Racial classifications of human populations are politically and socially determined. There is no biological or genetic basis for these racial classifications.
Health behaviors may be influenced by culture and poverty. Disparities in health outcomes, sometimes resulting in higher mortality rates for African Americans appear to influence end of life decision-making attitudes and behaviors. To improve the quality of end-of-life care in African American communities, health care professionals must better understand and work to eliminate disparities in health care, increase their own skills, knowledge and confidence in palliative and hospice care, and improve awareness of the benefits and values of hospice and palliative care in their patients and families.
- Disparities in health between blacks and whites are manifested in all major disease categories and occur in all clinical settings -- hospitals, outpatient clinics, emergency departments, operating rooms, and nursing homes.
- Race is a socially and politically determined designation that often serves as a surrogate designation for more direct and authentic causes of health disparities such as poverty, low socioeconomic status, social injustice, and cultural factors.
- If differences in age-adjusted mortality between African Americans and whites were eliminated between 1990 and 2000, then approximately 890,000 African lives would have been saved.
- Conditions of clinical uncertainty are accentuated by time pressures which promote stereotyping, making African American patients and their doctors facing the complexity of end-of-life decisions even more vulnerable than in other settings.
- Fewer than 10% of patients utilizing hospice in 2004 were African American, even though they make up more than 13% of the U.S. population, suffering a disproportionately higher mortality than whites.
- The effects of racism and poverty and the associated marginalization compromise the attainment of quality caring in these domains of end-of-life care.