Hospices Seek Stronger Ties with Underserved Asian Communities

Racial and socioeconomic disparities in hospice and palliative care have been persistent problems in the field for decades, including among communities of Asian origin.

To help providers close some of those gaps, the National Hospice and Palliative Care Organization (NHPCO) has released a new Chinese American Resource Guide. 

The Asian population in the United States is the fastest growing relative to other demographics, having risen 29.3% between 2010 and 2019. For comparison, the African American and Hispanic populations grew 11.6% and 20%, respectively. 

Yet Asians, African Americans and Hispanics represented only 20% of Medicare hospice patients in 2018, while the remaining 80% were Caucasian, according to NHPCO.

“To improve access to hospice and palliative care, providers must connect with different populations in their communities, build relationships, and deepen understanding about the care they provide,” NHPCO President and CEO Edo Banach said in a statement. “The data show that the number of people choosing hospice care has grown for twenty years. Yet, the uptake amongst white Medicare beneficiaries remains higher than among their Asian, Black, Hispanic, or Native Americans peers.”

NHPCO’s Diversity Advisory Council collaborated with the Chinese American Coalition for Compassionate Care (CACCC) to develop the guide. NHPCO has released similar resources in the past for other underserved communities. 

The guide includes discussions of Chinese-American cultural beliefs, resources for community engagement, outreach strategies, and an English-to-Chinese glossary of hospice and palliative care.

Hospice care is unfamiliar to high proportion of Chinese Americans, according to NHPCO and CACCC.

“NHPCO’s Chinese American Resource Guide examines the importance of partnerships to advance best practices in community engagement, Advance Care Planning, training and utilizing volunteers, and developing culture-specific end-of-life resources,” Sandy Chen Stokes, founder of CACCC and member of NHPCO’s Diversity Advisory Council, said in a statement. “The guide benefits from knowledge gained through collaborations with local, state, and national end-of-life experts who understand the importance of cultural and ethnic considerations in end-of-life decision-making.”

A rising number of hospices during the past two years have been devoting more effort and resources to diversity, equity and inclusion — more than 70% among home-based care providers who responded to a 2021 Axxess survey.

Companies that develop socially-conscious practices for racial and ethnic diversity were 35% more likely to have financial returns above their respective national industry medians, according to a 2015 McKinsey & Company report. Meanwhile, those that focused on gender diversity were 15% more likely to have higher financial returns, the report indicated.

“To get to equitable access, providers need to focus on making connections with these communities,” Banach said. “The Chinese American Resource Guide is one tool in a suite of resources developed by our Diversity Advisory Council for this purpose. This effort is so important that we make these resources available to both NHPCO members and non-members on our website.”