Culturally Centered Palliative Care: A Framework for Equitable Neurocritical Care

Area of Science:

• Neurocritical Care
• Palliative Care
• Health Equity
• Health Disparities

Background:

• Health disparities persist for racial and ethnic minority patients in the U.S.
• These disparities are evident in critical care settings, particularly for patients with neurologic injury and those nearing end of life.
• Existing inequities in palliative care within neurointensive care units (NICUs) require urgent attention.

Purpose of the Study:

• To highlight racial and ethnic disparities in neurocritical care and palliative care.
• To offer recommendations for an anti-racist approach to palliative care in the NICU.
• To promote health equity for underserved populations in critical neurologic care.

Main Methods:

• Review of existing literature on health disparities in neurocritical and palliative care.
• Analysis of the impact of structural racism and social determinants of health on care.
• Development of recommendations for an anti-racist framework.

Main Results:

• Significant racial and ethnic disparities exist in palliative care access and quality for patients with neurologic injury.
• Structural racism and social determinants of health are key drivers of these disparities.
• Current palliative care approaches in NICUs may perpetuate inequities.

Conclusions:

• Achieving health equity in neurocritical care palliative care necessitates acknowledging and actively addressing structural racism.
• Implementing an anti-racist approach is vital for equitable care delivery.
• Clinicians must be equipped with strategies to mitigate disparities and promote justice in end-of-life care for all patients.