Sunday, April 28, 2013

End-of-Life Racial Disparities in Nursing Homes: Hospice, Hospitalization, Advance Directives (Research, Video 3:00)

Healthcare disparities refer to inequalities that exist in the quality of healthcare among groups such as racial and ethnic populations. Causes for the inequalities may be access to good health care, community obstacles, and personal behaviors.  In America, racial-ethnic disparities have continued to persist, even when income, health insurance, and access to care are the same among various racial-ethnic groups. This post focuses on research on end-of-life racial disparities in nursing home residents who are deceased.

Nursing homes certified for Medicare or Medicaid reimbursement were included in this study. Assessed were advance directive measures, hospice use, and hospitalization with these results:

1)   Across different types of advance directives, black, Hispanic, and Asian nursing home residents were significantly less likely to have these documented in their files.
2)   Compared with white residents, Asian residents were also significantly less likely to receive hospice services during their last year of life, whereas Hispanic residents were more likely to receive services.
3)   Finally, all racial-ethnic groups were more likely to experience hospitalization within 90 days before death, regardless of whether they had documentation of a do-not-hospitalize order.

These results indicate a great need for more education of healthcare workers and community members as well as more monitoring and accountability to eliminate disparities.

You can read more about cradle-to-grave African American healthcare disparities here:

An explanation of racial inequalities in healthcare is featured in this video:

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at booksellers such as Amazon and Barnes and Noble.


  1. I'm fairly certain they conducted some of these studies in some of the independent apartments in Westminster CO, I remember seeing some sort of out of place folks there. They ought to do this kind of thing every year, keep on the pressure to make sure documents are always maintained.

  2. It is sad and disappointing that racial and ethnic disparities still exist, and it should never be tolerated. Every patient deserves the highest quality of care, no matter what the color of their skin is. Healthcare workers need to be properly education and need to be monitored and held accountable for their actions, to prevent future racism and abuse.

  3. Hi, Thanks for the very nice post about health care disparities. Really useful post for everyone who needs home care.

  4. AnonymousMay 22, 2013

    There has been a lot of research and articles lately about the aging minority population and how racism is still a problem unfortunately. When looking for a nursing home for your loved one, make sure you know what you're getting into.