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Journal of Aging and Health
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End-of-Life Communication: Ethnic Differences Between Korean American and Non-Hispanic White Older Adults

Eunjeong Ko, PhD

San Diego State University School of Social Work, San Diego, CA, eko{at}mail.sdsu.edu

Jaehoon Lee, PhD

University of Kansas Schiefelbusch Institute for Life Span Studies, Lawrence, KS

Objective: This study examined ethnic differences in end-of-life communication between Korean American and non-Hispanic White older adults using the Health Belief Model as a conceptual framework. Method: A cross-sectional design was employed to survey 217 community-dwelling older adults (112 Korean Americans and 105 Non-Hispanic Whites). Results: Half of the participants had never held end-of-life discussions with significant others. Non-Hispanic Whites were more likely to engage in end-of-life communication than Korean Americans, but the ethnicity effect was not evident in a multivariate analysis. Only participants’ knowledge, perceived barriers, perceived severity, and experience of illness significantly predicted the likelihood of the end-of-life communication. Higher knowledge, stronger beliefs about the perceived severity and barriers, and greater experience of illness were related to having end-of-life communication. Discussion: Knowledge and health beliefs play an important role in end-of-life communication which differs by ethnicity. Culturally competent health care practitioners need to consider ethnic variation in advance care planning.

Key Words: end-of-life communication • ethnicity • Korean American • health belief

Journal of Aging and Health, Vol. 21, No. 7, 967-984 (2009)
DOI: 10.1177/0898264309344179
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