Frochen Stephen, Ailshire Jennifer, Rodnyansky Seva
Leonard Davis School of Gerontology, University of Southern California, Los Angeles, United States; USC Davis School of Gerontology, 3715 McClintock Ave., Los Angeles, CA, 90089.
Leonard Davis School of Gerontology, University of Southern California, Los Angeles, United States.
Local Environ. 2019;24(3):274-288. doi: 10.1080/13549839.2018.1564254. Epub 2019 Jan 4.
Residential care has increased in number of facilities and has grown in density in urban areas, yet it is disproportionately dispersed in cities and only beginning to meet the current long-term care need of older adults as an alternative to institutional and in-home care. California State Department of Social Services residential care facility data were linked with Los Angeles County census tract data to examine the spatial distribution of facilities through hot spot analysis of small and large clusters of facilities and zero-inflated negative binomial regression of census tract facility counts on older age and race groups, older disabled adults, and older adults in poverty in the area. The results show clusters of large facilities west of downtown Los Angeles and clusters of small facilities in the northern suburbs of the city in the San Fernando Valley. Increases in pre- and early-retired adults and older Hispanics in census tracts are associated with the greatest decreases in facility tract capacity in the area, whereas increases in the oldest old and older disabled adults are associated with the greatest increases. Understanding spatial disparities in residential care can help local agencies and developers plan and partner in more intentional and equitable development of facilities. The greatest opportunity for such development may lie in institutional tools for eldercare facility development such as the eldercare facility ordinance of Los Angeles and development of board and care facilities in residential zones of Los Angeles and other cities.
城市地区的养老机构数量增加且分布更为密集，但这些机构在城市中的分布并不均衡，作为机构养老和居家养老的替代方式，它们才刚刚开始满足老年人当前的长期护理需求。加利福尼亚州社会服务部的养老机构数据与洛杉矶县普查区数据相关联，通过对大小不同的养老机构集群进行热点分析以及对普查区养老机构数量与该地区老年人群体、种族群体、老年残疾成年人和贫困老年人进行零膨胀负二项回归，来研究养老机构的空间分布。结果显示，在洛杉矶市中心以西有大型养老机构集群，在圣费尔南多谷市北部郊区有小型养老机构集群。普查区中退休前和提前退休的成年人以及老年西班牙裔人口的增加与该地区养老机构容纳能力的最大降幅相关，而高龄老年人和老年残疾成年人的增加则与最大增幅相关。了解养老机构的空间差异有助于地方机构和开发商更有针对性、更公平地规划和合作建设养老设施。这种发展的最大机遇可能在于养老设施开发的制度工具，如洛杉矶的养老设施条例以及在洛杉矶和其他城市的住宅区建设寄宿护理设施。
