Minority Presence Increases in Nursing Homes, Whites Choosing Other Options

Many Americans are choosing alternatives to nursing homes as they get older, which means that nursing homes are getting smaller, and the demographics are starting to shift. A new study shows that Hispanic, Asian, and African-American presence in nursing homes has increased significantly in the past decade or so, while the number of Caucasians has shrunk.

Brown University researchers published a study in the July edition of Health Affairs, saying this trend stems from changing demographics and disparities in what people can afford. While at first glance it may seem that minorities are gaining greater access to nursing home care, this growth is more likely due to the fact that blacks, Hispanics, and Asians aren’t as able to afford more desirable forms of health care as wealthier whites are, says Zhanlian Feng, assistant professor of community health in the Warren Alpert Medical School of Brown University.

“Seemingly, we are closing the gap in terms of minority access to nursing home beds, but I don’t think that is something to celebrate,” says Feng. “They are really the last resort. Most elders would rather stay in their homes, or some place like home, but not a nursing home unless they have to.”


This appears to be true for whites, whose presence in nursing homes has gone down 10.2% nationwide, compared to a more than 50% growth rate for both Hispanics and Asians, and a 10.8% increase for blacks. Overall, the number of residents in nursing homes has gone down 6.1% between 1999 and 2008, to just over 1.2 million, says Feng.


In addition to economic and racial demographics, says Feng, there’s also disparity between the quality of care received by residents depending on geographic location. Nursing homes located among high minority populations are more likely to shut down, or give lesser quality care, whereas more desirable forms of long term care, such as assisted living facilities, are generally built in higher-income areas.


Researchers for the study found that the representation of blacks, Hispanics and Asians in nursing homes increased as their share of elderly in the total population increased, while the same did not hold true for whites. It appears that minorities often have no choice but to enter a nursing home as they age, the Brown study revealed, while whites who have more money also have more options.

In order to “rebalance” this trend in nursing home demographics, Feng mentions shifts in Medicaid funding to support home and community-based service so that minorities are afforded alternative options for care.

Written by Alyssa Gerace