Methods for Overcoming Barriers in Palliative Care for Ethnic/Racial Minorities: A Systematic Review

Donna P. Mayeda
Katherine T. Ward
Peer-Reviewed Article
July 2019


Tailoring palliative care interventions for people who are members of ethnic and racial minority groups may support increased access to palliative care and end-of-life services.


People who are members of ethnic and racial groups have historically had lower rates of palliative care utilization and reduced access to these services. Ensuring access to and awareness of palliative care services can help providers meet patients' complex needs as they manage their serious illness. This systematic review looks at studies of interventions tailored for ethnic and racial minority groups and determines if they improve receptivity and use of palliative care.


Nine studies were included in this systematic review, with priority populations including African Americans, Hispanic or Latinos, and Asian or Pacific Islanders. All nine studies had components of home- and community-based palliative care interventions, and all showed increased receptivity and use of palliative care services when a tailored intervention was implemented. While the overall quality of evidence was moderate to low, one study that evaluated a patient navigation intervention for Latinos facing advanced medical illness was found to be high quality and showed significant increases of palliative care participation.

This review also identified three main barriers that people in racial and ethnic minority groups face when it comes to accessing traditional palliative care models: low health literacy, poor access to health care resources, and lack of effective communication caused by language and cultural differences. 


Organizations seeking to increase health equity for patients with serious illness by improving access to palliative care services can implement culturally-tailored interventions to overcome barriers presented by traditional care. Interventions that target the three main barriers identified in the systematic review have the strongest evidence of being effective.

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