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The Centers for Disease Control and Prevention estimates that approximately 40 million people in the United States suffer from a serious illness that limits their daily activities. These illnesses include heart and lung disease, cancer, diabetes, and Alzheimer's disease and other forms of dementia. However, significant disparities exist across different communities in the quality and access to care for these illnesses. Factors such as race, ethnicity, gender, geography, socioeconomic status, or insurance status exacerbate these complex disparities. It is critical to reevaluate the current models of care delivery across diverse communities and vulnerable populations.

On April 4, 2019, The National Academies of Sciences, Engineering, and Medicine convened a workshop to investigate barriers, policy initiatives, and opportunities for improving access to and equity of care for people living with a serious illness. The workshop featured presentations and panel discussions on topics that included:

• Barriers that impede access to care for serious illness (e.g., advance care planning, palliative care, and hospice) among vulnerable populations and strategies to address those barriers
• Strategies to build trust and effectively engage patients, families, and caregivers in diverse cultural, ethnic, racial and socioeconomic environments, in order to communicate with patients and families in a culturally competent manner regarding expectations and values related to end-of-life care, and to ensure that treatment is aligned with preferences
• Approaches to enhancing the diversity of the workforce providing care to people with serious illness
• Models of care delivery that currently serve vulnerable populations with serious illness, including public-private partnerships and community-level interventions such as use of community health coaches for peer-to-peer interventions, and partnering with faith-based organizations
• Research gaps and key questions for further research

About the affiliated organization: The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide expert advice on some of the most pressing challenges facing the nation and world. Our work helps shape sound policies, inform public opinion, and advance the pursuit of science, engineering, and medicine.