Integrating Palliative Care into the Chronic Illness Continuum: a Conceptual Model for Minority Populations

J Racial Ethn Health Disparities. 2019 Dec;6(6):1078-1086. doi: 10.1007/s40615-019-00610-y. Epub 2019 Jun 27.


Although the use of palliative care has increased in recent years, chronically ill Americans within a racial/ethnic minority (non-White) population underutilize this supportive and comfort-giving healthcare service. Consequently, chronically ill minority Americans experience increased pain, symptom burden, and inappropriate use of healthcare resources compared to their white counterparts. A literature review was conducted to compile and synthesize the current state of research pertinent to improving the use of palliative care among chronically ill minority Americans. Selection criteria produced 18 relevant publications, which aided in developing a conceptual model that assimilated early, episodic, and late palliative care phases along the chronic illness continuum. The goal of the conceptual model was to provide a roadmap for healthcare professionals to use when designing, implementing, managing, and/or evaluating palliative care services for chronically ill minority Americans. The literature review demonstrated that minority patients benefitted the most from culturally tailored, systematic interventions (such as advanced care planning education) in all phases of palliative care, which led to increases in advance directive completion, better symptom control, and hospice utilization. The article concludes with a discussion and fictional case study portraying the importance of culturally tailored early palliative care as a catalyst for engaging minority patients in palliative care services.

Keywords: Chronic illness; Conceptual model; Minority populations; Palliative care.

Publication types

  • Review

MeSH terms

  • Advance Care Planning
  • Advance Directives
  • Black or African American
  • Chronic Disease / therapy*
  • Continuity of Patient Care
  • Delivery of Health Care
  • Ethnicity*
  • Hispanic or Latino
  • Hospice Care
  • Humans
  • Minority Groups*
  • Palliative Care / organization & administration*