In the United States, racial and ethnic minorities and people with lower socioeconomic status (SES) face structural, health system, and interpersonal barriers to optimal health care, including palliative care. Much of the available data on palliative care in racial and ethnic minorities and people with lower SES have identified disparities according to race, ethnicity, and SES. Limitations to understanding disparities in palliative care include the fact that much of the available data are cross-sectional, drawn from administrative or claims data, or based on qualitative work in limited geographic areas. To advance our knowledge and achieve health equity with respect to palliative care in patient groups that have been understudied or that are known to receive disparate care, gaining a deeper understanding of the barriers to palliative care is necessary from patients, families, referring providers, and communities. In addition, cultural competency training for all members of the palliative care team and referring providers needs to be changed from being obligatory to being intentional and assessed continuously. Finally, concerted changes in coordination of care, payment structures, and policy are needed.

中文翻译：

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癌症患者姑息治疗的差异

在美国，种族和少数民族以及社会经济地位 (SES) 较低的人在获得最佳医疗保健（包括姑息治疗）方面面临结构性、卫生系统和人际障碍。许多关于种族和少数族裔以及 SES 较低的人的姑息治疗的可用数据已经确定了种族、族裔和 SES 之间的差异。理解姑息治疗差异的局限性包括以下事实：大部分可用数据是横截面的，来自行政或索赔数据，或基于有限地理区域的定性工作。为了在研究不足或已知接受不同护理的患者群体中提高我们的知识并实现姑息治疗的健康公平，患者、家属、转诊提供者和社区需要更深入地了解姑息治疗的障碍。此外，姑息治疗团队所有成员和转诊提供者的文化能力培训需要从强制性转变为有意并持续评估。最后，需要在护理、支付结构和政策的协调方面做出协调一致的改变。