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Emma Deary, BA

Pronouns

She/Her/Hers

Job Title

Research Assistant

Academic Rank

Department

Psychiatry

Authors

Emma C. Deary, B.A., Henry K. Onyeaka, M.D., M.P.H., Katrina Grace Sadang, B.A., Elizabeth Daskalakis, B.A., Marie C. Desir, M.D., Juliana Zambrano, M.D., M.P.H., Josie François, M.D., M.P.H., Janet L. Abrahm, M.D., Hermioni L. Amonoo M.D., M.P.P.

Principal Investigator

Hermioni L. Amonoo M.D., M.P.P.

Research Category: Psychiatry/Mental Health

Tags

US Immigrant Utilization and Perceptions of Palliative Care

Scientific Abstract

Background: US immigrants experience significant palliative care disparities. However, the factors that drive these disparities remain unclear. Hence, we examined whether perceptions of palliative care contribute to care disparities among US immigrants.

Methods: We completed a cross-sectional analysis of data from a nationally representative sample (N=3,430), the Health Information National Trends Survey 5 Cycle 2 (H5C2), conducted from January-May 2018. Using descriptive statistics, bivariate analyses, and logistic regressions, we investigated whether immigration status had a significant impact on perceptions of palliative care. Jack-knife replicate weights were applied for population-level estimates.

Results: Compared to US-born individuals, immigrants were less likely to have a regular healthcare provider, higher levels of educational attainment, and higher levels of income. After adjusting for age, gender, education, income, race/ethnicity, geographical residence, access to a regular provider, cancer history, and self-rated health, immigrants were less likely to somewhat/strongly disagree that palliative care automatically makes them think of death (aOR=0.19, p=0.040) and less likely to somewhat/strongly disagree that accepting palliative care means giving up (aOR=0.31, p=0.032).

Conclusions: Misconceptions about palliative care are prevalent among US immigrants. More research is needed to uncover the sources of these misconceptions and how they contribute to palliative care disparities among US immigrants.

Lay Abstract

US immigrants experience significant palliative care disparities. However, the factors that drive these disparities remain unclear. Hence, we examined whether perceptions of palliative care contribute to care disparities among US immigrants. We completed and analyzed data from a nationally representative sample, the Health Information National Trends Survey 5 Cycle 2 (H5C2), conducted from January-May 2018. Using survey responses, we investigated whether immigration status had a significant impact on perceptions of palliative care. Compared to US-born individuals, immigrants were less likely to have a regular healthcare provider, higher levels of educational attainment, and higher levels of income. Regardless of age, gender, education, income, race/ethnicity, geographical residence, access to a regular provider, cancer history, and self-rated health, immigrants were less likely to somewhat/strongly disagree that palliative care automatically makes them think of death and less likely to somewhat/strongly disagree that accepting palliative care means giving up. Misconceptions about palliative care are prevalent among US immigrants. More research is needed to uncover the sources of these misconceptions and how they contribute to palliative care disparities among US immigrants.

Clinical Implications

This study demonstrated the pervasive misconceptions of palliative care among the US immigrant community. Thus, more research is needed to understand how misconceptions about palliative care contribute to disparities in palliative care and EOL care utilization among US immigrants.