Health
Racial Disparities in End-of-life Care; Many Are Unaware of Hospice Care (Part 2)
For those nearing death, hospice care can help alleviate the pain, discomfort, and suffering that often accompanies the dying process. But for many African-Americans, “hospice” is misunderstood and is equated with “hastening death” or “giving up.”
Many are either unaware of hospice care or lack a clear understanding of what hospice is. Keeping hope alive is a strong part of African-American culture and surviving difficult times. Even though there’s little chance of full recovery, African Americans are more likely than whites to choose life-sustaining measures.
Far fewer African Americans utilize hospice compared to whites. Among Medicare beneficiaries who died in 2010, 45.8 percent of whites used hospice compared to 34 percent of African Americans.
Survival at all costs is part of African-American culture that can be traced back to the days of slavery. The country’s long history of racism and poverty included unequal access to medical care. To this day, some suspect that the health care system is limiting their treatment options.
Rev. Cynthia Carter Perrilliat, a minister at the Allen Temple Baptist Church in East Oakland, often encounters this fear among her congregants, who she says ask: “Why should I trust that you’re going to do the right thing for me?”
“Statistics will tell you that in communities of color, particularly African-American communities, they always say ‘give me everything,’” says Perrilliat. “You know, all the treatment that there is, because typically we don’t get the treatment we need.”
Racial disparities and discrimination have long been part of America’s health care system from birth to death. Infant mortality rates are twice as high for African-Americans compared to whites. White Americans live 3.5 years longer than African-Americans.
Research further indicates that ethnic minorities are less likely to receive even routine …medical procedures and experience a lower quality of health services. At the end of life, racial disparities persist. Significantly fewer African-Americans, Asians, and Latinos enrolled in hospice compared to whites.
Rev. Perrilliat had her own positive experience with hospice many years ago when her father died of cancer. She realized that churches needed to become more active in end-of-life care. Seventy percent of African Americans are religious and churches are highly respected institutions.
“The faith community is one of the last bastions of resource out there where there is still some level of trust,” said Perrilliat.
In 2014, Perrilliat partnered with five churches, and started the Alameda County Care Alliance, a faith-based, non-profit providing critical support for predominantly African-American adults with advanced illness and their caregivers. It’s considered the nation’s first community-faith-health partnership of its kind. Ministers and faith leaders are trained to help their congregants prepare for the end of life and provide spiritual guidance and support related to their advanced illness.
At the heart of the ACCA’s program is its navigation system. Community care navigators are trained to provide support and connect participants with needed resources such as transportation, meals, medical services, and hospice care.
“You have to have a heart for people, a desire to help,” said Alexis Owens, one of the ACCA’s navigators, “We want to make sure they know we’re actively listening. We want them to trust us.”
In the last four years, the ACCA’s hub churches have grown from five to 14. Its medical partners include Kaiser Permanente, U.C. Davis School of Nursing, and the Public Health Institute. “We’re well over 2,500, close to 3,000 plus folks now in our third year,” said Perrilliat, “So there’s no lack of need, I promise you.” The ACCA hopes to reach beyond the African-American community and expand throughout the Bay Area. Major cities such as San Francisco, Los Angeles, Chicago, and New York have expressed interest in replicating the ACCA’s navigator system.
If the model spreads nationwide, it could go a long way in reducing racial disparities in end of life care. This story is part of a series examining racial disparities in accessing hospice and comfort care at the end of life. JoAnn Mar’s report was produced as a project for the USC Annenberg Center for Health Journalism’s 2018 California Fellowship.
Activism
OP-ED: Like Physicians, U.S. Health Institutions Must ‘First, Do No Harm’
Coupled with their lack of government and healthcare-related experience, we are concerned these nominees will significantly undermine public health, increase the number of uninsured people, worsen health outcomes, and exacerbate health disparities. Physicians observe Hippocrates’ maxim to “First Do No Harm,”, and we urge Trump administration officials to do the same. It is critical that the leadership of HHS and its agencies make decisions based on facts, evidence, and science. Misinformation and disinformation must not guide policymaking decisions and undermine evidence-based public health strategies. Spreading these falsehoods also erodes trust in our public institutions.
By Albert L. Brooks MD
Special to The Post
Presidential administrations significantly impact the health and wellbeing of our patients and communities.
