Poverty, choice and dying in the UK: a call to examine whether public health approaches to palliative care address the needs of low-income communities

Abstract

People living on a low income are less likely to access palliative care in the UK; however, beyond the statistics, little is known about the impact of poverty on attitudes towards death and experiences of dying and bereavement. Covid-19 has disproportionally affected poorer communities and foregrounded issues of social and health inequalities including experiences of loss and grief. Whilst this might suggest an opportune moment for embracing inclusive health-promoting approaches to palliative care, this paper argues that the centrality of concepts such as choice within such approaches, and assumptions about what constitutes a ‘good death’, disregard the ways in which structural, social and economic aspects of poverty interface with attitudes towards and experiences of dying, and may exacerbate inequalities in death and dying.