The United States of America is a country composed of various ethnicities. This country is considered to be a multi-cultural society. There are various cultural traditions values, norms and superstitious practices within each ethnic group. Attitudes toward end of life care are complex and vary differently across each ethnic group. This study explored factors that explained African Americans' disproportionate use of hospice. Access to hospice care was address, experience with hospice was explored, and recommendations were provided. This study conducted non-experimental research. The design of this exploratory study was quantitative in nature. A survey approach was utilized to collect data that was statistically analyzed. The important concept was African American disproportionate use of hospice. The variable willingness to use was employed to try to explain African Americans' disproportionate use of hospice. The independent variables African Americans who mistrust formal healthcare providers and knowledge about hospice services were operationalized using multiple indicators. The independent variable experience with hospice services did not use a scale. The research findings supported all three study hypotheses. This research results recommend that an important focus of the future be to counsel persons on the availability of hospice as an option for end-of-life care. Well-structured programs of training in cultural awareness and cultural competence throughout the ranks of the health care system must be instituted. Such an effort will pay dividends in reducing cultural mistrust and push closer to eliminating health disparities between minority groups and the rest of society.