Blacks Often Receive Poorer Quality Nursing Home Care Than Whites

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Nursing Home Care

Blacks in the U.S. are more likely to receive lower-quality nursinghome care than whites, according to a study published in theSeptember/October issue of the journal Health Affairs, CQ HealthBeat reports. The study -- led by Vincent Mor, chair of the Department of Community Health at Brown University, and funded by the Commonwealth Fund -- examined data from 2000 on 7,196 nursing homes that have more than 800,000 residents in 147 metropolitan areas nationwide.

Accordingto the study, Milwaukee, Wis., had the largest disparity in quality ofcare for blacks and whites in nursing homes, and 10 of the 20facilities with the largest disparities were located in Indiana,Michigan, Ohio and Wisconsin. The study found that the disparity inquality of care for blacks and whites in nursing homes related toracial segregation. Nursing homes in Cleveland were the mostsegregated, followed by Gary, Ind.; Milwaukee; Detroit; Indianapolis;Chicago; St. Louis; Harrisburg, Pa.; Toledo, Ohio; and Cincinnati(Carey, CQ HealthBeat, 9/11).

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The study alsofound that blacks were nearly three times as likely as whites to livein nursing homes with a large proportion of Medicaid beneficiaries, andsuch facilities are more likely to have limited staff, which can leadto lower quality of care. In addition, blacks were almost twice aslikely as whites to live in nursing homes that lost their ability toparticipate in Medicare and Medicaid because of low quality of care,the study found. Blacks also were almost 1.5 times as likely as whitesto live in nursing homes cited for violation that could result inimmediate injuries to residents, according to the study (Fackelmann, USA Today, 9/11).

Recommendations, Comments

In response to the disparity in quality of care for blacks and whitesin nursing homes, the study recommended increased reimbursements tonursing homes with a large proportion of Medicaid beneficiaries and areduction in the gap between reimbursements to the facilities fromMedicaid and private health insurers, and broader regional planning toaddress the issue. Mor said, "Blacks and whites aren't gettingdifferent care in the same nursing homes. They're getting differentcare because they live in different nursing homes," adding, "In thesame urban areas, blacks are more likely to be concentrated insubstandard nursing homes -- homes with smaller budgets, smaller staffsand poorer regulatory performance" (CQ HealthBeat, 9/11).

Alan Rosenbloom, president of the Alliance for Quality Nursing Home Care, said, "This study reflects disparities in the quality of care for African-American seniors, and that is simply wrong" (USA Today, 9/11).

Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser WeeklyHealth Disparities Report,search the archives, and sign up for email delivery at kaisernetwork.org/email. The Kaiser Weekly Health Disparities Report is published for kaisernetwork.org, afree service of The Henry J. Kaiser Family Foundation.

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