Hospice utilization among native americans residing in native American dominant counties
Since the Indian Health Care Improvement Act of 1992 called for a hospice feasibility study, few studies have examined hospice availability for Native American (NA) tribes. Using the CDC's race-mortality data and hospice program data obtained from California and Arizona, we compared hospice utilization rates in 2010 between NAs living in NA-dominant counties and non-NA counties. Counties within each state were divided into two groups (NA-dominant versus non NA) using an NA percentage of each county population (8% in Arizona and 4% in California), resulting in 7 NA-dominant counties in Arizona and 12 in California. In addition, we interviewed 25 tribal members of the Great Lakes Region, with 15 residing on reservation lands and 10 residing in metropolitan areas. In Arizona, about 7% of NA deaths occurred under hospice care in NA-dominant counties, compared to 26% in non NA counties, with overall hospice utilization rates of 36% in NA-dominant counties and 62% in non NA counties. In California, about 14% of NA deaths in NA-dominant counties occurred under hospice care, compared with 32% in non NA counties, with overall hospice utilization rates of 27% in NA-dominant counties and 49% in non NA counties. Our interviews confirmed our quantitative findings: Great Lakes tribal members residing on reservations reported that no hospice care was available to reservation residents. Furthermore, interviewees living on reservations were more likely than those living in metropolitan areas to emphasize the importance of the provision of hospice care respecting Indian culture and beliefs concerning the dying process.
Assessment of individual and community needs for health education
Assess low hospice utilization rates among Native American Indians living in Indian areas, compared to Indians living in Non-Indian areas
Describe the importance of Indian culture and beliefs concerning the dying process in the provision of hospice care to Native American Indians
Keyword(s): Indigenous Populations, End-of-Life Care
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I have been teaching topics in hospice and long-term care in one California state university and publishing peer-reviewed journal articles.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.