Dying in the margins: understanding palliative care and socioeconomic deprivation in the developed world

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Journal Article
Journal of Pain and Symptom Management, 2011, 42 (1), pp. 105 - 118
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Individuals from low socioeconomic (SE) groups have less resources and poorer health outcomes. Understanding the nature of access to appropriate end-of-life care services for this group is important. This article evaluated the literature in the developed world for barriers to access for low SE groups. Electronic databases searched in the review included MEDLINE (1996â2010), CINAHL (1996â2010), PsychINFO (2000â2010), Cochrane Library (2010), and EMBASE (1996â2010). Publications were searched for key terms âsocioeconomic disadvantage,â âsocioeconomic,â âpoverty,â âpoorâ paired with âend-of-life care,â âpalliative care,â âdying,â and âterminal Illness.â Articles were analyzed using existing descriptions for dimensions of access to health services, which include availability, affordability, acceptability, and geographical access. A total of 67 articles were identified for the literature review. Literature describing end-of-life care and low SE status was limited. Findings from the review were summarized under the headings for dimensions of access. Low SE groups experience barriers to access in palliative care services. Identification and evaluation of interventions aimed at reducing this disparity is required.
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