Barriers to end-of-life care for African Americans from the providers' perspective: opportunity for intervention development

Am J Hosp Palliat Care. 2015 Mar;32(2):137-43. doi: 10.1177/1049909113507127. Epub 2013 Oct 4.


Research has shown that African Americans (AAs) are less likely to complete advance directives and enroll in hospice. We examined barriers to use of these end-of-life (EOL) care options by conducting semi-structured interviews with hospice and palliative medicine providers and leaders of a national health care organization. Barriers identified included: lack of knowledge about prognosis, desires for aggressive treatment, family members resistance to accepting hospice, and lack of insurance. Providers believed that acceptance of EOL care options among AAs could be improved by increasing cultural sensitivity though education and training initiatives, and increasing staff diversity. Respondents did not have programs currently in place to increase awareness of EOL care options for underrepresented minorities, but felt that there was a need to develop these types of programs. These data can be used in future research endeavors to create interventions designed to increase awareness of EOL care options for AAs and other underrepresented minorities.

Keywords: African Americans; barriers; disparities; hospice and palliative care; interventions; underutilization.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Attitude to Health
  • Black or African American*
  • Family
  • Female
  • Health Knowledge, Attitudes, Practice
  • Hospice Care / psychology
  • Humans
  • Insurance Coverage
  • Interviews as Topic
  • Male
  • Patient Acceptance of Health Care / ethnology*
  • Patient Acceptance of Health Care / psychology
  • Religion and Medicine
  • Terminal Care*
  • Trust