“We Are Here to Assist All Individuals Who Need Hospice Services”: Hospices’ Perspectives on Improving Access and Inclusion for Racial/Ethnic Minorities

Background: Racial/ethnic minority populations in the United States are less likely to utilize hospice services nearing their end of life, potentially diminishing their quality of care while also increasing medical costs. Objective: Explore the minority hospice utilization gap from the hospice perspective by examining perceived barriers and facilitators as well as practices and policies. Method: Qualitative surveys were conducted with 41 hospices across the United States. Qualitative data analysis included performing a limited content analysis, including the identification of themes and representative quotations. Results: Commonly reported barriers to hospice care for racial/ethnic minorities included culture/beliefs, mistrust of the medical system, and language barriers. A major theme pertaining to successful minority hospice enrollment was an inclusive culture that provided language services, staff cultural training, and a diverse staff. Another major theme was the importance of community outreach activities that extended beyond the medical community and forming relationships with churches, racial/ethnic minority community leaders, and Native American reservations. Conclusion: The importance of incorporating a culture of inclusivity by forming committees, providing language services, and offering culturally competent care emerged in this qualitative study. Building strong external relationships with community groups such as churches is a strategy used to increase racial/ethnic minority utilization of hospice.

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Preventable Cancer Burden Associated With Poor Diet in the United States

JNCI Cancer Spectrum ◽

10.1093/jncics/pkz034 ◽

2019 ◽

Vol 3 (2) ◽

Cited By ~ 24

Author(s):

Fang Fang Zhang ◽

Frederick Cudhea ◽

Zhilei Shan ◽

Dominique S Michaud ◽

Fumiaki Imamura ◽

...

Keyword(s):

United States ◽

Ethnic Minorities ◽

The United States ◽

Dietary Factors ◽

Assessment Model ◽

Annual Number ◽

Cancer Type ◽

Middle Aged ◽

Cancer Burden ◽

Racial Ethnic

Abstract Background Diet is an important risk factor for cancer that is amenable to intervention. Estimating the cancer burden associated with diet informs evidence-based priorities for nutrition policies to reduce cancer burden in the United States. Methods Using a comparative risk assessment model that incorporated nationally representative data on dietary intake, national cancer incidence, and estimated associations of diet with cancer risk from meta-analyses of prospective cohort studies, we estimated the annual number and proportion of new cancer cases attributable to suboptimal intakes of seven dietary factors among US adults ages 20 years or older, and by population subgroups. Results An estimated 80 110 (95% uncertainty interval [UI] = 76 316 to 83 657) new cancer cases were attributable to suboptimal diet, accounting for 5.2% (95% UI = 5.0% to 5.5%) of all new cancer cases in 2015. Of these, 67 488 (95% UI = 63 583 to 70 978) and 4.4% (95% UI = 4.2% to 4.6%) were attributable to direct associations and 12 589 (95% UI = 12 156 to 13 038) and 0.82% (95% UI = 0.79% to 0.85%) to obesity-mediated associations. By cancer type, colorectal cancer had the highest number and proportion of diet-related cases (n = 52 225, 38.3%). By diet, low consumption of whole grains (n = 27 763, 1.8%) and dairy products (n = 17 692, 1.2%) and high intake of processed meats (n = 14 524, 1.0%) contributed to the highest burden. Men, middle-aged (45–64 years) and racial/ethnic minorities (non-Hispanic blacks, Hispanics, and others) had the highest proportion of diet-associated cancer burden than other age, sex, and race/ethnicity groups. Conclusions More than 80 000 new cancer cases are estimated to be associated with suboptimal diet among US adults in 2015, with middle-aged men and racial/ethnic minorities experiencing the largest proportion of diet-associated cancer burden in the United States.

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Trends in age and red blood cell donation habits among several racial/ethnic minority groups in the United States

Transfusion ◽

10.1111/trf.14108 ◽

2017 ◽

Vol 57 (7) ◽

pp. 1644-1655 ◽

Cited By ~ 10

Author(s):

Mark H. Yazer ◽

Ralph Vassallo ◽

Meghan Delaney ◽

Marc Germain ◽

Matthew S. Karafin ◽

...

