The 130th Annual Meeting of APHA

Abstract #42361

Janet B. Craig, RN, DHA, Palmyra Medical Centers, 2000 Palmyra Road, P. O. Box 1908, Albany, GA 31702-1908, 229-434-2152, craigjb@surfsouth.com and Walter J. Jones, PhD, Department of Health Administration and Policy, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425.

In the U. S., a major challenge is the exploration and understanding of racial and socioeconomic differences in End-of-Life (EOL) care. This study's primary objective is to identify the differences in EOL care satisfaction as perceived by family members of African-American versus Caucasian-American decedents of different socioeconomic backgrounds in Southwest Georgia. This study pioneers in using a modified telephone survey instrument initially developed by Tolle et al. (2000) at the Oregon Health Sciences University ("Barriers to Improving Care of the Dying") to collect additional information on relationships between race, socioeconomic status and EOL attitudes. After reviewing death certificates, the researchers conducted the telephone survey of decedent family or family proxies between the second and sixth month following the decedents' deaths. Out of an initial sample of 325, a total of 100 respondents (50 African-American, 50 Caucasian-American) were interviewed. Interviews and data analyses were completed during the first five months of 2002. Preliminary findings indicate that while there are no significant differences between African and Caucasian-American respondents with respect to barriers to EOL care satisfaction, African-Americans have less advance care planning and communication of EOL care preferences prior to death, both within the family and with the physician. African-American decedents also experience more ICU days than Caucasian-Americans. Both respondent groups report significantly greater dissatisfaction with comfort care and communication with EOL care clinicians than that reported in previous research.

Learning Objectives: At the conclusion of this presentation, the participant should be able to

• Understand the health policy issues surrounding End-Of-Life (EOL) care.
• Be familiar with the major variables determining racial and socioeconomic differences in EOL preferences and actual care patterns.
• Be aware of the extent to which there are significant differences between African-Americans and Caucasian-Americans with respect to EOL care.
• List and understand the implications of the study's results for health providers, caregivers and policymakers.

Keywords: End-of-Life Care, Death

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.