For a study, researchers sought to present a review of the current research on racial differences in palliative and end-of-life care quality and to highlight gaps in the investigation of the underlying processes that cause these disparities. Numerous studies conducted over several decades have indicated that the healthcare system in the United States routinely provides lower quality end-of-life care to Black patients than to white ones. Yet, effective efforts to eliminate these discrepancies are scarce and hampered by a lack of knowledge of the underlying reasons.
They looked through PubMed, CINAHL, and PsychInfo for research papers that investigated ideas concerning the causes of inequalities in end-of-life care for Black patients. These research were classified according to the areas defined by the National Institute of Minority Health and Health Disparities (NIMHD), which include biological, behavioral, physical/built environment, sociocultural, and health care systems. In addition, individual, interpersonal, communal, and societal levels of impact research were subdivided into these areas.
The vast majority of research concentrated on the Healthcare System and Sociocultural areas. Individual, interpersonal, and community influence research were evenly dispersed across the Health Care System domain, whereas the societal levels of impact received less attention. Most research in the Sociocultural area concentrated on the person’s level of impact. Those who focused on the individual degree of impact were of lower quality.
The socio-cultural milieu, physical/built environment and behavioral and biological domains remain areas of putative causation mechanisms for racial inequalities in end-of-life care that have received little attention. Social impacts such as healthcare policy and legislation are understudied in the Healthcare System area. Most studies in the sociocultural domain continue to focus on the individual level of influence, leaving out significant areas of research in interpersonal discrimination and local and societal structural discrimination. Individual-factor studies should be adequately reviewed to ensure that they are of good quality and do not stigmatise Black communities.
Reference: jpsmjournal.com/article/S0885-3924(22)00485-7/fulltext
