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 this month 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.
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.
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.
