A recent analysis of Medicare claims data found that Black and Hispanic older adults living with dementia have greater healthcare costs, according to the National Institutes of Health (NIH).

Researchers led by Tufts Medical Center studied healthcare and Medicare claims data from 2000 to 2016 for people aged 65 and older with a dementia diagnosis. At the time of their diagnosis, older adults in the study were 81 years old on average, and slightly more than half, 61%, were women.

Total Medicare expenses were tracked through four phases: The year prior to diagnosis, the first year following a dementia diagnosis, ongoing care, and the last year of life. Researchers found that across all four phases, Medicare expenditures averaged $165,730 for Black older adults, $160,442 for Hispanic beneficiaries, and $136,326 for white beneficiaries.

Average Medicare expenses in the year prior to diagnosis for Black older adult beneficiaries totaled $26,337, followed by $23,176 for Hispanic beneficiaries and $21,399 for white beneficiaries. In the year following diagnosis, Medicare expenditures for Black beneficiaries were $20,429, compared to $18,244 for white beneficiaries and $17,182 for Hispanic older adults, the analysis found.

The final year of life was the most costly for all three groups, but Medicare spending for Black ($51,294) and Hispanic ($47,469) beneficiaries remained “far above” that of white beneficiaries, who incurred $39,499 in Medicare expenses, according to the researchers.

“These differences, especially in the last year of life, were mostly due to greater use of high-cost medical services such as the emergency department, inpatient hospital stays, and intensive care,” the report states.

The results of the analysis also “raised questions about possible racial and ethnic disparities in dementia care coordination, frequency of follow-up visits, and communication about and access to different care options, especially at the end of life.”

These disparities in Medicare expenses tied to dementia care are the latest in a series of research outlining the racial disparities in the senior living industry.

In 2020, NIH-funded research found that Black older adults were less likely to move into an assisted living community and more likely to move into a nursing home compared to white older adults. The disparity in assisted living and nursing care can be explained by various enabling and need factors—including economic status, pre-existing health conditions, and access to care.

This comes as the senior housing industry has grappled with expanding diversity, equity, and inclusion (DEI) initiatives within their organizations.

The 2023 Kelly Global Re:Work report found that DEI initiatives and progress around inclusion have slowed. The report found that the prevalence of senior managers holding open conversations on inclusion dropped from 30% in 2022 to 21% in 2023.

“I think what we saw in the last four or so years, within senior living is … many providers waking up to the notion that we weren’t necessarily serving in a very diverse or inclusive way that was demonstrative,” said Marvell Adams, Jr., co-founder and CEO of W. Lawson Company, in an interview with SHN earlier this year. “I think the push forward wasn’t as big of a push as some other institutions may have seen, industry-wise.”