|Title||Racial and Ethnic Differences in Informal and Formal Advance Care Planning Among U.S. Older Adults.|
|Publication Type||Journal Article|
|Year of Publication||Forthcoming|
|Authors||Lenko, R, Voepel-Lewis, T, Robinson-Lane, SG, Silveira, MJ, Hoffman, GJ|
|Journal||Journal of Aging and Health|
|Keywords||Advance care planning, Advance directives, end of life, Healthcare Disparities, race and ethnicity|
OBJECTIVE: To examine advance care planning (ACP) trends among an increasingly diverse aging population, we compared informal and formal ACP use by race/ethnicity among U.S. older adults (≤65 years).
METHODS: We used Health and Retirement Study data (2012-2018) to assess relationships between race/ethnicity and ACP type (i.e., no ACP, informal ACP only, formal ACP only, or both ACP types). We reported adjusted risk ratios with 95% confidence intervals.
RESULTS: Non-Hispanic Black and Hispanic respondents were 1.77 (1.60, 1.96) and 1.76 (1.55, 1.99) times as likely, respectively, to report no ACP compared to non-Hispanic White respondents. Non-Hispanic Black and Hispanic respondents were 0.74 (0.71, 0.78) and 0.74 (0.69, 0.80) times as likely, respectively, to report using both ACP types as non-Hispanic White respondents.
DISCUSSION: Racial/ethnic differences in ACP persist after controlling for a variety of barriers to and facilitators of ACP which may contribute to disparities in end-of-life care.