@article {9914, title = {The association between the number of chronic health conditions and advance care planning varies by race/ethnicity.}, journal = {Aging \& Mental Health}, volume = {24}, year = {2020}, pages = {453-463}, type = {Journal}, abstract = {

OBJECTIVES: Although a national consensus exists on the need to increase the rates of advance care planning (ACP) for all adults, racial/ethnic differences in ACP have been consistently observed. This study investigated the intersection of racial/ethnic differences and the number of chronic health conditions on ACP among middle-aged and older adults in the United States.

METHOD: Responses from 8,926 adults from the 2014 wave of the Health and Retirement Study were entered into multilevel hierarchical logistic regression analyses with generalized linear mixed models to predict ACP focused on assigning a durable power of attorney for healthcare (DPOAHC) and having a written living will after adjusting for covariates.

RESULTS: We found a significant positive relationship between the number of chronic health conditions and ACP. Non-Hispanic Blacks/African Americans and Hispanics were less likely to engage in ACP than non-Hispanic Whites/Caucasians. Racial/ethnic disparities were even starker for completing a living will. The number of chronic health conditions had a greater effect for Hispanics than non-Hispanic Whites/Caucasians on ACP through assigning a DPOAHC and having a living will. The initial disparity in ACP among Hispanics with no chronic health conditions decreased as the number of chronic health conditions increased.

CONCLUSION: Our findings suggest that more chronic health conditions increase the likelihood that Hispanics will complete ACP documents. These ACP differences should be highlighted to researchers, policymakers, and healthcare professionals to reduce stark racial/ethnic disparities in ACP. A comprehensive and culturally caring decision-making approach should be considered when individuals and families engage in ACP.

}, keywords = {Advance care planning, Comorbidity, Racial/ethnic differences}, issn = {1364-6915}, doi = {10.1080/13607863.2018.1533521}, url = {https://www.tandfonline.com/doi/abs/10.1080/13607863.2018.1533521?journalCode=camh20}, author = {Shinae L Choi and Ian M McDonough and Kim, Minjung and Kim, Giyeon} } @article {10399, title = {Estate planning among older Americans: The moderating role of race and ethnicity}, journal = {FINANCIAL PLANNING REVIEW}, volume = {2}, year = {2019}, pages = {e1058}, abstract = {This study investigated whether race and ethnicity moderated the associations of bequest expectations to leave an inheritance and charitable giving with having a valid will among older Americans. Drawn from the 2014 Health and Retirement Study, we analyzed 13,261 respondents using multilevel logistic regression with generalized linear mixed models. People with higher bequest expectations and more charitable giving were more likely to have a valid will. Ethnic minorities had much lower bequest expectations and much less charitable giving than non-Hispanic Whites, controlling for socioeconomic indicators. Hispanics showed a stronger effect of bequest expectations but a weaker effect of charitable giving on having a valid will compared with non-Hispanic Whites. Our findings reveal novel racial and ethnic disparities in engagement in estate planning among older adults and suggest alternative means are needed to promote interest in estate planning in later life depending on one{\textquoteright}s racial and ethnic background.}, keywords = {bequest expectations, charitable giving, estate planning, ethnicity, race, valid will}, doi = {10.1002/cfp2.1058}, author = {Shinae L Choi and Ian M McDonough and Kim, Minjung and Kim, Giyeon} }