# Investigating Disparities in End-of-Life Care in Undocumented Hispanic Immigrants

> **NIH NIH R36** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2023 · $36,184

## Abstract

Project Summary/Abstract
The U.S. undocumented immigrant population ranges from 10.5 million to 12 million and makes up to 3.2% to
3.6% of the population. Over 80% of these undocumented immigrants are Hispanic. This population faces
numerous barriers to obtaining healthcare services, largely due to fear of deportation and limited access to
healthcare. Undocumented immigrants’ lack of eligibility for hospice services and palliative care limits them to
care in outpatient clinics or emergency departments, contributing to poor end-of-life care outcomes.
Undocumented immigrants are at greater risk of dying from untreated and undiagnosed chronic diseases, such
as cancer and heart failure, the top two leading causes of death among Hispanics. Yet, little is known about the
end-of-life care outcomes of this population and less is known about the challenges healthcare providers face
when caring for this population. The objectives of the proposed project are two-fold: 1) to determine challenges
and facilitators hospital-based palliative care healthcare providers encounter in caring for seriously ill
undocumented Hispanic immigrants; and 2) to explore the healthcare service use experiences of seriously ill
undocumented Hispanic immigrants and factors affecting their access to care. I will conduct individual, semi-
structured interviews with seriously ill undocumented Hispanic older adults and palliative care healthcare
providers at two public hospitals. Ten to 12 palliative care healthcare providers who regularly treat
undocumented Hispanic immigrants will be invited to participate in a 30 to 45 minute audiotape-recorded
interview. In addition, I will interview 18 to 20 patients who are aged 18 and older, identify as Hispanic, and are
diagnosed with one of the following serious illness diagnoses: cancer, heart failure, chronic obstructive
pulmonary disease, liver disease, or end-stage renal disease. All interviews will be transcribed and translated
into English and transcripts will be analyzed in NVivo 12 using thematic analysis. This study is guided by
Andersen’s Behavioral Model of Health Care Use and will follow the Consolidated Criteria for Reporting
Qualitative Studies (COREQ) guidelines, a 32-item checklist for interviews. Results from the proposed project
will inform the development of targeted interventions that aim to mitigate the identified barriers and promote
quality of life for undocumented immigrants at end of life.

## Key facts

- **NIH application ID:** 10593462
- **Project number:** 1R36AG077135-01A1
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** Valeria Lucia Cardenas
- **Activity code:** R36 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $36,184
- **Award type:** 1
- **Project period:** 2023-05-15 → 2023-12-13

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10593462

## Citation

> US National Institutes of Health, RePORTER application 10593462, Investigating Disparities in End-of-Life Care in Undocumented Hispanic Immigrants (1R36AG077135-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10593462. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*