Inequity in palliative care and bereavement support: an umbrella review of the evidence
- 1Department of Nursing and Midwifery, School of Health Sciences, College of Medicine and Health, University of Birmingham
- 2St Giles Hospice
Abstract
Introduction: Inequitable, unfair or unjust service provision pervades palliative and bereavement care globally within and across countries. There is growing research into the needs of population groups known to experience inequity. This paper presents an evidence synthesis of systematic reviews examining inequities in palliative care and bereavement support for adults, to identify the key facilitators, barriers, and structural determinants of inequity across population groups, and to develop evidence-informed recommendations for policy, education, research, and practice.
Methods: Joanna Briggs Institute Umbrella review methodology was used. Searches were conducted across six electronic databases (CINAHL, Medline, PsycINFO, Scopus, Embase, and Cochrane Collaborative Database of Systematic Reviews) from January 2012 to November 2023 and updated the search in May 2025. Joanna Briggs Institute critical appraisal tools were used for quality assessment.
Results: Forty-eight reviews were included. Only 1 review focused exclusively on bereavement, a further 2 studies included it within a broader scope. Barriers and facilitators to equity were identified at individual, population-specific, and system-wide levels. Common structural determinants across all groups included low socioeconomic status, limited health literacy, geographical and structural impediments, cultural and language dissonance, and individual vulnerability due to interconnected personal characteristics. Key recommendations to improve equity included enhancing cultural competence, inclusive communication, intersectional awareness, person-centred care, shared decision-making, and community engagement.
Discussion: Inequity in palliative care and bereavement support reflect collective and shared experiences. The structural determinants of inequity that transcend population groups may be useful in identifying, assessing and measuring inequity in palliative care and bereavement support and aid the commissioning, delivery and evaluation of inclusive services.
Related
- Informal carers’ experiences of mental health services regarding supporting those they care for and getting support for their own wellbeing: A systematic umbrella review of qualitative evidence
- Perinatal bereavement care skills, training needs, and workplace support in an Italian descriptive study
- How to tackle inequities in bereavement support for ethnically diverse communities: a national qualitative study using experience-based co-design.
- Religious life, monastic support, and healthcare inequity among aged Han Buddhist monks in China: an explanatory mixed-methods study
- Evidence quality assessment of traditional Chinese medicine and integrated traditional Chinese and Western medicine for acute upper respiratory infection in children: an umbrella review of systematic reviews and meta-analyses
BibTeX
@article{pettifer2026inequity,
title = {{Inequity in palliative care and bereavement support: an umbrella review of the evidence}},
author = {Annie Pettifer and Muzeyyen Seckin and Nikolaos Efstathiou and Ping Guo and Rumandeep Tiwana and Cara Bailey},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1943244},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1943244/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Inequity in palliative care and bereavement support: an umbrella review of the evidence
AU - Annie Pettifer
AU - Muzeyyen Seckin
AU - Nikolaos Efstathiou
AU - Ping Guo
AU - Rumandeep Tiwana
AU - Cara Bailey
PY - 2026
DA - 2026/10/19
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1943244
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1943244/full
AB - Introduction: Inequitable, unfair or unjust service provision pervades palliative and bereavement care globally within and across countries. There is growing research into the needs of population groups known to experience inequity. This paper presents an evidence synthesis of systematic reviews examining inequities in palliative care and bereavement support for adults, to identify the key facilitators, barriers, and structural determinants of inequity across population groups, and to develop evidence-informed recommendations for policy, education, research, and practice. Methods: Joanna Briggs Institute Umbrella review methodology was used. Searches were conducted across six electronic databases (CINAHL, Medline, PsycINFO, Scopus, Embase, and Cochrane Collaborative Database of Systematic Reviews) from January 2012 to November 2023 and updated the search in May 2025. Joanna Briggs Institute critical appraisal tools were used for quality assessment. Results: Forty-eight reviews were included. Only 1 review focused exclusively on bereavement, a further 2 studies included it within a broader scope. Barriers and facilitators to equity were identified at individual, population-specific, and system-wide levels. Common structural determinants across all groups included low socioeconomic status, limited health literacy, geographical and structural impediments, cultural and language dissonance, and individual vulnerability due to interconnected personal characteristics. Key recommendations to improve equity included enhancing cultural competence, inclusive communication, intersectional awareness, person-centred care, shared decision-making, and community engagement. Discussion: Inequity in palliative care and bereavement support reflect collective and shared experiences. The structural determinants of inequity that transcend population groups may be useful in identifying, assessing and measuring inequity in palliative care and bereavement support and aid the commissioning, delivery and evaluation of inclusive services.
SN - 2296-2565
ER -