In metropolitan areas across the United States, blacks are more likely than whites to live in poor-quality nursing homes, according to results of a new study published in the September/October issue of Health Affairs.
The problem is most acute in the Midwest. Researchers found that 10 of the 20 nursing homes with the greatest disparities in quality of care were located in Indiana, Michigan, Ohio, and Wisconsin. The metropolitan area with the greatest disparity in care is Milwaukee, where blacks are more than twice as likely as whites to live in a nursing home with significant inspection deficiencies, substantial staffing shortages, and financial problems.
According to the research, blacks make up about 15 percent of all U.S. nursing home residents, yet around 60 percent of black residents were concentrated in less than 10 percent of those homes. The 10 percent of U.S. nursing homes in which blacks reside tend to be in the bottom quartile with respect to quality, the study showed.
The study authors recommended several policy changes that could potentially eliminate the disparities highlighted by the study, including improvements to payment structures for nursing homes with a high proportion of Medicaid residents, and closing the gap between the amount paid to nursing homes by Medicaid and private payers.
