CANCEL Addressing Palliative and End-of-Life Inequities in End-Stage Kidney Disease: What's Our Responsibility?

Outcomes 1. Examine strategies for becoming political advocates as PEOL professionals to advocate for programs that will benefit minoritized populations.2. Discuss various legal and ethical implications of employment within right-to-work states and becoming an advocate that contradicts the political conviction of the state. Key Message Palliative/end-of-life (PEOL) healthcare providers and researchers must become engaged in curbing the effects of political and social determinants of health that negatively affect minoritized populations. In recognition of the vast political environments that PEOL professionals practice, it is essential that PEOL find a balance between positive activism to benefit minoritized populations while remaining in influential positions. Abstract It is well known that Black, Indigenous, and People of Color (BIPOC) have less equitable access to palliative/end-of-life care (PEOL) providers than White counterparts. In rural settings, access to PC is further complicated by a host of factors such as geography, nearness of healthcare facility offering PEOL and healthcare provider shortages. Exacerbating these inequities are the political and social determinants of health (PDOH/SDOH).PDOH are a systematic process of how relationships are structured, resources are distributed, and power is administered. These areas work together to create opportunities to advance health equity or exacerbate inequities.Recent pilot data shows the striking impact of SDOH on American Indigenous persons with end-stage kidney disease (ESKD) and reveals stark disparities in survival statistics and hospice care use when compared to White persons. As PEOL care researchers, what is our responsibility to meaningfully address these inequities?This presentation will share a case study where we will explore ESKD, SDOH, and PDOH that should be considered to impart systematic change to improve equity in ESKD. We will explore how to become effective political advocates as PEOL professionals. Next, we'll discuss the need to become actively involved in the policy-making processes in our states and advocating for programs that will positively impact BIPOC access to PEOL services, like Medicaid expansion programs. Finally, we will explore the importance of understanding the institutional barriers faced by many within their places of employment or within their state's political climate.For example, if a researcher works at a state-funded university in a right-to-work state and actively advocates against the political policy, they could find themselves in a difficult situation. Finding a balance between positive activism to benefit minoritized populations while remaining in the influential position is a difficult position to maintain, albeit vital to impart long-term change in these states. Keywords Ethical / Legal Aspects of Care; Scientific Research