Keyword(s):

United States ◽

Blood Cell ◽

Ethnic Minority ◽

Red Blood Cell ◽

Minority Groups ◽

The United States ◽

Ethnic Minority Groups ◽

Racial Ethnic

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Closing the Gap in Hospice Utilization for the Minority Medicare Population

Gerontology and Geriatric Medicine ◽

10.1177/2333721419855667 ◽

2019 ◽

Vol 5 ◽

pp. 233372141985566 ◽

Cited By ~ 5

Author(s):

M. Courtney Hughes ◽

Erin Vernon

Keyword(s):

Quality Of Life ◽

Ethnic Minority ◽

Ethnic Minorities ◽

Cost Savings ◽

Community Outreach ◽

For Profit ◽

Medicare Population ◽

Closing The Gap ◽

Racial Ethnic

Background: Medicare spends about 20% more on the last year of life for Black and Hispanic people than White people. With lower hospice utilization rates, racial/ethnic minorities receive fewer hospice-related benefits such as lesser symptoms, lower costs, and improved quality of life. For-profit hospices have higher dropout rates than nonprofit hospices, yet target racial/ethnic minority communities more through community outreach. This analysis examined the relationship between hospice utilization and for-profit hospice status and conducted an economic analysis of racial/ethnic minority utilization. Method: Cross-sectional analysis of 2014 Centers for Medicare & Medicaid Services (CMS), U.S. Census, and Hospice Analytics data. Measures included Medicare racial/ethnic minority hospice utilization, for-profit hospice status, estimated cost savings, and several demographic and socioeconomic variables. Results: The prevalence of for-profit hospices was associated with significantly increased hospice utilization among racial/ethnic minorities. With savings of about $2,105 per Medicare hospice enrollee, closing the gap between the White and racial/ethnic minority populations would result in nearly $270 million in annual cost savings. Discussion: Significant disparities in hospice use related to hospice for-profit status exist among the racial/ethnic minority Medicare population. CMS and state policymakers should consider lower racial/ethnic minority hospice utilization and foster better community outreach at all hospices to decrease patient costs and improve quality of life.

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Diversity in emergency management scholarship

Journal of Emergency Management ◽

10.5055/jem.2019.0407 ◽

2019 ◽

Vol 17 (2) ◽

pp. 148

Author(s):

DeeDee M. Bennett, PhD

Keyword(s):

Emergency Management ◽

Ethnic Minority ◽

Ethnic Minorities ◽

The United States ◽

Future Research ◽

Minority Communities ◽

Response And Recovery ◽

Negative Impacts ◽

Using Data ◽

Racial Ethnic

Women and racial/ethnic minorities have long been underrepresented in the field of emergency management. This is true for both practice and research. The lack of women and racial/ethnic minorities in the profession and their perceived absence in research or scholarly study may have impacts on the effectiveness of response and recovery efforts as well as the broader scientific knowledge within the field. Historically, women and racial/ethnic minority communities have disproportionately experienced negative impacts following disasters. Earlier related studies have pointed to the underrepresentation as a contributing factor in community vulnerability. The scarcity of women in practice and as students in this field has been particularly evident in the United States. Using data from a recent survey of emergency management programs nationwide, this article reviews the concerns in research with regards to women and ethnic minority communities during disasters, efforts to increase representation of these groups in the field, and discusses the implications for practice, policy, and future research. The findings show that women have a strong presence in emergency management programs nationwide, and while specific data on racial and ethnic minorities are lacking, the observed increases reported in this article encourages further study.

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Is Culture More Important for Racial/Ethnic Minorities than for Whites? An Experiment and Survey on the Cultural (Mis)Attribution Bias Among College Students in the United States

10.31234/osf.io/74rmp ◽

2021 ◽

Author(s):

José M. Causadias ◽

Woochan Kwon ◽

Christina Pedram ◽

Kevin Michael Korous

Keyword(s):

United States ◽

College Students ◽

Ethnic Minorities ◽

The United States ◽

Cultural Dimension ◽

Partial Support ◽

Convenience Sample ◽

Psychological Dimension ◽

Attribution Bias ◽

Racial Ethnic

•Objectives: The aim of this study is to determine the degree to which college students in the United States endorse the Cultural (Mis)Attribution Bias, the belief that culture matters more for racial/ethnic minorities than for Whites. We hypothesized that students will rate more favorably a sample of minorities for a homework assignment on culture (Hypothesis 1), more favorably a sample of Whites for an assignment on psychology (Hypothesis 2), will indicate that psychological processes are more influential in shaping the behavior of Whites (Hypothesis 3), that cultural processes are more influential in the behavior of minorities (Hypothesis 4), and will believe that other college students endorse these views (Hypothesis 5). We expected none of these effects to be moderated by participant’s race/ethnicity.•Methods: Convenience sample of college students (N = 798), 48% racial/ethnic minority, 66% female, Mage = 19.02. We conducted an experiment and survey with the same sample.•Results: We found support for Hypothesis 1, no support for Hypothesis 2, partial support for Hypothesis 3, support for Hypothesis 4, and partial support for Hypothesis 5. •Conclusions: These findings provide clear support to the “minorities are more cultural” dimension of this bias, but less support for the “Whites are more psychological” dimension. These findings have important implications, as they document that a sample of college students endorse this bias in ways that are both consistent and different to older, more educated, and less diverse faculty.

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