The Center to Advance Palliative Care (CAPC), part of the Icahn School of Medicine at Mount Sinai, in New York City, recently released a 39-page health guide entitled, “Advancing Equity for Black Patients with Serious Illness.” Here’s what it covers and why it matters.
Background on palliative care
Palliative care is an interdisciplinary medical approach that focuses on improving the quality of life for people with complicated and often terminal illnesses. This short but dense guide was preceded by a 2021 CAPC comprehensive literature review to understand disparities in health care experiences and quality of life, specifically for Black people living with serious illnesses and their families.
The literature review found that Black patients living with serious illnesses receive poorer quality pain management from their healthcare providers and Black Americans frequently incur higher medical costs and provide more unpaid family caregiving than non-Black families. The recently released guide offers suggestions for overcoming acknowledged challenges and implementing health equity interventions that deliver better care for Black patients and their communities.
Recommendations for treating Black patients
“We stand at a pivotal crossroads where institutions cannot afford to retreat – this is an opportunity to push forward. It’s critical that healthcare institutions and professional organizations renew and intensify their commitments to take action and address disparities that persist in healthcare delivery,” says Brittany Chambers, MPH, MCHES, one of the guide’s three lead authors, tells BDOPro. She adds that the guide can help healthcare institutions live up to their ideals, ensuring that all individuals—regardless of their background— can access the quality care they need and deserve.
The guide advises writing a business plan to think through the details of designing responsive health equity initiatives that will reflect the needs of the patient. The social ecological model and policy tailwinds are particularly useful, but practitioners will appreciate the business planning segment that includes tips to develop partners and to collect data for monitoring and evaluation.
“We encourage the development of high-quality business plans for developing equitable palliative care services, as they help to clearly define the program’s intended goals, eligible patient population, and resource allocation to ensure success. We recommend the same for the development of health equity initiatives, because a business plan can help to ensure that program leaders are explicitly naming health equity goals and measures, considering the social determinants of health affecting underserved populations, actively engaging community members in program design, requesting sufficient resources, and continuously evaluating progress that will improve health outcomes for Black patients and families,” Chambers explains.
Case studies reflected varied and innovative lessons learned from around the country, including Hospice of the Chesapeake in Maryland, California-based interventions at the AC Care Alliance, and the faith-based Louisville Community Model of Care Project.
Patient engagement
To engage patients, caregivers, and community voices, the guide explains Community-Based Participatory Research and approaches to creating Patient and Family Advisory Councils. CAPC recognizes the impact of caregiving on the caregiver, too. Among other caregiver support services, CAPC found respite care that gives Black caregivers a temporary break from their caregiving responsibilities an effective strategy when thinking of scalability and sustainability. The guide even suggests efforts to secure funding for community-based efforts through aligned philanthropic institutions. Chambers adds that a local funder or grant would be strong options for sustainable funding as well.
This new guide is so meaningful because it commits to do more than talk about historical drivers of inequities for Black Americans. Instead, it teaches health leaders how best to design long-lasting health equity initiatives that assess and respond to the needs of Black communities.