Where There’s a Will: The Link Between Estate Planning and Disparities in Advance Care Planning by White and Black Older Adults

Data from the Health and Retirement Study (n = 6,946) were used to test whether differences in estate planning accounted for disparities in advance care planning between White and Black older adults. White participants were more likely to have advance directives after controlling for demographic, he...

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Bibliographic Details
Published in:Research on aging 2018-03, Vol.40 (3), p.281-302
Main Authors: Koss, Catheryn S., Baker, Tamara A.
Format: Article
Language:English
Subjects:
Advance Care Planning - statistics & numerical data
Advance directives
African Americans - statistics & numerical data
Aged
Black people
Black white differences
Care plans
Economic Status
End of life decisions
Estate planning
European Continental Ancestry Group - statistics & numerical data
Female
Health planning
Health services
Healthcare Disparities
Home ownership
Humans
Income
Longitudinal Studies
Male
Medical decision making
Older people
Ownership
Predictions
Race
Racial differences
Retirement
Sociodemographics
Surveys and Questionnaires
Trusts
Wealth
Wills
Wills - ethnology
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Summary:Data from the Health and Retirement Study (n = 6,946) were used to test whether differences in estate planning accounted for disparities in advance care planning between White and Black older adults. White participants were more likely to have advance directives after controlling for demographic, health, and financial variables. When estate planning was also controlled, the odds of having an advance directive were equal for White and Black participants. In contrast, Whites remained more likely to discuss end-of-life preferences after controlling for demographic, health, financial, and estate planning variables. White participants were almost four times as likely to have wills or trusts. Wealth, income, and home ownership were predictive of estate planning. Financial disparities contributed to lower rates of estate planning which in turn explained in large part why Black older adults were less likely to have advance directives but did not account for race disparities in advance care discussion.
ISSN:0164-0275
1552-7573
DOI:10.1177/0164027517697116