Two studies leaning on research out of the Rutgers School of Nursing and School of Public Health found New Jersey has low utilization of palliative and hospice care for patients with metastatic cancer, compared to the rest of the United States.

Some of the alarming disparities across demographics may be due to the Garden State being the most ethnically diverse in the nation, said the first author of both studies, Bridget Nicholson, a School of Nursing PhD graduate, clinical consultant, and nurse practitioner, but further research will be needed to determine if that theory holds.

What is clear is that metastatic cancer patients have a high symptom burden, characterized primarily by pain and depression, which Nicholson said can both be eased by palliative care.

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The studies, "Hospice Referral in Advanced Cancer in New Jersey," published in the Journal of Hospice and Palliative Nursing, and "Palliative Care Use in Advanced Cancer in the Garden State," published in Cancer Nursing: An International Journal for Cancer Care Research, established some opposing trends.

Nicholson said palliative care access was more affected by the age, income level, or insurance status of a patient than race or a language barrier, but treatment of the main symptoms, pain and depression, differed.

"Pain influenced the use of palliative care, and if you had pain, you were much more likely to have a palliative care consult, but depression was not predictive of an inpatient palliative care consult," she said, while adding that depression can manifest in some unique ways. "We need culturally sensitive scales to measure depression in diverse populations, so that we can identify it more appropriately across populations."

But she said Black and Hispanic residents were less likely to receive hospice referrals, which is concerning because it puts into sharp focus what New Jersey could be doing better to provide in-home care in certain communities and extend survival for patients — even if the path to get there has not yet really taken shape.

"Those patients who did not speak a primary language of English also had significantly lower odds of receiving a hospice referral," Nicholson said.

The data that was examined came from well before the COVID-19 pandemic, in 2018, but Nicholson admitted the coronavirus has changed everything, and newer figures need to be studied to really determine if New Jersey is improving in any of these areas.

Next would be giving health care providers the necessary education and training to infiltrate and benefit underserved communities.

"Patients deserve the same level of care regardless of their language spoken or their demographics, and pain and depression are symptoms that really need to be addressed," Nicholson said.

Patrick Lavery is a reporter and anchor for New Jersey 101.5. You can reach him at patrick.lavery@townsquaremedia.com

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These are the best hiking spots in New Jersey

A trip to New Jersey doesn't have to be all about the beach. Our state has some incredible trails, waterfalls, and lakes to enjoy.

From the Pine Barrens to the Appalachian Trail to the hidden gems of New Jersey, you have plenty of options for a great hike. Hiking is such a great way to spend time outdoors and enjoy nature, plus it's a great workout.

Before you go out on the trails and explore some of our listeners' suggestions, I have some tips on hiking etiquette from the American Hiking Society.

If you are going downhill and run into an uphill hiker, step to the side and give the uphill hiker space. A hiker going uphill has the right of way unless they stop to catch their breath.

Always stay on the trail, you may see side paths, unless they are marked as an official trail, steer clear of them. By going off-trail you may cause damage to the ecosystems around the trail, the plants, and wildlife that live there.

You also do not want to disturb the wildlife you encounter, just keep your distance from the wildlife and continue hiking.

Bicyclists should yield to hikers and horses. Hikers should also yield to horses, but I’m not sure how many horses you will encounter on the trails in New Jersey.
If you are thinking of bringing your dog on your hike, they should be leashed, and make sure to clean up all pet waste.

Lastly, be mindful of the weather, if the trail is too muddy, it's probably best to save your hike for another day.

I asked our listeners for their suggestions of the best hiking spots in New Jersey, check out their suggestions:

Every NJ city and town's municipal tax bill, ranked

A little less than 30 cents of every $1 in property taxes charged in New Jersey support municipal services provided by cities, towns, townships, boroughs and villages. Statewide, the average municipal-only tax bill in 2021 was $2,725, but that varied widely from more than $13,000 in Tavistock to nothing in three townships. In addition to $9.22 billion in municipal purpose taxes, special taxing districts that in some places provide municipal services such as fire protection, garbage collection or economic development levied $323.8 million in 2021.

How the world saw New Jersey — 1940s to 1980s

This is how New Jersey saw the world from 1940-to 1980. All these photos are from AP and Getty publications, meaning they were used in a magazine or newspaper. There has been plenty of inventions and history made in New Jersey. Check the photos below.