Ensuring Equity in Access to Palliative Care

Palliative care provides high-quality care that can provide relief from the symptoms of a serious illness, but just as there are issues to accessing cancer treatments, there are barriers to palliative care, as well as racial disparities in access, explained Nadine J. Barrett, PhD, MA, MS, FACCC, senior associate dean for community engagement and equity in research, Wake Forest University School of Medicine and Atrium Health, and current president of the Association of Cancer Care Centers (ACCC).

November is Hospice and Palliative Care Month, which aims to raise awareness about the use of hospice and palliative care to provide high-quality care for individuals coping with a life-limiting illness. There are misconceptions about what palliative care is that may limit the utilization of it, but also existing disparities mean fewer Black and Hispanic individuals access these services compared with their White counterparts.

Transcript

What do we know about disparities in palliative care, and are the barriers to accessing palliative care different or the same as the barriers to accessing cancer treatment?

So, what we do know is that African Americans, for example, are less likely to get the same quality and even access to palliative care in the same way that their White counterparts do. Those disparities certainly exist, and that's why there's many people like Dr Kimberly Johnson [of Duke University], Dr Ramona Rhodes [of UT Southwestern], and Dr Cardi B. Smith [of Mount Sinai Health System]—all colleagues of mine who are working in this space of really ensuring that there's equity in palliative care.

The cancer care treatment and access to care and palliative care should be the same in terms of everyone gets access to the best quality care available, including palliative care. But that is not the case right now. There are a number of factors that play into this, and I think it's a great opportunity for us to really engage in that conversation, so much so that ACCC is actually focusing now, under my presidential theme, focusing specifically on palliative care and seeing where can we, as ACCC, how can an organization provide the appropriate resources, tools, and support to ensure that our cancer centers are giving our patients not just the best palliative care, but ensuring that everyone gets access to the best quality care possible when it relates to managing symptoms.

No one wants to be sick. No one wants to even hear the words, "You've got cancer." But being able to know that there are resources available to help reduce those symptoms, and not everyone's getting them; that's a problem. It's a social justice issue, and it's an opportunity for us to continue to do better.

Reference

Cole AP, Nguyen D-D, Meirkhanov A, et al. Association of care at minority-serving vs non-minority-serving hospitals with use of palliative care among racial/ethnic minorities with metastatic cancer in the United States. JAMA Netw Open. 2019;2(2):e187633. doi:10.1001/jamanetworkopen.2018.7633