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Black U.S. residents often receive poorer quality nursing home care than Whites, study finds

Sep 12, 2007-- Blacks in the U.S. are more likely to receive lower-quality nursing home care than whites, according to a study published in the September/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.

According to the study, Milwaukee, Wis., had the largest disparity in quality of care for blacks and whites in nursing homes, and 10 of the 20 facilities with the largest disparities were located in Indiana, Michigan, Ohio and Wisconsin.

The study found that the disparity in quality of care for blacks and whites in nursing homes related to racial segregation. Nursing homes in Cleveland were the most segregated, followed by Gary, Ind.; Milwaukee; Detroit; Indianapolis; Chicago; St. Louis; Harrisburg, Pa.; Toledo, Ohio; and Cincinnati (Carey, CQ HealthBeat, 9/11).
 

The study also found that blacks were nearly three times as likely as whites to live in nursing homes with a large proportion of Medicaid beneficiaries, and such facilities are more likely to have limited staff, which can lead to lower quality of care. In addition, blacks were almost twice as likely as whites to live in nursing homes that lost their ability to participate in Medicare and Medicaid because of low quality of care, the study found. Blacks also were almost 1.5 times as likely as whites to live in nursing homes cited for violation that could result in immediate 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 whites in nursing homes, the study recommended increased reimbursements to nursing homes with a large proportion of Medicaid beneficiaries and a reduction in the gap between reimbursements to the facilities from Medicaid and private health insurers, and broader regional planning to address the issue. Mor said, "Blacks and whites aren't getting different care in the same nursing homes. They're getting different care because they live in different nursing homes," adding, "In the same urban areas, blacks are more likely to be concentrated in substandard nursing homes -- homes with smaller budgets, smaller staffs and 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). The study is available online.