School of Social Work, University of Wisconsin-Madison.
J Gerontol B Psychol Sci Soc Sci. 2020 Oct 16;75(9):1972-1982. doi: 10.1093/geronb/gbz141.
Investigate black-white disparities in older adults' moves to assisted living and nursing homes and draw from the Andersen Healthcare Utilization Model to test explanations for any disparities.
Data are from a nationally representative sample of older community-dwelling Medicare beneficiaries from the 2015 (N = 5,212) National Health and Aging Trends Study (NHATS). We use stepwise multinomial logistic regression to examine black-white disparities in moves out of community housing to assisted living or a nursing home over 2 years, before and after adjusting for predisposing (age, gender), enabling (income, housing tenure, Medicaid, living arrangement) and need (activities of daily living [ADL] limitation, physical capacity, self-rated health, and dementia) factors.
Black older adults are less likely to move to assisted living and are more likely to move to a nursing home compared to white older adults. Black-white disparities in moves to nursing homes are explained by black-white differences in enabling and need factors, whereas black-white disparities in moves to assisted living remain even after adjusting for enabling and need factors.
Unmeasured factors related to systemic racism (e.g., residential racial segregation, racial discrimination) and/or black-white differences in care preferences might further explain black-white disparities in moves to assisted living and warrant further investigation.
调查老年人搬入辅助生活和护理院的黑-白差异，并借鉴安德森医疗保健利用模型来检验任何差异的解释。
数据来自于全国代表性的 2015 年（N=5212）国家健康与老龄化趋势研究（NHATS）中居住在社区的老年医疗保险受益人样本。我们使用逐步多项逻辑回归来检验在调整了倾向性（年龄、性别）、能力（收入、住房所有权、医疗补助、居住安排）和需求（日常生活活动[ADL]限制、身体能力、自我评估健康和痴呆）因素前后，黑人老年人搬离社区住房进入辅助生活或护理院的黑-白差异。
与白人老年人相比，黑人老年人更不可能搬入辅助生活，更有可能搬入护理院。护理院搬入的黑-白差异可以用能力和需求因素来解释，而辅助生活搬入的黑-白差异在调整了能力和需求因素后仍然存在。
与系统性种族主义（例如，居住种族隔离、种族歧视）相关的未测量因素和/或护理偏好的黑-白差异可能进一步解释辅助生活搬入的黑-白差异，并值得进一步研究。
