Nurse Service of New York (VNSNY) —the Harlem Palliative Care Network (HPCN). HPCN will work to (1) increase access to palliative care services for patients facing life-threatening illnesses and their families who reside in Central and East Harlem; (2) overcome cultural and environmental barriers among minority populations concerning timely intervention for life-threatening illnesses; (3) enhance the continuity and coordination of care through greater integration of community-based and institutional services; (4) improve the quality of life for Harlem patients through better pain and symptom management; and (5) provide support services to meet the emotional and spiritual needs of patients and their families. HPCN will achieve these goals by identifying Network Partners—consisting of faith-based organizations, social and community development agencies, and community health care providers—who will agree to assist in identifying patients and to provide services in the community for those patients.

3. HPCN will target patients with a diagnosis of progressive cancer, congestive heart failure, chronic obstructive pulmonary disease, end-stage renal disease, and AIDS in Central and East Harlem. This geographic area is the primary service area of NGH, and it will be the hub for inpatient, outpatient, and community-based palliative care services.

4. The “Initiative to Improve Palliative and End-of-life Care in the African-American Community” is supported by funding from the Open Society Institute’s Project on Death in America (PDIA). The Initiative brought together a group of professionals to begin to delineate and document historical, social, cultural, ethical, economic, legal, policy, and other factors that affect the attitudes toward, acceptance of, access to, and utilization of palliative and hospice services by African Americans. During a planning meeting in February 2000, four key barriers were identified: (1) mistrust of the health care system, (2) lack of effective end-of-life planning, (3) inattention to the spiritual aspects of healing and dying, and (4) viewing pain as a natural or expected part of dying. Plans have also begun toward a national conference, planned for late 2001, to consolidate and disseminate information concerning barriers to improving end-of-life care for African Americans and to suggest specific strategies for change.

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Crawley L, Payne R, Bolden J, Payne T, Washington P, Williams S. Palliative and end-of-life care in the African American community. JAMA 2000; 284:2518–2521.


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