Literature Review

Integrating social determinants into palliative care Hospice News; by Holly Vossel; 4/16/25 Strong staff education and reimbursement are among the keys to successfully integrating social determinants of health within a palliative care program. Screening tools developed by the U.S. Centers for Medicare & Medicaid Services’ (CMS) include five areas of social determinants of health: food and housing insecurity, transportation needs, utility difficulties and interpersonal safety. Supplemental domains include financial stability, employment and family and social support, among others.

Housing instability complicates end-of-life care for aging unhoused populations The Conversation; by Pilar Ingle, University of Denver; 4/7/25 Research estimates that one-third or more of the unhoused population in the U.S. is age 50 or older. Unhoused people of all ages face high rates of chronic and serious illness. They also die at younger ages compared with people who are not unhoused. Yet, there are few options for palliative and end-of-life care for unhoused people. ... In 2024, Colorado saw a 30% increase in the number of people experiencing homelessness from the year before. Nationally, 771,480 people — the highest number ever recorded — experienced homelessness last year. As the number of people experiencing homelessness in the U.S. grows, so too does the need for palliative and end-of-life care for these individuals. ... [Continue reading ...]

Thompson Scholars and AdventHealth host successful Health Equity Health Fair AdventHealth Manchester, Manchester, KY; by Christina Couch; 3/25/25 The Thompson Scholars Foundation and AdventHealth are proud to announce the successful completion of the Health Equity Health Fair held [March 24] ... in Manchester, KY. With over 250 participants, the event brought together medical professionals, community representatives, and attendees to address health disparities and promote wellness within the community. The Health Equity Health Fair featured a wide range of activities and resources, including: ... Hospice Care ...

Grief support groups available for Spanish speakers The Times-Standard, Eureka, CA; by The Times-Standard; 3/23/25 Hospice of Humboldt and Healing Roots Curando Raíces PC have announced a new partnership to offer free grief support groups in Spanish for the community. These groups will provide a safe and welcoming space for Spanish-speaking individuals to process loss, connect with others and receive compassionate support. ... Like Hospice of Humboldt’s Grief Support Groups in English, these groups are open to anyone in the community and are not limited to Hospice of Humboldt patients and families. “We are honored to collaborate with Healing Roots Curando Raíces PC to expand access to grief support for our Spanish-speaking community,” said Dianne Keating, CEO of Hospice of Humboldt. “Grief can feel isolating, and having support available in one’s preferred language makes a meaningful difference in the healing process.” 

Researcher proposes new framework for language equity in health technologyJAMA; Yulin Hswen, ScD, MPH; Nora Collins; 2/25In a recent Editorial in JAMA Network Open, Pilar Ortega, MD, MGM, a clinical associate professor of medical education and emergency medicine at the University of Illinois College of Medicine in Chicago, and her coauthors emphasized the urgent need for integrating language equity into digital health solutions. “Technology may enhance health equity, but only if marginalized populations’ perspectives and root causes of health disparities are considered across key aspects of health care provision and at every stage of project development: design, evaluation, implementation, and revision,” they wrote. There are [more than] 350 languages spoken in the US. We need to do things that on a system level make it possible for individuals of any language preference to not only access care but that the health care quality they receive is comparable and equitable, so they can be enrolled in clinical trials [and] access all the different levels of care they might need. 

CMS deletes Medicare Advantage vision statement, signaling another shift from health equity Fierce Healthcare - Regulatory; by Noah Tong; 3/10/25 The Centers for Medicare & Medicaid Services (CMS) wiped away the agency’s stated intentions for the future of Medicare Advantage (MA), underlining new uncertainty for the future of health-related social needs, CMS Innovation Center models and the federal health program. ... A frequently asked questions page gave further explanation, as did an executive summary of a report to be released in early 2025. The page included a section with the question, “What is CMS’ vision for the future of the MA program?” as of Feb. 22, archived versions of the web page shows. But that question and answer was quietly deleted, and the page was last modified Feb. 26. It previously described how the VBID model helped health plans address health-related social needs and stressed health equity as an important cornerstone of its mission. ... The CMS did not immediately respond to a request for comment.

Mahogany CEO: Hospice on cusp of ‘tremendous revolution’Hospice News; by Holly Vossel; 3/7/25 Mahogany Home Health and Hospice recently launched services in southwestern Ohio. The new hospice startup is the first Black-owned hospice and home health organization statewide with a drive to improve utilization among underserved populations. This is according to Victor Couzens, owner, founder and CEO of Mahogany Home Health and Hospice. The organization recently received a green light from state licensing agencies to begin serving Cincinnati and Dayton, Ohio and surrounding communities. ... Couzens recently told Hospice News, ... "As a hospice chaplain, I was often confronted with the pressure of trying to fit a square peg into a round hole when it comes to how underserved communities are actually reached and cared for. It’s about offering insights, or even evidence-based approaches, to meeting the needs of Black and brown people, the needs of the LGBTQ+ community, the needs of immigrants and just any other groups who do not make up the majority of the patient population. ..."

