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Little Mixing of Black, White Seen in Elderly Care

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  • Little Mixing of Black, White Seen in Elderly Care

    Little Mixing of Black, White Seen in Elderly Care
    Mon Sep 2, 1:53 PM ET
    By Merritt McKinney

    NEW YORK (Reuters Health) - When it comes to nursing homes and other types of long-term care for the elderly, blacks and whites lead largely separate lives, new research suggests.

    In a study of 220 US nursing homes, retirement centers and assisted-living facilities in four states, nearly all whites lived in centers that were mainly white, while the majority of African Americans lived in facilities that were mostly black.

    In fact, in two types of facilities, assisted-living or retirement centers with fewer than 16 residents and traditional nursing homes, most facilities did not have a single African-American resident, according to a report on the findings in the August issue of the American Journal of Public Health, journal of the American Public Health Association ( news - web sites).

    But more studies are needed, researchers say, to understand the causes of the racial differences and determine whether they have a negative impact on the care that African Americans receive.

    "Through our research we are beginning to document the racial disparity in healthcare that exists for the African-American elderly and how this disparity may be lessened by effectual policy change," the lead author of the report, Dr. Daniel L. Howard of Shaw University in Raleigh, North Carolina, told Reuters Health.

    "Future research," Howard said, "must examine if facilities are reacting to racial, social or economic factors with regard to the admission of African Americans into long-term care settings."

    According to Howard, changes are needed in the admission criteria of facilities and, perhaps, in the reimbursement levels received by homes and centers.

    While research is needed to make sure that African Americans receive adequate care, "We need to avoid a gut reaction that racial separation is necessarily bad, because older people value being with others whose cultural background they share," according to Dr. Philip D. Sloane of the University of North Carolina at Chapel Hill, one of the study's co-authors.

    "The challenge," according to Sloane, "is to assure that quality is equal across a variety of facility types."

    Another co-author of the study, Dr. Sheryl Zimmerman of the University of North Carolina at Chapel Hill, agreed that it is too soon to say that African Americans receive lower quality long-term care than whites.

    "While access to different kinds of settings definitely differs for people with less money," she told Reuters Health, "there is no real evidence to cause alarm about the quality provided to minorities. The real issue is whether the care they receive is culturally sensitive (and) consistent with what they and their families want."

    Zimmerman added, "The fact that racial separation occurs may actually be a good thing in that regard."

    The study included long-term care facilities in Florida, Maryland, New Jersey and North Carolina. There were no African-American residents at 58% of facilities, and African Americans made up no more than a quarter of the residents at 27% of long-term care centers.

    The percentage of African-American residents varied among different types of facilities, ranging from 24% at traditional nursing homes to just 4% to 5% in assisted-living or retirement centers. The newest type of assisted-living facilities, which are growing more rapidly than any other type of long-term care facility, had the lowest percentage of African-American residents, raising concerns that racial disparities may be increasing, according to the report.

    Not surprisingly, perhaps, the proportion of African-American residents in a facility was related to the size of the black community in the surrounding area. Facilities with a higher proportion of African Americans were also more likely to admit mentally retarded residents or individuals with problems walking. These facilities also tended to have poorer cleanliness, maintenance and lighting scores.

    SOURCE: American Journal of Public Health 2002;92:1272-1277.

    "Experience teaches that, of all the emotions, fear stands alone in its power to move us, or to capture us in its grip forever. In a world of terrors, there is nothing more fearsome that the unknown...especially when what is unknown is ourselves." Outer Limits(Fear Itself)

  • #2
    Just an fyi

    Thought I sound off on this briefly, one reason from my experiences for the disparity is that traditionally African American families tend to take care of the elderly in their homes and not send them to nursing homes. Of course it does happen but this is a cultural phenom, I believe you see it in other cultures as well - native american, asian, hispanic come to mind. Just my 2 cents.