Correcting Health Disparities at End-of-Life in Persons of Color

Forty years after the creation of the Medicare hospice benefit, low use of hospice and palliative care services in persons of color increases suffering and aggressive care at the end of life related to social determinants of death. A lack of culturally appropriate programs, diversity in hospice personnel, and education for health care personnel, and marginalized populations remain problematic. This article provides tools for nurse practitioners and other health care personnel in spiritual, cultural, and goals-of-care assessments, quality improvement, and an explanation of the benefits of faith-based programs and partnerships •Descriptions are provided on social determinants of death and importance of accessibility of end-of-life care to persons of color to address disparities.•Tools such as the Plan-Do-Study-Act cycle in community health quality improvement, FICA (Faith, Belief, Meaning, Importance or Influence, Community, and Address/Action) model in spiritual assessments, and faith-based initiatives such as the Community Health Evangelism model are presented to assist with cultural humility and quality improvement.•Examples of cultural humility and transformational leadership are explained in the context of end-of-life care.•Considerations in cultural preferences in advance care planning and Medical Orders for Life-Sustaining Treatment (MOLST) forms are described.