Feelings Of Mistrust For Curative Treatment Influence Blacks' Perception Of Hospice Care

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Mistrust ofthe 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 hospicecare, according to a study presented last weekend, HealthDay News/Forbes reports. The study, by KimberlyJohnson, a geriatrician and palliative care specialist at Duke University Medical Center, was presented at the annualmeeting of the American Academy of Hospice andPalliative Medicineand 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 65and older about their knowledge and opinion of hospice care. According to thestudy, 4% of whites had never heard of hospice care, compared with more than21% of blacks. In addition, Johnson said, "African-Americans were morelikely to believe that pain and suffering is sometimes 'part of God's plan' foryour life. Something like that would be inconsistent with the hospicephilosophy."

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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 Johnsonfound that blacks were 70% more likely than whites to leave hospice care toseek life-prolonging treatment unavailable in a hospice (Kaiser HealthDisparities Report, 2/1).

HealthDay/Forbes reports that the "biggest factor atplay" was blacks' mistrust of the health system and the sense that thehealth system is generally less accessible to black patients. Johnson said thatthe issue of trust "seemed to explain the racial disparity more than anyother factor.

The study also found that 34% of blacks thought they would not be able toafford hospice care if they wanted it, compared with 20% of whites. Accordingto Johnson, hospice services usually are covered by Medicare (HealthDayNews/Forbes, 2/5).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Weekly Health Disparities Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Weekly HealthDisparities Report is published for kaisernetwork.org, a free service of TheHenry J. Kaiser Family Foundation.

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