Feelings of Mistrust, Preference for Curative Treatment Influence Blacks’ Perception of Hospice Care, Study Shows
Mistrust of the health care system, as well as a strong preference for curative treatment, might in part explain why blacks are less likely than whites to use hospice care, according to a study presented last weekend, HealthDay News/Forbes reports. The study, by Kimberly Johnson, a geriatrician and palliative care specialist at Duke University Medical Center, was presented at the annual meeting of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association.
Data collected in 2006 show that 8% of those receiving hospice care were black, while 81% were white, HealthDay/Forbes reports.
For the study, Johnson and colleagues surveyed 205 white and black adults ages 65 and older about their knowledge and opinion of hospice care. According to the study, 4% of whites had never heard of hospice care, compared with more than 21% of blacks. In addition, Johnson said, "African-Americans were more likely to believe that pain and suffering is sometimes 'part of God's plan' for your life. Something like that would be inconsistent with the hospice philosophy."
Further, blacks seemed more likely than whites to ask for continued treatment, even if there was little chance that it could help them, according to the study (HealthDay News/Forbes, 2/5). Other recent research by Johnson found that blacks were 70% more likely than whites to leave hospice care to seek life-prolonging treatment unavailable in a hospice (Kaiser Health Disparities Report, 2/1).
HealthDay/Forbes reports that the "biggest factor at play" was blacks' mistrust of the health system and the sense that the health system is generally less accessible to black patients. Johnson said that the issue of trust "seemed to explain the racial disparity more than any other factor.
The study also found that 34% of blacks thought they would not be able to afford hospice care if they wanted it, compared with 20% of whites. According to Johnson, hospice services usually are covered by Medicare (HealthDay News/Forbes, 2/5).