Addressing Disparities in Palliative Care
Kimberly Johnson, MD, MHS’05, HS’00-’02, is the Brenda E. Armstrong, MD Distinguished Professor in medicine and geriatrics. She believes health care disparities research needs to move from documenting the presence of disparities to developing and testing interventions to improve inequities. “We need to figure out the needs of our patients and families and what we can do better to promote equitable care,” she says.
Health disparities continue to be ubiquitous and highly prevalent, despite years of research. Studies show disparities in the quality of serious illness care for African Americans in pain and symptom management, communication with providers, and access to hospice and palliative care when compared to white populations.
Palliative care is a newer field of research, but there’s an increased focus on equity. This includes individuals and interpersonal interactions that might impact care and how structures, processes, and inequitable access to resources contribute to poor quality care.
Specifically, what services are available, accessible, and appropriate to meet the needs of diverse patients with serious illness? How is palliative care delivery impacted by social drivers of health that disproportionately disadvantage minoritized populations, such as neighborhood safety, quality of home health services, access to food and transportation, and other caregiving supports?
The availability of non-hospice based palliative care has grown, but these services are still less available in some areas where minoritized groups might be more likely to receive care. We must ensure that services have equitable accessibility and quality.
We need to focus on policies and outcomes most important to patients and families, such as feeling heard and understood or receiving care that reflects values and preferences, or strategies that reduce the financial toxicity.
I am excited about the future of palliative care research. A growing number of investigators at Duke and beyond have either a primary focus on health disparities research or are thinking about how their research findings might apply to equitable health care delivery for different populations – particularly those who disproportionately experience poor health outcomes throughout the continuum of care.
What Comes Next:
- Neuroscience: Using New Technologies to Understand the Brain
- Medical Education: Training Students to be Change Agents
- Vaccines: Fine-tuning Immune Response
- Geriatric Medicine: Caring for the Aging Brain
- Cancer Research and Care: Personalized and More Effective Therapies
- Epidemiology and Population Health: Reaching Beyond Our Walls
- Integrative Immunobiology: Unraveling the Mysteries of the Human Immune System
- Genomics and Precision Health: Using Genetic Tools to Prevent Disease
Story originally published in DukeMed Alumni News, Fall 2024.
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