Is there 'white flight' from US nursing homes?

Minority elders are more frequently becoming nursing home residents compared to whites, a new study reveals. Available nursing home spots in the United States decreased over 6 percent between 1999 and 2008, while still having to accommodate 1.2 million people. A disproportionate number of residents are black, Latino and Asian, the study finds. And, compared to 1999, fewer residents are white. The study, published in Health Affairs, focuses on the top 10 metropolitan areas for each minority group. While nursing home admissions fell by 10 percent for white elders, admissions are up 11 percent for blacks, and even more for Hispanics and Asians — over 50 percent. This increase might suggest better access to nursing home care for minorities, but lead researcher, Dr. Zhanlian Feng, of Brown University, explains that it may be the opposite. The higher rates are actually due to a lack of access to more desirable care options for elders of ethnic minority groups, he says. “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 says. “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 study suggests that the growth in the number of minority elders living in nursing homes may be driven largely by demographics and disparities. Nursing homes located in areas with high proportions of ethnic minorities are often of poorer quality and more likely to shut down than those located in high-income areas, previous research has shown. The elders in assisted living facilities and even this nursing home in peoria live independently in private units, but in a supervised setting with staff members available to help and ensure their safety — are more likely in areas of high income. The result is a disparity that plays out not only economically and geographically, but also racially, Feng says, reflecting on his findings. “We know those alternatives are not equally available, accessible, or affordable to everybody — certainly not to many minority elders,” says Feng. (more…)

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