The Persistence of Race and Ethnicity in the use of Long-Term Care

We examine the use of nursing homes, formal personal care, informal Activities of Daily Living (ADL) assistance, and no care to identify racial differences in their use. Using the 1987 National Medical Expenditure Survey of both nursing homes and the community, multinominal logistic regressions cont...

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Bibliographic Details
Published in:The journals of gerontology. Series B, Psychological sciences and social sciences Psychological sciences and social sciences, 1998-03, Vol.53B (2), p.S104-S112
Main Authors: Wallace, Steven P., Levy-Storms, Lene, Kington, Raynard S., Andersen, Ronald M.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging
Continental Population Groups
Ethnic Groups
Female
Health Services Accessibility
Humans
Long term health care
Long-Term Care - statistics & numerical data
Male
Minority & ethnic groups
Prejudice
Race
Social research
United States - ethnology
Utilization review
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Summary:We examine the use of nursing homes, formal personal care, informal Activities of Daily Living (ADL) assistance, and no care to identify racial differences in their use. Using the 1987 National Medical Expenditure Survey of both nursing homes and the community, multinominal logistic regressions controlled for predisposing, enabling, and need variables as well as other types of service use. Additional state-level variables make few changes in race/ethnicity parameters, indicating that race/ethnicity are not simply proxies for state-level variables. Older African Americans are less likely to use nursing homes than similar whites, with the lower institutionalization replaced by a higher use of paid home care, informal-only care, and no care. This suggests that formal in-home community care is not fully compensating for the racial differences in nursing home use. Persistent effects of race/ethnicity could be the result of culture, class, and/or discrimination that may impair equitable access to services.
ISSN:1079-5014
1758-5368
DOI:10.1093/geronb/53B.2.S104