Voices

Jennifer Bires: Advancing Racial Equity in End-of-Life Care with Kristine Naputo

Jennifer Bires/LinkedIn and Kristine Naputo/LinkedIn

Sep 3, 2025, 15:47

Jennifer Bires: Advancing Racial Equity in End-of-Life Care with Kristine Naputo

Jennifer Bires, Executive Director at Inova Schar Cancer Institute, shared a post on LinkedIn:

“Why do patients of color continue to face inequities in palliative and end-of-life care despite decades of evidence and advocacy?

The stories are not abstract.

We see families navigating late referrals, mistrusting the system, receiving less adequate pain control, and experiencing more aggressive treatments in their final days, care that often misaligns with their values.

This is not about “preferences” or “individual bias” alone.

It’s about structural racism embedded in policies, referral patterns, provider assumptions, and resource allocation.

That’s why Kristine Naputo, LMSW and I wrote “Structural Racism and Access to End-of-Life Care: An Agenda for Oncology Social Workers” as part of the AOSW DEI Committee.

We wanted to highlight how these inequities are impacting patients and families and offer evidence-based strategies for dismantling inequities.

Some key takeaways for healthcare teams:

1. Anchor care in equity. Track race and ethnicity alongside referrals, pain management, and hospice utilization. Data reveals patterns we can no longer ignore.
2. Audit for accountability. Advocate for equity reviews within palliative and hospice services.
3. Educate with a racial equity lens. Train teams to recognize implicit bias in pain assessments and EOL planning.
4. Build trust. Move from “families are mistrusting” to “how do we earn their trust?” through language access, inclusive family involvement, and narrative practices.
5. Advocate beyond the bedside. Push for policies and reimbursement models that center equity in palliative and hospice care.

As oncology social workers, we are uniquely positioned to lead this work – at the bedside, within teams, and across institutions. Because equitable end-of-life care is not optional. It is our ethical responsibility.

Kristine Naputo, LMSW and I would love to hear: What steps are you seeing (or taking) in your institutions to dismantle these inequities?”

More posts featuring Jennifer Bires on OncoDaily.