The Roles of Estate Planning and Social Support in Racial/Ethnic Disparities in Advance Care Planning and End-of-Life Care

Advance Care Planning (ACP)– completing advance directives, discussing end of life care preferences, and assigning a durable power of attorney for healthcare – may be associated with improvements in quality of end of life care and more specifically with receiving care congruent with one’s wishes. Despite this, stark differences in completion rates by Non-Hispanic Blacks and Hispanics compared to Non-Hispanic Whites are observed. Much of the research on ACP has focused on describing associations between sociodemographic factors and planning completion or planning completion and health care received at the end of life (End-of-Life). However, few studies have proposed testable hypotheses and investigated causal relationships for ACP completion, particularly among Hispanic subgroups, and effects on end of life care received. This study uses nationally representative data from the Health and Retirement Study to investigate explanatory causal pathways in ACP completion and its effects on End-of-Life healthcare with a focus on Hispanics. Results from this study will help providers better understand sociodemographic factors that predispose patients to high risk for failing to plan for the end of life, health systems identify target areas for system change, and policy makers understand the role socioeconomic disparities play in end of life planning.