Through the Department of Health and Human Services (HHS) and the agencies within it, such as the Centers for Medicare & Medicaid Services and the National Institutes of Health, this new administration will decide how financial resources are allocated, dictate the focus of federal research, and determine how our public health care insurance systems are managed, including the Affordable Care Act (ACA), the Children’s Health Insurance Program, the Vaccines for Children program, Medicare, and Medicaid.
The decisions made over the next four years will impact all Americans but will be felt more acutely by those most underserved and vulnerable.
As physicians, we are greatly concerned by the nominations announced by President Trump to critical healthcare related positions. Many of their previous statements and positions are rooted in misinformation.
Coupled with their lack of government and healthcare-related experience, we are concerned these nominees will significantly undermine public health, increase the number of uninsured people, worsen health outcomes, and exacerbate health disparities. Physicians observe Hippocrates’ maxim to “First Do No Harm,”, and we urge Trump administration officials to do the same.
It is critical that the leadership of HHS and its agencies make decisions based on facts, evidence, and science. Misinformation and disinformation must not guide policymaking decisions and undermine evidence-based public health strategies. Spreading these falsehoods also erodes trust in our public institutions.
Vaccines, in particular, have been a target of disinformation by some HHS nominees. In fact, research continues to confirm that vaccines are safe and effective. Vaccines go through multiple rounds of clinical trials prior to being approved by the Food and Drug Administration (FDA) for administration to the public.
Vaccines protect against life-threateningdiseasessuch as measles, polio, tetanus, and meningococcal disease and, when used effectively, have beenshowntoeliminateorsubstantiallyreducediseaseprevalenceand/orseverity.
Because of vaccine mis- and disinformation, there has been a resurgence in vaccine-preventable diseases such as measles and whooping cough, endangering those who are too young or unable to be vaccinated.
Several nominees have spread disinformation alleging that fluoride in public drinking water is harmful. In fact, fluoride in drinking water at the recommended level of 0.7 parts per million, like we have in our EBMUD water, is safe and keeps teeth strong. Because of public health interventions dating back to the 1960s that have resulted in 72.3% of the U.S. population now having access to fluoridated water, there has been a reduction in cavities by about 25% in both children and adults.
We also encourage the next administration to invest in our public health infrastructure. The COVID-19 pandemic highlighted the critical role of public health agencies in preventing and responding to health crises in our communities.
Health departments at the state and local levels rely on federal funding support and technical assistance to develop public health response plans, implement public health strategies, and work with on the ground organizations to serve hard to reach communities. Public health agencies are critical for protecting everyone in our communities, regardless of income-level, insurance status, or housing status.
Health officials should also work to protect the significant improvements in insurance coverage that have occurred since the passage of theACAin 2010.According to HHS, the numberofuninsuredAmericansfellfrom48millionin2010to25.6millionin2023.
California has led the way by investing in Medi-Cal and expanding eligibility for enrollment. In fact, it reached its lowest uninsured rate ever in 2022 at 6.2%. Voters affirmed this commitment to expanding and protecting access to care in November by passing Proposition 35, which significantly expanded funding for California’s Medi-Cal program. The administration should advance policies that strengthen the ACA, Medicaid, and Medicare and improve access to affordable health care.
Regardless of the president in power, physicians will always put the best interests of our patients and communities at the forefront. We will continue to be a resource to our patients, providing evidence-based and scientifically proven information and striving to better their lives and our community’s health. We urge the new Trump administration to do the same.
Albert L. Brooks MD is the immediate past president of the Alameda-Contra Costa Medical Association, which represents 6,000 East Bay physicians.
Activism
Oakland Poll: Tell Us What You Think About the Cost of Groceries in Oakland
Food banks and grocery giveaways are a large part of the resources nonprofits in Oakland prioritize, particularly in areas like East and West Oakland where low-income families of color tend to reside. These neighborhoods are often labeled as “food deserts” or communities that have limited access to affordable and nutritious foods.
By Magaly Muñoz
In 2023, the average spending on groceries increased by nearly $30 each month from the year before;people are spending over $500 a month to put food on the table.
Through previous reporting by the Post, we’ve learned that families in Oakland are depending more and more on free or low cost groceries from food banks because they can no longer afford the rising costs of food at the store.
