Where There's a Will: The Link Between Estate Planning and Disparities in Advance Care Planning by White and Black Older Adults. (March 2018)

• Record Type: Journal Article
• Authors: Koss, Catheryn S.; Baker, Tamara A.
• Is Part Of: Research on aging. Volume 40:Number 3(2018)
• Page Start: 281
• Page End: 302
• Publication Date: 2018-03
• Subjects: advance care planning -- advance directives -- estate planning -- medical decision making -- race disparities; Old age -- Periodicals; Gerontology -- United States -- Periodicals; 305.2605
• DOI: 10.1177/0164027517697116
• Languages: English
• ISSNs: 0164-0275

Abstract

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.