What do the ashes symbolize in life, death, and cultural rituals? Brain Wise Mind - Symbolism; by Jodie Lawrence; 1/26/25In this article, you’ll explore the rich symbolism behind ashes, from themes of loss and renewal to connections with the cycle of life. By understanding these meanings, you can gain a deeper appreciation for how ashes play a role in various rituals and practices. Get ready to uncover the significance that lies within these seemingly simple remnants. ... Ashes symbolize a range of profound concepts, particularly in relation to life and death. You can find their meanings in various cultures and traditions, reflecting significant themes.

Challenges to video visits for patients with non–English language preference-A qualitative studyJAMA Network Open; Marianna Kong, MD; Francine Rios-Fetchko, BA; Madelyn Olmos-Rodriguez, BA; Linda Branagan, PhD; Bradley Iott, MPH, MS, PhD; Therese Chan Tack, DO, MPH; Carol Yarbrough, MBA; Kevin Grumbach, MD; Alicia Fernandez, MD; 2/25Telemedicine, or synchronous video or audio-only visits, has made clinical encounters more convenient and accessible for many patients. Prior to the COVID-19 pandemic, video and telephone visits comprised a small minority of primary care visits, but by April 2020, approximately one-half of US physicians were treating patients virtually and nonurgent telemedicine video visits increased by more than 600%. In this qualitative study, participants with NELP [non-English language preference] perceived multiple barriers to video visits, including greater communication difficulties, lower medical evaluation quality, and technical issues. These findings suggest that addressable technical challenges associated with language barriers hamper access to video visits and decrease motivation for use and that interventions are needed to increase telehealth equity. 

Partnership grows to help more clinicians of color find community in Vermont Vermont Business Magazine - Vermont Biz (VB), South Burlington, VT; by Tim, The University of Vermont Medical Center; 2/18/25 A growing partnership between University of Vermont Medical Center and the Vermont Professionals of Color Network (VT PoC) aims to help people of color adjust to life in Vermont and build the personal and professional relationships community leaders say are crucial to both individual wellbeing and keeping residency students in the state after they complete their clinical training. “During my 20 plus years here, I have heard from so many black and brown people about how difficult it can be to adjust to life in Vermont – and this goes for medical residents too,” said Tino Rutanhira, co-founder and co-executive director of VT PoC. "... Without support, many of these professionals decide to leave Vermont at a time when our state desperately needs young, skilled and diverse people to help it grow.” Editor's note: Parteners listed include The University of Vermont Health Network - Home Health & Hospice.

Celebrating Black History Month: 12 Black American medical pioneers Brighton Hospice; blog from 2/24/21, still relevant todayThese trailblazing clinicians, researchers, inventors, and advocates broke barriers, shattered stereotypes, and advanced medicine in this country and beyond. 

Care for patients with a history of immigrationJAMA; Margaret Wheeler, MS, MD; Juan Raul Gutierrez, MD; Alicia Fernandez, MD; 1/25Home to 20% of the world’s immigrants, the US is the leading destination for people leaving their birth countries, and the US Census estimates that almost 14% of the US population in 2022 was born outside the US. ... The 2023 US Preventive Services Task Force Guideline on screening for latent tuberculosis recommends screening for tuberculosis in patients from Latin America, the Caribbean, Africa, Asia, Eastern Europe, and Russia because in 2020, 71% of cases of active tuberculosis in the US occurred among individuals from these areas. Assessment of clinically relevant premigration factors involves consideration of the epidemiology of disease, health care practices, and sociopolitical and environmental exposures in an immigrant’s country of origin. These factors can alter risk assessment in differential diagnoses; for example, neurocysticercosis should be considered in the differential diagnosis of seizures in a patient from Central America.

Use of digital health technologies by older US adultsJAMA Network Open; Cornelius A. James, MD; Tanima Basu, MS, MA; Brahmajee K. Nallamothu, MD, MPH; Jeffery T. Kullgren, MD, MPH, MS; 1/25Older adults use various types of DHT [digital health technologies], and they use patient portals most often. Although some older adults have unique physical and cognitive needs that can affect the utility and usability of DHTs, in aggregate they share some predictors of DHT use with younger adults. Additionally, our study showed a statistically significant association between non-Hispanic Black race and ethnicity and DHT use. Various factors may contribute to this finding, including medical mistrust among Black patients leading to decreased engagement with the health system and increased reliance on DHTs. This study highlights the need to carefully consider the unique characteristics of older adults when developing and deploying DHTs to avoid worsening the digital divide.