The COVID-19 pandemic has exposed more families to hospice care and expanded acceptance among those who want to keep their loved ones at home during their final days. But the service is still used more frequently by white Medicare patients than Black patients.
Roughly 41% of Black Medicare beneficiaries who died in 2019 were enrolled in hospice care, compared to 54% of white patients.
David Turner is the executive director of St. Croix Hospice. He's been in the industry for more than a decade, and in that time, he says he's seen some improvement in the number of people of color seeking hospice care. But he says there are some historical and generational reasons why Black Americans may be hesitant to use hospice.
"Just like anything else, when friends and family and church members and people that you socialize (with) are utilizing a service, the more that they use it and talk about it," Turner said.
Turner is part of a small number of people of color in senior management or ownership in the hospice industry. That's something he's working to change, too.
"Part of what I am trying to do is to be the model of that to show people that, hey, this too is a potential career for senior leadership or for people who are interested in expanding into that as an entrepreneur," he said.
Turner has started Black-focused hospice agencies in Detroit and Nashville, and he is looking to expand to Kentucky next.
"I've always said that in hospice, the messenger is as important as the message," Turner said. "If you have a diverse team, and when you're sitting down with that individual or that individual's guardian or family, you understand the cultural ramifications and the spiritual ramifications."
Turner says he sees a lot of referrals for hospice care that doesn't come from doctors. They instead come after the family has received a diagnosis and has gone to see the pastor.
In Nashville, Turner has a pastor of a Black church as part of the hospice leadership team. Partnering with Black pastors is one thing the hospice industry's national trade group recommends to reach more Black patients.
It released a diversity and inclusion guide this year that also recommends the hiring of more Black nurses.