Racial Differences in Associations of Perceived Health and Social and Physical Activities With Advance Care Planning, End-of-Life Concerns, and Hospice Knowledge.
Associations of perceived health and social and physical activities with end-of-life (EOL) issues have been rarely studied, not to mention racial disparities in such associations. To address this gap, this study examined racial differences in the associations of perceived health and levels of social and physical activities with advance care planning, EOL concerns, and knowledge of hospice care among community-dwelling older adults in Alabama. Data from a statewide survey of 1044 community-dwelling older adults on their long-term care needs were analyzed using descriptive statistics and logistic and linear regressions. Results showed that black older adults were less likely to know about or document advance care planning and to have accurate knowledge of hospice care; however, despite their poorer perceived health, black older adults reported fewer EOL concerns. Higher levels of perceived health and social and physical activities were associated with knowledge about advance care planning among white older adults but not among black older adults. Both black and white older adults with poorer perceived health and lower levels of social and physical activities tended to have more EOL concerns and less knowledge of hospice care. These findings suggest that interventions to address suboptimal levels of perceived health and social and physical activities among black older adults may increase knowledge of advance care planning. Also, supportive services to address EOL concerns should be targeted at older adults with poorer perceived health and limited participation in social and physical activities.
1 School of Social Work, University of Alabama, Tuscaloosa, AL, USA.
Hyunjin
H
Noh
2 Korea Institute for Health and Social Affairs, Sejong, South Korea.
Junghyun
J
Kim
3 Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.|4 Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.|5 Comprehensvie Center for Healthy Aging, University of Alabama at Birmingham, Birmingham, AL, USA.|6 Center for AIDS Research, University of Alabama at Birmingham, Birmingham, AL, USA.
Omar T
OT
Sims
7 Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.
Shaonin
S
Ji
8 Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA.
Patricia
P
Sawyer
D032722:Advance Care Planning / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama; D015444:Exercise / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006304:Health Status; D017051:Hospice Care / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D044469:Racial Groups / Q000706:statistics & numerical data*; D058992:Social Participation / Q000523:psychology; D012959:Socioeconomic Factors; D013727:Terminal Care / Q000706:statistics & numerical data*
advance care planning; end-of-life; hospice; perceived health; physical activity; racial disparities; social activity