Black people face enduring racial inequities in end-of-life care, including poorer clinician communication, inadequate pain management, and limited access to palliative care. Despite ample research highlighting these inequities, effective tools to address them remain limited. To bridge this gap, our project aims to confront one of the root causes of racial inequities in end-of-life care: structural racism. Structural racism is defined as the totality of ways in which societies foster discrimination through mutually reinforcing institutions, laws, and systems that limit opportunities and resources based on race and ethnicity.

Our approach centers on using community-based participatory research (CBPR) methods to foster close collaboration with affected communities in the San Francisco Bay Area and Birmingham, Alabama. Working with Black community members as equal partners, we seek to understand the impact of structural racism on the quality of end-of-life care. Leveraging this understanding, we will develop an intervention to mitigate structural racism at our institution and examine its effects on patients and caregivers. We hope to eventually pilot test and tailor this structural intervention to other institutions in order to make a lasting advancing on racial equity in end-of-life care across the country.