Does ethnicity affect where people die?

The study, published this month in PLoS ONE, was carried out by researchers at Cicely Saunders Institute, King’s College London.

Lead author, Dr Jonathan Koffman, explains their findings: “We identify for the first time that that among the 93,375 cancer deaths in London spanning a ten year period, place of death is influenced by country of birth. Dying at home or in a hospice, typically the most preferred locations of death, were less likely for black, Asian and minority ethnic groups compared to those born in the UK. Correspondingly, hospital deaths, typically the least preferred location, were more common among some ethnic groups.”

The paper points out that, while studies on end of life preferences in the UK, Europe and the rest of the world have found that most people prefer to die at home, there is little research on preferred place of death amoung BAME groups.

Koffman adds: “We believe that further investigation is needed to determine whether these differences result from patient-centred preferences, which may be culturally patterned, or other environment or service-related factors. This knowledge will enable strategies to be developed to improve access to relevant palliative care and related services, where necessary.”

The authors also discuss inequity of access to palliative care and the possible reasons for this, such as lack of awareness and knowledge of palliative care and related services, referral patterns to specialist palliative care, lack of understanding among professionals about exactly which patients to refer and when, gate-keeping by services, complex linguistic and communication barriers, preferences including for more aggressive or curative care at the end of life, or a cultural mistrust of end of life care, and strong religious and familial support systems.

Access the article on the PLoS One website: Koffman J, Ho YK, Davies J, Gao W, Higginson IJ (2014) Does Ethnicity Affect Where People with Cancer Die? A Population-Based 10 Year Study. PLoS ONE 9(4): e95052. doi:10.1371/journal.pone.0095052