Featured Research

from universities, journals, and other organizations

New disparity in US nursing homes: Whites leave, minorities enter

Date:
July 7, 2011
Source:
Brown University
Summary:
Nursing homes in the United States are shrinking and their residents are becoming proportionately more black, more Hispanic, more Asian, and less white, according to a new study. The nationwide trend, reflected in metropolitan areas from New York to Los Angeles, results from changing demographics and disparities in what people can afford.

An old disparity. As the nation ages, the proportion of white elderly in nursing homes declines while the minority proportion increases. Whites, having greater economic resources, may be finding better alternatives.
Credit: Zhanliang Feng/Brown University

Nursing homes in the United States are shrinking and their residents are becoming proportionately more black, more Hispanic, more Asian, and less white, according to a new study by Brown University researchers. The nationwide trend, reflected in metropolitan areas from New York to Los Angeles, results from changing demographics and disparities in what people can afford. The study is published in the July edition of Health Affairs.

In the last decade, minorities have poured into nursing homes at a time when whites have left in even greater numbers, according to a new Brown University study that suggests a racial disparity in elder care options in the United States.

At first blush the analysis, published July 7 in the journal Health Affairs, suggests that elderly blacks, Hispanics, and Asians are gaining greater access to nursing home care. But the growing proportion of minorities in nursing homes is coming about partly because they do not have the same access to more desirable forms of care as wealthier whites do, said the study's lead author Zhanlian Feng, assistant professor of community health in the Warren Alpert Medical School of Brown University.

Seemingly, we are closing the gap in terms of minority access to nursing home beds, but I don't think that is something to celebrate," Feng said. "They are really the last resort. Most elders would rather stay in their homes, or some place like home, but not a nursing home unless they have to."

The new analysis shows that between 1999 and 2008 the nation's nursing home population shrank by 6.1 percent to just over 1.2 million people. In that time period the number of whites in nursing homes decreased by 10.2 percent nationwide, while the number of blacks rose 10.8 percent, the number of Hispanics rose by 54.9 percent and the number of Asians rose by 54.1 percent. The study also looked at nursing home population changes in the top 10 metropolitan areas for each minority.

Prior research has shown that the nursing homes in predominately minority areas are often of lower quality and are more likely to close, while assisted living facilities are more likely to be built in areas where residents have high incomes. The result, reflected in the figures in the new Health Affairs paper, is a disparity that plays out not only economically and geographically, but also racially, Feng said.

"We know those alternatives are not equally available, accessible, or affordable to everybody, certainly not to many minority elders," he said.

As policymakers look to "rebalance" elder care from nursing homes to other forms of care, for instance with shifts in Medicaid funding to support home and community-based services, they should account for these disparities, Feng said. As it is, whites are clearly more likely to be using more desirable alternatives; more concerted efforts may be required to promote minority elders' use of them too, he said.

"Rebalancing is a recognition of most people's preferences for long-term care," Feng said. "For that effort to be successful you have to consider who is using what."

To determine the figures, Feng and his co-authors used the federally mandated Minimum Data Set, which tracks the population of nursing home users and assesses their care needs on a routine basis, because they receive substantial Medicare and Medicaid funding. Similar data is not available for other kinds of elder care, which is predominantly paid for with private insurance dollars.

Metropolitan shifts

One way Feng and his co-authors have quantified the disparity in eldercare is by grouping metropolitan areas into quartiles based on the proportion of whites, blacks, Hispanics or Asians 65 or older in each area. The researchers found that the representation of blacks, Hispanics and Asians in nursing homes increased as their share of elderly in the total population increased. That correlation did not hold for whites, who did not appear to be obliged to choose nursing homes as they age.

In New York, a top 10 metropolitan area for blacks, Hispanics and Asians, nursing home residents from these groups increased 22 percent, 84 percent and 40 percent, respectively. In Los Angeles/Long Beach, the increases were 1 percent for blacks, 41 percent for Hispanics and 56 percent among Asians.

With different rates in different cities, the challenge facing policymakers is not only national, but also local, the researchers said.

"Efforts to reduce disparities should target both communities and facilities with high concentrations of minority residents," they wrote in Health Affairs.

In addition to Feng, the paper's other authors at Brown are Mary Fennell, professor of sociology; Denise Tyler, gerontology researcher; Melissa Clark, associate professor of community health; and Vincent Mor, the Florence Pirce Grant Professor of Health Services, Policy, and Practice.

The National Institute on Aging supported the research.


Story Source:

The above story is based on materials provided by Brown University. Note: Materials may be edited for content and length.


Journal Reference:

  1. Z. Feng, M. L. Fennell, D. A. Tyler, M. Clark, V. Mor. Growth Of Racial And Ethnic Minorities In US Nursing Homes Driven By Demographics And Possible Disparities In Options. Health Affairs, 2011; 30 (7): 1358 DOI: 10.1377/hlthaff.2011.0126

Cite This Page:

Brown University. "New disparity in US nursing homes: Whites leave, minorities enter." ScienceDaily. ScienceDaily, 7 July 2011. <www.sciencedaily.com/releases/2011/07/110707111033.htm>.
Brown University. (2011, July 7). New disparity in US nursing homes: Whites leave, minorities enter. ScienceDaily. Retrieved July 22, 2014 from www.sciencedaily.com/releases/2011/07/110707111033.htm
Brown University. "New disparity in US nursing homes: Whites leave, minorities enter." ScienceDaily. www.sciencedaily.com/releases/2011/07/110707111033.htm (accessed July 22, 2014).

Share This




More Health & Medicine News

Tuesday, July 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Courts Conflicted Over Healthcare Law

Courts Conflicted Over Healthcare Law

AP (July 22, 2014) Two federal appeals courts issued conflicting rulings Tuesday on the legality of the federally-run healthcare exchange that operates in 36 states. (July 22) Video provided by AP
Powered by NewsLook.com
Why Do People Believe We Only Use 10 Percent Of Our Brains?

Why Do People Believe We Only Use 10 Percent Of Our Brains?

Newsy (July 22, 2014) The new sci-fi thriller "Lucy" is making people question whether we really use all our brainpower. But, as scientists have insisted for years, we do. Video provided by Newsy
Powered by NewsLook.com
Scientists Find New Way To Make Human Platelets

Scientists Find New Way To Make Human Platelets

Newsy (July 22, 2014) Boston scientists have discovered a new way to create fully functioning human platelets using a bioreactor and human stem cells. Video provided by Newsy
Powered by NewsLook.com
Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins