Health Equity: Foundation of Serious Illness Care

Health equity is foundational to the delivery of high-quality serious illness care. Despite advances in palliative care, substantial disparities persist in symptom burden, quality of life, caregiver distress, access to specialty services, and end-of-life outcomes across racial, ethnic, socioeconomic, geographic, and other structurally marginalized populations. These inequities are driven not by individual patient characteristics alone, but by structural, institutional, and social factors including discrimination, language discordance, disability, transportation barriers, housing instability, food insecurity, and unequal access to healthcare resources. Achieving equitable serious illness care requires moving beyond documenting disparities toward intentionally integrating equity into the design, implementation, and evaluation of clinical care, research, education, and health systems. Equity should not be viewed as a separate initiative but as a defining characteristic of quality. This article explores health equity as the foundation of serious illness care and highlights opportunities for clinicians, researchers, healthcare organizations, and policymakers to develop equity-informed models of care in partnership with patients, caregivers, and communities.