Exploring the Impact of Structural Racism on End of Life Care Among Older African Americans: An Oral History Approach (GP124)

Outcomes 1. Gain a comprehensive understanding of the multifaceted ways in which structural racism profoundly influences the quality and equity of end-of-life care for older African Americans, including both systemic and individual aspects.2. Develop proficiency in the application of oral history as a valuable research method within the context of healthcare disparities, appreciating its significance in capturing the lived experiences and voices of marginalized communities in order to inform more inclusive and effective healthcare policies and practices. Key Message This abstract delves into the profound consequences of structural racism on end-of-life care for older African Americans, employing an oral history approach which preserves personal narratives and perspectives authentically. It underscores the urgent need to address disparities and foster equitable access to compassionate and dignified end-of-life support for marginalized communities. Importance Studies show older African Americans are less likely to receive appropriate pain management, palliative care, and hospice services compared to their White counterparts, leading to unnecessary suffering and decreased quality of life towards the end of life. Structural racism, defined as how mutually reinforcing systems woven into laws, policies, and institutions result in racial discrimination, limiting resources and opportunities based on race and ethnicity, is a root cause of racial inequities, particularly in end-of-life care. Objective(s) This study aims to illuminate older African Americans’ experiences facing serious illness and to critically examine structural racism's role in shaping their end-of-life care. Scientific Methods Utilized The study employed a qualitative approach, combining oral history interviews with a diverse group of older African Americans (aged >55) living with serious illness, and a comprehensive literature review. The search strategy encompassed academic databases, journals, and books, focusing on relevant studies from 2000 to 2022. Participants were selected from the hospital and community to capture a range of lived experiences. Results We have so far conducted five interviews. Our findings underscore the pervasive influence of structural racism on the end-of-life care experiences of older African Americans. Participants have shared narratives of inequities in healthcare access, unequal treatment, limited communication with healthcare providers, and barriers to making informed decisions. These inequities intersect with age, gender, socioeconomic status, and geographic location across the life course. Conclusion(s) The oral histories collected shed light on the enduring impacts of structural racism on end-of-life care for older African Americans. The findings underscore the need for policies and interventions to dismantle these inequities, promoting access to high-quality, culturally responsive, and patient-centered end-of-life care. Impact This study challenges conventional understanding, revealing structural racism's profound healthcare impact. By amplifying the voices of those most affected by these issues, this study contributes to broader dialogue on healthcare inequities and social justice.