Skip to main content

Older Adults Say Their Care Preferences Are Considered by Clinicians, But Inequities Persist

Analysis  |  By John Commins  
   June 15, 2023

Hispanic and Black adults were less likely than white adults to report having their care preferences considered by clinicians.

A solid majority (73%) of U.S. adults aged 50 and older say their care preferences are taken into consideration by providers, a 9.5% increase over 2014 responses to the same question asked in a survey sponsored by The SCAN Foundation.

However, the findings come with stark racial, economic, and geographic caveats.

Hispanic (52%) and Black adults (62%) were less likely than white adults (83%) to report having their care preferences always or usually considered in 2020 by clinicians, according to a data review by The LeadingAge LTSS Center @UMass Boston and Community Catalyst -- the first review of care preferences since the start of the COVID-19 pandemic.

Preferences include medications, treatment plans, care venues, and trust in their clinicians’ experience and demeanor.

"Ensuring personalized care as individuals age is vital for attaining quality outcomes and ensuring the utmost patient satisfaction," said Sarita A. Mohanty, MD, MPH, MBA, president / CEO of The SCAN Foundation. "Racial and ethnic disparities in how individuals perceive their care preferences being considered is deeply alarming and unacceptable. When preferences are not asked and respected, suboptimal care results."

Other findings show:

  • Income matters. Adults 50+ with household incomes less than $30,000 were less likely to say their care preferences were always or usually considered (66.1%) compared to those with incomes greater than $75,000 (85.1%).
     
  • Geography matters. Adults 50+ in the South were less likely to report care preferences were always or usually considered (71.9%) compared to those in the Northeast (76.4%), West (76.5%) and Midwest (80.2%).
     
  • Relationships matter. Adults 50+ with a usual source of care (e.g., a primary care doctor) reported an increase in their care preferences being usually or always considered (77.1% in 2020 vs. 69.9% in 2014).

"Numerous studies have shown that care that aligns with patient preferences is more effective," says Marc Cohen, PhD, co-director of The LeadingAge LTSS Center @UMass Boston and research director at Community Catalyst. "The healthcare system has a lot of work to do to address deep-seated inequities in how it listens and responds to patients of color."

“Racial and ethnic disparities in how individuals perceive their care preferences being considered is deeply alarming and unacceptable.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

Hispanic (52%) and Black adults (62%) were less likely than white adults (83%) to report having their care preferences always or usually considered in 2020 by clinicians.

Adults 50+ with household incomes less than $30,000 were less likely to say their care preferences were considered (66.1%) compared to those with incomes greater than $75,000 (85.1%).

Adults 50+ in the South were less likely to report care preferences were always or usually considered (71.9%) compared to those in the Northeast (76.4%), West (76.5%) and Midwest (80.2%).

Adults 50+ with a usual source of care reported an increase in their care preferences being usually or always considered (77.1% in 2020 vs. 69.9% in 2014).


Get the latest on healthcare leadership in your inbox.