Food banks and grocery giveaways are a large part of the resources nonprofits in Oakland prioritize, particularly in areas like East and West Oakland where low-income families of color tend to reside. These neighborhoods are often labeled as “food deserts” or communities that have limited access to affordable and nutritious foods.
We’ve recently spoken to families across these two areas of Oakland and have heard several stories that all point to one problem: food is expensive. Some individuals are spending upwards of $150 a week for themselves or double if they have teens or small children in the family.
We’ve also heard stories of people with chronic illnesses like diabetes and high blood pressure struggling to maintain their diets because they’re having a hard time affording the food that helps them stay healthy.
Do these experiences sound similar to what you or your family are dealing with every month? Are you struggling to afford your basic groceries every week? Do you depend on food banks to help you get by? Are there any chronic illnesses in your household that need to be managed by a special diet?
We want to hear about your experiences and ideas for solutions!
The Oakland Post is investigating food access in Oakland and how residents are surviving as the cost of living continues to increase. Your experiences will help shape our reporting and show local leaders the need to invest in our communities.
In order to get as much feedback as possible, we ask that you click this link to fill out a brief questionnaire or visit tinyurl.com/Oakland-Post-food-survey. You can also scan the QR code above to reach the survey. After you fill it out, please consider sharing the link with your friends and family in Oakland.
If you have questions, please reach out to our Oakland reporter Magaly Muñoz at mmunoz@postnewsgroup or text/call her at (510) 905-5286.
California Black Media
Gov. Newsom Announces Historic Boost to Paid Family Leave Benefits
This new policy will allow eligible workers earning less than $63,000 annually to receive up to 90% of their regular wages while on leave. Workers earning above this threshold will receive 70% of their wages, marking a substantial enhancement in support for workers needing time off to care for a sick family member, recover from an illness, or bond with a new child.
By Bo Tefu, California Black Media
Gov. Gavin Newsom announced a significant increase in California’s paid family leave and disability benefits, effective Jan. 1, 2025.
“Expanded paid family leave benefits are about making it easier for Californians to care for themselves, bond with a new child, and care for their families without worrying about how they’ll pay the bills,” said Newsom about the historic change.
This new policy will allow eligible workers earning less than $63,000 annually to receive up to 90% of their regular wages while on leave. Workers earning above this threshold will receive 70% of their wages, marking a substantial enhancement in support for workers needing time off to care for a sick family member, recover from an illness, or bond with a new child.
The increase, enacted under Senate Bill (SB) 951, aims to make it more affordable for California workers to take time off for critical life events such as pregnancy, childbirth, recovery from illness, or caring for a loved one, including during military deployment. First Partner Jennifer Siebel Newsom emphasized that the policy reflects the state’s commitment to supporting working mothers, parents, and caregivers.
Sen. Maria Elena Durazo (D-Los Angeles), SB 951’s author, celebrated the law’s passage, highlighting its importance for middle and low-income workers who will now receive up to 90% of their wages while on leave. The Employment Development Department (EDD) also lauded the policy, noting its role in strengthening California’s workforce and improving the lives of millions of workers.
The new benefits apply to claims filed on or after Jan. 1, 2025, while claims filed in 2024 will continue at the 2024 rates of 60% to 70%.
-
Activism4 weeks ago
Oakland Post: Week of January 15 – 21, 2025
-
Activism2 weeks ago
Oakland Post: Week of January 22 – 28, 2025
-
Activism2 weeks ago
Oakland Poll: Tell Us What You Think About the Cost of Groceries in Oakland
-
#NNPA BlackPress2 weeks ago
PRESS ROOM: Top Climate Organizations React to Trump’s Executive Orders Attacking Health, Environment, Climate and Clean Energy Jobs
-
#NNPA BlackPress3 weeks ago
Nancy Leftenant-Colon, Trailblazing Army Nurse and Air Force Veteran, Dies at 104
-
#NNPA BlackPress3 weeks ago
Trump’s First Week Back in Office Marked by Racist Actions, Rollback of Worker Protections
-
#NNPA BlackPress3 weeks ago
Trump’s Broken Promises Pile Up as Day-One Pledges Falter
-
#NNPA BlackPress2 weeks ago
BLACK HISTORY MONTH 2025 We Proclaim It