End-of-life pain is poorly managed across the board, but why, even with palliative care efforts, do minorities suffer disproportionately?
Tackling what he calls the first study to investigate pain experiences among Whites, Blacks and Latinos following inpatient palliative care (IPC) consults, USC Davis School of Gerontology doctoral student Jeff Laguna won the Gerontological Society of America’s Elaine M. Brody Award, given for excellence in research.
Co-authored with Rebecca Goldstein, M.D., and USC Davis School Hanson Family Trust Assistant Professor of Gerontology Susan Enguidanos, Ph.D., MPH, the study was funded by the Archstone Foundation, examining 484 seriously ill patients and how their racial/ethnic differences impacted their end-of-life pain.
“We found something very interesting. Although palliative care did a great job at reducing pain among a racially/ethnically diverse patient population, it seems that Latinos were still more likely to report pain at hospital discharge,” Laguna said. “Previous research suggests a couple possible explanations, but a more detailed study will be needed to understand why Latinos appear to respond differently.”
Some of the existing explanations include the potential for Latinos to view end-of-life pain as a time of necessary and even welcome personal and/or spiritual cleansing, highlighting Laguna’s findings that IPC interventions may need to increase cultural sensitivity. He also finds that this increased awareness will inform future policy changes, which could help revolutionize the way we think about end-of-life care.
“After decades of recognizing the existence of ethnic disparities in health care access and health outcomes, we are continuing to see these patterns today. Illuminating these disparities is a first step to understanding and overcoming them,” Enguidanos said. “Jeff’s commitment to investigating disparities and improving equitable quality of care is commendable and critical.”
“For me, this award is the culmination of a lot of hard work, as I had to travel halfway across the country to master the analyses performed in this study,” Laguna said. “It is my hope that this study opens the door for a more detailed investigation. While this is the first step of many, I believe that it is an important step.”