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. 2020 Oct 16;75(9):1972-1982.
doi: 10.1093/geronb/gbz141.

Black-White Disparities in Moves to Assisted Living and Nursing Homes Among Older Medicare Beneficiaries

Meghan Jenkins Morales  1 , Stephanie A Robert  1
Affiliations

Black-White Disparities in Moves to Assisted Living and Nursing Homes Among Older Medicare Beneficiaries

Meghan Jenkins Morales et al. J Gerontol B Psychol Sci Soc Sci. .

Abstract

Objectives: Investigate black-white disparities in older adults' moves to assisted living and nursing homes and draw from the Andersen Healthcare Utilization Model to test explanations for any disparities.

Methods: Data are from a nationally representative sample of older community-dwelling Medicare beneficiaries from the 2015 (N = 5,212) National Health and Aging Trends Study (NHATS). We use stepwise multinomial logistic regression to examine black-white disparities in moves out of community housing to assisted living or a nursing home over 2 years, before and after adjusting for predisposing (age, gender), enabling (income, housing tenure, Medicaid, living arrangement) and need (activities of daily living [ADL] limitation, physical capacity, self-rated health, and dementia) factors.

Results: Black older adults are less likely to move to assisted living and are more likely to move to a nursing home compared to white older adults. Black-white disparities in moves to nursing homes are explained by black-white differences in enabling and need factors, whereas black-white disparities in moves to assisted living remain even after adjusting for enabling and need factors.

Discussion: Unmeasured factors related to systemic racism (e.g., residential racial segregation, racial discrimination) and/or black-white differences in care preferences might further explain black-white disparities in moves to assisted living and warrant further investigation.

Keywords: Living environments; Long-term care; Minority aging (race/ethnicity); Residential relocation.

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References

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