Factors Associated With Advance Care Planning by Race

Am J Hosp Palliat Care. 2023 Feb;40(2):164-172. doi: 10.1177/10499091221094779. Epub 2022 Apr 25.

Abstract

Objective: This study aims to quantify and interpret Black-White differences in the factors associated with advance care planning (ACP), with specific attention to self-reported presence of chronic conditions and healthcare stereotype threat (HCST) in medical settings.

Method: Black and White individuals aged 50 and older (N = 499) were recruited from community centers and assisted living facilities in southern California and on Amazon Mechanical Turk. Six sequential logistic regressions assessed the effect of age, presence of chronic conditions, income, and HCST on predicting 3 components of ACP by race.

Results: Findings suggest that the awareness of ongoing chronic conditions predicts all 3 aspects of ACP for Whites, but not for Blacks. HCST positively predicts the appointment of a durable power of attorney, but only for Black respondents.

Discussion: These findings offer a novel perspective on racial disparities in ACP that may inform health care providers and community practices.

Keywords: African Americans; advance directive; care discussions; durable power of attorney; medical mistrust; self-rated health.

MeSH terms

  • Advance Care Planning*
  • Aged
  • Black or African American*
  • Health Personnel
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Middle Aged