In California and across the country, people with a serious illness¹ and those approaching the end of life endure unnecessary suffering. As of 2013, 25% of people nearing the end-of-life experience unmet needs for pain, 50% experience unmet needs for anxiety and sadness, and 14% had decisions made without enough input from themselves or their family². This experience is like even worse for people of color. In a 2021 survey commissioned by the Stupski Foundation, it was revealed that the majority of decedents who did not have wishes or plans for end-of-life care were people of color.

Fortunately, there are existing solutions to improve care for people with a serious illness including palliative care and advance care planning. Unfortunately, not enough people know about the importance of palliative care and advance care planning, or how to engage and access these services. An estimated 71% of adults reported having never heard of palliative care, and communities of color often have even less awareness^3,4. Additionally, even when people claim to know what palliative care is, their understanding can be inaccurate or incomplete, often conflating palliative care with hospice. For some people, these widespread misperceptions can be compounded by broader issues of mistrust resulting from institutional racism and other forms of discrimination within health care systems.

There is significant opportunity to address these challenges and enhance the uptake of serious illness care services by educating patients and families about the nature of these services, their benefits, and how to access them more broadly. According to a 2019 study commissioned by the California Health Care Foundation, when the type of services palliative care offers was described, 9 in 10 Californians expressed their desire for such care in the event of a serious illness, regardless of their race or ethnicity⁵.

Increasing awareness, acceptance, and ultimately the use of palliative care and advance care planning requires a multi-stakeholder approach. The San Francisco Palliative Care Work Group is making a significant contribution to this goal by actively engaging and educating patients and families, and by providing a vision and a unified framework to harness the capabilities of health systems, community-based organizations, faith-based organizations, and municipal government entities.