Hospices, Keep Fighting for DEI, Underserved Patients
Diversity, equity and inclusion initiatives (DEI) are under attack in this country, and I urge hospices not to give up on reaching underserved populations.
While we strive to maintain objectivity and not bring our personal political stances into our coverage on Hospice News, I will risk bringing up this politically charged topic here on Inside Hospice, as I feel strongly about the issue not only as a moral matter but as a pressing issue for hospices’ business models.
It doesn’t take much to establish that the current presidential administration is vehemently anti-DEI, but some of Trump’s recent statements hammered that home.
“We will terminate every diversity, equity, and inclusion program across the entire federal government,” Trump said in a White House Fact Sheet issued last week.
Among Trump’s first actions in the White House was to sign a series of executive orders designed to root out and eliminate diversity initiatives in the federal government and beyond.
These orders intend to accomplish a wide range of objectives, including termination of all diversity, equity, and inclusion offices, positions, and programs in the federal government; elimination equity-related grants and contracts and ensuring that government contractors and grantees do have have DEI programs, and more as you as you can see on this list from The Leadership Conference of Civil and Human Rights.
Despite these pressures, hospices must stay the course to alleviate widespread and well-documented disparities in both who accesses their services and the larger health care system.
Let’s look at these numbers from the National Alliance for Care at Home:
Non-Hispanic white populations account for more than 2 million of the 2.5 million Medicare decedents nationwide who died in hospice care in 2024. Black patients accounted for 272,370. Asian and Pacific Islander patients represented 48,313, and only 60,738 of those patients were Hispanic. Native American populations had the lowest utilization at 11,682.
This is a systemic failure that signals widespread health equity problems throughout our health care system. While the trends are unsurprising, the numbers take me aback a little bit — 2 million out of 2.5 million — but even more profound and disturbing is the meaning behind the data. More people among these groups are suffering at the end of life and likely dying in hospitals.
This is a tragedy, and it should be an outrage. But at the end of the day it seems like a thing that is sometimes acknowledged, and with the exception of a few passionate advocates, largely accepted as a matter of course.
While those numbers focus on race, DEI of course goes beyond that. Other groups are also underserved by hospices, including those who have serious mental illnesses, the disabled, unhoused population and the LGBTQ+ community among others.
Hospices should devote themselves to DEI for moral reasons. However, a business case does exist. In cold financial terms, these populations represent untapped markets, and efforts to increase their utilization would likely help providers beef up their patient census and foster growth.
I know that some hospices are staying the course on DEI initiatives. We’ve spoken with them and covered them on Hospice News. I hope more will take up the banner for DEI, and I hope they will give it more than lip service or window dressing.
People are suffering. They are dying in pain. Caring for them is your mission. It’s time to fulfill that promise for everyone who is eligible for care.
Also, check out my post from last week in which I lay out while my work covering hospice is my passion and personal mission.