In honor of this Black History Month, it is important to discuss the history of serious illness/end of life care such as palliative and hospice care, and the opportunities to improve care for those who have experienced mistreatment and distrust towards receiving care. Although the use of these services for people have been increasing as the education and training have been expanding since established back in the 1960’s; only 9% of the African American community are recipients to this care. The mistreatment and distrust towards medical care stems from historical racism and discrimination, including specific situations such as the Tuskegee syphilis experiment that was conducted between 1932 and 1972 and slavery. There are also the factors of the cultural and spiritual aspects; studies have shown that African Americans value the care from a loved one rather than a medical team, as well as their spirituality guiding them to prefer to pray rather than accepting serious illness/end-of-life options.
An article by the Center for Health Journalism explains, “Established racial disparities and discrimination have long been part of America’s health care system from birth to death. Infant mortality rates are twice as high for African Americans compared to whites. White Americans live 3.5 years longer than African Americans. Research further indicates that U.S. racial and ethnic minorities are less likely to receive even routine medical procedures and experience a lower quality of health services. Even at the end of life, racial disparities persist. Significantly fewer African Americans, Asians, and Latinos enrolled in hospice compared to whites.”
A clinical journal by Sheronda Drisdom explains that changing the perception and knowledge about care for African Americans should be by providing culturally competent care, using severity of illness to begin conversation, inquire about current perception of care, and emphasize what care can do for them in a culturally relevant way. An article discussing Drisdom’s clinical journal explains the sense of community in African American culture, outreach and engagement can help to inform African American’s about the care they would benefit from receiving. The article discussed that Drisdom would emphasize hospice’s focus on family and spiritual considerations. Drisdom highlighted the inclusion of a chaplain on the multidisciplinary team, she recommended building relationships with African American community leaders, and placing information about care in accessible locations. It is apparent that healthcare providers need to develop and practice strategies to communicate and educate those in search of care in a culturally sensitive manner.
Helpful Links and Resources:
https://cjon.ons.org/cjon/17/4/barriers-using-palliative-care
