Black and White older adults’ end-of-life experiences: does hospice use mitigate racial disparities?

Deborah Carr and Lucie Kalousová

The Journals of Gerontology: Series B, 2025, vol. 80, issue 10, gbaf137.

Abstract: ObjectivesRacial disparities in end-of-life care are well documented, but less is known about how these inequalities shape assessments of death quality. This study examines Black–White differences in two core dimensions of proxy-reported end-of-life experience: perceived death quality and perceived care concordance. We also assess whether hospice care moderates racial differences in death quality outcomes.MethodsData are from the Health and Retirement Study Core and Exit Interviews conducted between January 2018 and September 2023. Our analytic sample included 2,498 decedents (450 Black, 2,048 White). Multivariable ordinary least squares and logistic regression models are used to estite the associations between race, hospice use, and our two end-of-life experience outcomes.ResultsProxies for Black decedents reported higher perceived death quality than those for White decedents, despite evidence of greater structural disadvantage. However, perceived care concordance was significantly lower among Black decedents. Hospice care was associated with improved perceived death quality for Black decedents but not for Whites. When accounting for socioeconomic and death experience controls, hospice care did not moderate perceived care concordance.DiscussionOur findings highlight the importance of considering expectations, context, and reference group comparisons when interpreting subjective end-of-life measures. Expanding equitable access to high-quality hospice care y help reduce persistent racial disparities, but interventions must also address how care is experienced, evaluated, and aligned with individual preferences.

Keywords: Death quality; Racial disparities; Hospice care; Proxy-reported outcomes (search for similar items in EconPapers)
Date: 2025
References: Add references at CitEc
Citations:

Downloads: (external link)
http://hdl.handle.net/10.1093/geronb/gbaf137 (application/pdf)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:oup:geronb:v:80:y:2025:i:10:p:gbaf137.

Ordering information: This journal article can be ordered from
https://academic.oup.com/journals

Access Statistics for this article

The Journals of Gerontology: Series B is currently edited by Psychological Sciences - S. Duke Han, PhD and Social Sciences - Jessica A Kelley, PhD, FGSA

More articles in The Journals of Gerontology: Series B from The Gerontological Society of America Oxford University Press, Great Clarendon Street, Oxford OX2 6DP, UK.
Bibliographic data for series maintained by Oxford University Press ().