Racial and ethnic differences in advance care planning: identifying subgroup patterns and obstacles.

OBJECTIVE

The author investigated (a) whether Whites, Blacks, Latinos, and Asians differ in their rates of advance care planning (ACP; that is, living will, health care proxies, discussions), (b) sources of within-racial group heterogeneity, and (c) racial differences in the explanations offered for not doing ACP.

METHODS

The author estimated logistic regression models with data from a national sample of married and cohabiting adults ages 18 to 64 in the Knowledge Networks study (N = 2,111).

RESULTS

Latinos are less likely than Whites to discuss preferences and to have a living will, although the latter gap is fully accounted for by education. Asians are less likely than Whites to have discussions, but more likely to have living wills. Black-White differences emerge only among low SES (socioeconomic status) subgroups. Each group noted distinctive obstacles to planning.

DISCUSSION

Public policies should target increasing rates of ACP for all adults prior to onset of major health concerns.