Planning for End-of-Life Care: Black-White Differences in the Completion of Advance Directives

The authors examined Black-White differences in the likelihood of completing written advance directives for end-of-life health care and engaging in informal verbal communication about advanced wishes. Data from the 1998 Health and Retirement Study (HRS) were combined with data from the 2000 HRS exit interview to analyze Black and White participants' completion rates. Whites were more likely than Blacks to grant durable power of attorney for health care, to complete a written will, and to informally communicate their wishes; group differences remained after controlling for personal characteristics. Also, Blacks were less likely than Whites to engage in more than one form of end-of-life planning. The authors speculate that sociocultural differences in trust in the medical system and knowledge about advance directives may partially account for these findings. The findings may aid policy makers and practitioners in increasing the level of participation in advance directives.