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Is Death “The Great Equalizer†? The Social Stratification of Death Quality in the United States

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  • Deborah Carr

Abstract

Socioeconomic status (SES) gradients in mortality risk are well documented, although less is known about whether the quality of older adults’ dying experiences is stratified by SES. I focus on six core components of a “good death†: pain and symptom management, acceptance, medical care that is concordant with one’s preferences, dying at home, emotional preparation, and formal preparations for end-of-life care. Analyses are based on four data sets spanning the 1980s through 2010s, a period marked by rising economic inequalities: Changing Lives of Older Couples (1986–1994), Wisconsin Longitudinal Study (1993–2010), New Jersey End of Life study (2005–2007), and Wisconsin Study of Families and Loss (2010–2014). I find evidence of SES disparities in two outcomes only: pain and advance care planning (ACP), widely considered an important step toward a “good death.†Implications for health care policy and practice, against the backdrop of the Affordable Care Act implementation, are discussed.

Suggested Citation

  • Deborah Carr, 2016. "Is Death “The Great Equalizer†? The Social Stratification of Death Quality in the United States," The ANNALS of the American Academy of Political and Social Science, , vol. 663(1), pages 331-354, January.
    • Handle: RePEc:sae:anname:v:663:y:2016:i:1:p:331-354
    DOI: 10.1177/0002716215596982
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    References listed on IDEAS

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    1. Deborah Carr & Dmitry Khodyakov, 2007. "End-of-Life Health Care Planning Among Young-Old Adults: An Assessment of Psychosocial Influences," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 62(2), pages 135-141.
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