Graduation Year


Document Type




Degree Granting Department


Major Professor

Ambar Basu


African American, culture-centered approach, end of life, health disparities, hospice, narrative theory


As the United States' population ages and grows more diverse, scholars and practitioners have grown increasingly concerned about persistent disparities in the cost and quality of end-of-life health care, particularly with regard to African Americans. Although a variety of factors may influence these disparities, most scholars agree that the underutilization of hospice care by this population is an important contributor. Drawing from the culture-centered approach to health communication and narrative theory, the present study explores African American patients and caregivers' experiences with hospice care and takes an initial step toward addressing disparities in end-of-life care. I begin this study, first, by positioning it within existing literature on health disparities and the underutilization of hospice care. I then outline the study's context and the ethnographic methods I used to complete it. Next, I discuss (a) participants' understanding of disparities in hospice utilization, (b) how participants' narrate their decisions about and experiences with hospice care, and (c) co-constructed solutions for addressing disparities in end-of-life care by creating partnerships between community members and local hospice organizations.