The most ethnically diverse state in the nation, California has an opportunity to set a national example for quality end-of-life care for all its residents. Providing quality care requires knowledge of the population served and its needs and preferences. This report reviews and analyzes current data, along with new research from focus groups and surveys. The report examines the causes and patterns of death and dying across California's populations and the impact on the delivery of health care. Hospice care is generally considered the "gold standard" for end-of-life care in California and across the country. However, the report finds there is wide variation in preferences for care among various racial and ethnic populations. In addition, there are significant limitations on the availability and appropriateness of hospice for some patients