On the heels of our post on food deserts, Family Inequality‘s Philip Cohen posted about “care vacuums.” In this case the research is referring to the shrinking number of nursing homes in the U.S., leaving people farther and farther away from the nearest nursing home.
Zhanlian Feng and colleagues found that between 1999 and 2008 we lost about 5% of all nursing home beds and these losses were disproportionately in neighborhoods populated by Blacks and Latinos. The maps below overlays the racial composition of neighborhoods (darker = higher percent minority) with open nursing homes (in black) and nursing home closures (in red). Both seem to be disproportionately in minority neighborhoods, but Feng et al. showed that the closures are even more so.
Here’s Chicago as an example:
Just as food deserts make it more difficult for people without access to personal, reliable transportation to get fresh, affordable food, care vacuums make it more difficult for those same people — disproportionately Black and Latino, and disproportionately poor — to visit loved ones in nursing homes. Ironically, this is despite the fact that use of nursing homes by minorities is rising and, among whites, falling.
Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.
Comments 4
Scapino — January 21, 2011
From the article:
"These studies have generally identified poor financial and quality performance as the most important and consistent antecedents of nursing home closure. In particular, closed facilities were more likely to have experienced financial troubles, lower occupancy, and a less profitable payer mix than nonclosed facilities (eg, more Medicaid-supported and fewer private-paying or Medicare-supported residents); they were also likely to have received more inspection deficiency citations prior to closure. These attributes are typical of facilities ranked in the lower tier of all nursing home providers based on available resources and quality-of-care problems."
The problem isn't that nursing homes in minority areas are closing (these homes are often quite horrible, and the patients would be better off living farther from their relatives), it's that they suck to begin with. They suck to begin with because of the incredibly goofy nursing home payment systems that are currently in place, the incredibly tight margins forced upon Medicaid/care reliant nursing homes, the relative profitability of rehab vs long-term care services, and poor decision making among those choosing nursing homes, which is an area where education is desperately needed.
Many areas are in fact horribly over-served with licensed beds, and some states have stopped issuing new licenses entirely, creating a market for the existing licenses, and further squeezing out homes in low-income/minority areas so that more suburban homes can struggle by with 50% occupancy.
Due to the massive expenses and tight margins at skilled nursing facilities, as well as the reluctance to touch anything that can anger the eagerly voting hordes of the elderly, this problem probably isn't going anywhere.
PO — January 21, 2011
I see a problem with the maps as they appear not to take into account population density. Given that AA and Latinos tend to live in urban areas (at least in the Boston area) they also live in denser neighborhoods. So, if changes in Medicaid reimbursement lead to, say, a 5% reduction in nursing homes, then one would expect the raw NUMBER of nursing homes closed to be higher in urban/AA/Latino neighborhoods while the raw number would be lower for "white areas" outside of the urban core even though the percentage is exactly the same.
Gender Focus | The Round-Up: Jan. 24, 2011 — July 19, 2014
[…] Sociological Images looks at nursing home closures in the US and how they seem to disproportionately affect neighbourhoods with high black or Latino populations. […]
Micheal Jordan — June 27, 2023
The nearness of nursing homes is a reality that many people face as they navigate the challenges of aging or caring for elderly loved ones.
<a href="https://besttowingusa.com/cap/24-hour-towing-services-in-fort-worth-tx/"24-Hour Towing Services Fort Worth TX