Cultural Beliefs May Keep Blacks From Hospice Care

Mistrust of medical system helps explain why many shun these services, survey finds

By E.J. Mundell
HealthDay Reporter

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TUESDAY, Feb. 5 (HealthDay News) -- End-of-life hospice care is used much less often by American blacks than whites, and certain cultural beliefs may explain why, a new survey finds.

An historical mistrust of the health-care system and a strong preference for curative treatment compared to palliative care encourage many black Americans to avoid or delay hospice services, the researchers found.

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"Blacks in our sample compared to whites clearly had less favorable beliefs and attitudes about hospice care," said study lead author Dr. Kimberly Johnson, a geriatrician and palliative care specialist at Duke University Medical Center.

She presented the findings over the weekend at the annual meeting of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association, in Orlando, Fla.

Over the past few decades, a growing number of terminally ill Americans have opted for hospice services, which focus on easing physical and emotional suffering in life's final stage rather than curative treatment.

And yet a clear racial gap has emerged in terms of who is using hospice care. According to Johnson, data collected in 2006 found that just 8 percent of hospice enrollees in the United States were black, even though they make up 12 percent of the population. That's compared to whites, who comprise 81 percent of hospice patients, even though they make up 74 percent of the population.

"If you consider that blacks have higher rates of death from cancer and heart disease, which are still the top causes of hospice admissions, then it seems that there is a significant gap there," said Johnson, who is also an assistant professor of medicine at Duke.

To find out why this might be so, her team surveyed 205 white and black adults aged 65 and older (average age 74) on their knowledge and opinion of hospice care.

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