title: Trends in Engagement in Advance Care Planning Behaviors and the Role of Socioeconomic Status.
abstract: We investigated the trends in advance care planning (ACP) between 2002 and 2010 and whether socioeconomic status explained such trends. We conducted a pooled regression analysis of Health and Retirement Study data from 6052 proxies of deceased individuals. We studied 3 ACP behaviors, discussing end-of-life (EOL) care preferences, providing written EOL care instructions, and appointing a durable power of attorney for health care (DPAHC). ACP increased by 12% to 23% every 2 years from 2002 to 2010. Higher household income increased the odds of having a DPAHC. Education was not associated with ACP. Socioeconomic status alone appears to play a very limited role in predicting ACP. Engagement in ACP likely depends on a constellation of many social and contextual factors.
authors.affiliation: Department of Health Sciences, University of Missouri, Columbia, MO, USA khoslan@health.missouri.edu.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Khosla
authors.affiliation: School of Social Work, University of Missouri, Columbia, MO, USA.
authors.forename: Angela L
authors.initials: AL
authors.lastname: Curl
authors.affiliation: Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, USA.
authors.forename: Karla T
authors.initials: KT
authors.lastname: Washington
mesh_terms: D032722:Advance Care Planning / Q000639:trends*; D016223:Advance Directives / Q000639:trends; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D012044:Regression Analysis; D012923:Social Class; D013727:Terminal Care
keywords: advance care planning; advance directives; end-of-life care; health and retirement study; older adults; socioeconomic status