nature of death. The Hispanic-White gap is partially accounted for by the belief that one's illness negatively affects one's family. Ethnic disparities are starkest for living will and DPAHC use, and less pronounced for discussions. Implications for policy and practice are discussed.
authors: Department of Sociology, Health Care Policy & Aging Research, Rutgers University, New Brunswick, New Jersey 08901, USA. carrds@sociology.rutgers.edu
authors: Deborah
authors: D
authors: Carr
mesh_terms: D032722:Advance Care Planning / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001293:Attitude to Death; D001294:Attitude to Health / Q000208:ethnology*; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D002908:Chronic Disease / Q000208:ethnology*; D003466:Cultural Characteristics; D003657:Decision Making; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D010358:Patient Participation; D012959:Socioeconomic Factors; D013727:Terminal Care / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*; D001741:Black or African American