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Separate and Unequal Access and Quality of Care in Nursing Homes: Transformation of the Long Term Care Industry and Implications of the Research Program for Aging Hispanics

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Aging, Health, and Longevity in the Mexican-Origin Population

Abstract

This chapter will review several important themes concerning long term care availability, quality of care, and market changes, with special reference to frail aging Hispanics. This review will be based on work performed by Brown University researchers under the aegis of an NIA Program Project, “Shaping Long Term Care in America” (1PO1 AG027296-01A1). Our review will include a brief historical overview of patterns in nursing home use, more recent analyses on racial/ethnic disparities in care access, and current trends in the composition of nursing home residents. We will also examine differences in nursing home performance for homes with different proportions of Hispanic and black residents. Finally, we will review results from a recent study of nursing home closure, which clearly shows differences in closure rates correlated with larger proportions of Hispanic and black residents. Implications of these trends will be discussed for the future of long term care availability and the needs of frail Hispanic elderly.

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Notes

  1. 1.

    A more extensive treatment of the history of nursing homes and civil rights enforcement was presented in Smith (1999), pp. 236–275.

References

  • Alon, S., & Haberfeld, Y. (2007). Labor force attachment and the evolving wage gap between white, black, and Hispanic young women. Work and Occupations, 34(4), 369–398.

    Article  Google Scholar 

  • Angel, J., & Hogan, D. (2004). Population aging and diversity in a new era. In K. Whitfield (Ed.), Closing the gap: Improving the health of minority elders in the new millennium. (pp. 1–12). Washington, DC: Gerontological Society of America.

    Google Scholar 

  • Angel, J.L., & Angel, R.J. (2006). Minority group status and healthful aging: Social structure still matters. American Journal of Public Health, 96(7), 1152–1159.

    Article  Google Scholar 

  • Angel, J. L., Angel, R. J., Aranda, M. P., & Miles, T. P. (2004). Can the family still cope? Journal of Aging and Health, 16(3), 338–354.

    Article  Google Scholar 

  • Angel, J. L., Angel, R. J., McClellan, J. L., & Markides, K. S. (1996). Nativity, declining health, and preferences in living arrangements among elderly Mexican Americans: Implications for long-term care. The Gerontologist, 36(4), 464–473.

    Article  Google Scholar 

  • Angel, R. J., & Angel, J. L. (1996). The extent of private and public health insurance coverage among adult Hispanics. The Gerontologist, 36(3), 332–340.

    Article  Google Scholar 

  • Angel, R. J., & Angel, J. L. (1997). Health service use and long-term care among Hispanics. In K. S. Markides & M. Miranda (Eds.), Minorities, aging, and health (pp. 343–366). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Angel, R. J., Angel, J. L., & Hill, T. D. (2009). Subjective control and health among Mexican-origin elders in Mexico and the United States: Structural considerations in comparative research. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 64(3), 390–401.

    Article  Google Scholar 

  • Angelelli, J., Mor, V., Intrator, O., Feng, Z., & Zinn, J. (2003). Oversight of nursing homes: Pruning the tree or just spotting bad apples? The Gerontologist, 43(suppl 2), 67–75.

    Article  Google Scholar 

  • Burton, L. M., Bonilla-Silva, E., Ray, V., Buckelew, R., & Hordge Freeman, E. (2010). Critical race theories, colorism, and the decade’s research on families of color. Journal of Marriage and Family, 72(3), 440–459.

    Article  Google Scholar 

  • Castle, N. G. (2005a). Nursing home closures and quality of care. Medical Care Research and Review, 62(1), 111–132.

    Article  Google Scholar 

  • Castle, N. G. (2005b). Nursing home closures, changes in ownership, and competition. Inquiry, 42(3), 281–292.

    Google Scholar 

  • Castle, N. G., & Banaszak-Holl, J. (1997). Top management team characteristics and innovation in nursing homes. The Gerontologist, 37(5), 572.

    Article  Google Scholar 

  • Castle, N. G., Engberg, J., Lave, J., & Fisher, A. (2009). Factors associated with increasing nursing home closures. Health Services Research, 44(3), 1088–1109.

    Article  Google Scholar 

  • Department of Health and Human Services. (2006). Nursing home enforcement: Application of mandatory remedies. No. OEI-06-03-00410). Available at http://oig.hhs.gov/oei/reports/oei-06-03-00410.pdf: Office of the Inspector General.

    Google Scholar 

  • Duncan, B., Hotz, V. J., & Trejo, S. J. (2006). Hispanics in the US labor market. In M. Tienda, & F. Mitchell (Eds.), Hispanics and the future of America (pp. 228–290). Washington, DC: National Academy Press.

    Google Scholar 

  • Dunlop, B. D. (1979). The growth of nursing home care. Lexington, MA: Lexington Books.

    Google Scholar 

  • Feng, Z., Fennell, M.L., Tyler, D.A., Clark, M., & Mor, V. (2011a). Growth of racial and ethnic minorities in US nursing homes driven by demographics and possible disparities in options. Health Affairs 30(7):1358–1365.

    Article  Google Scholar 

  • Feng, Z., Lepore, M., Clark, M. A., Tyler, D., Smith, D. B., Mor, V., & Fennell, M. L. (2011b). Geographic concentration and correlates of nursing home closures: 1999–2008. Archives of Internal Medicine, archinternmed/2010.492 v1, E1–E8.

    Google Scholar 

  • Fennell, M. L., Feng, Z., Clark, M. A., & Mor, V. (2010). Elderly Hispanics more likely to reside in poor-quality nursing homes. Health Affairs, 29(1), 65–73.

    Article  Google Scholar 

  • Flores, Y. G., Hinton, L., Barker, J. C., Franz, C. E., & Velasquez, A. (2009). Beyond familism: A case study of the ethics of care of a Latina caregiver of an elderly parent with dementia. Health Care for Women International, 30(12), 1055–1072.

    Article  Google Scholar 

  • Fuller-Thomson, E., Nuru-Jeter, A., Minkler, M., & Guralnik, J. M. (2009). Black – White disparities in disability among older Americans. Journal of Aging and Health, 21(5), 677–698.

    Article  Google Scholar 

  • Gambassi, G., Lapane, K. L., Sgadari, A., Carbonin, P., Gatsonis, C., Lipsitz, L. A.,... Bernabei, R. (2000). Effects of angiotensin-converting enzyme inhibitors and digoxin on health outcomes of very old patients with heart failure. Archives of Internal Medicine, 160(1), 53.

    Google Scholar 

  • Harrington, C., Zimmerman, D., Karon, S. L., Robinson, J., & Beutel, P. (2000). Nursing home staffing and its relationship to deficiencies. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 55(5), S278.

    Article  Google Scholar 

  • Ibarra, M.L. (2003). The tender trap: Mexican immigrant women and the ethics of elder care work. Aztlán: A Journal of Chicano Studies, 28(2), 87–113.

    Google Scholar 

  • Institute of Medicine. (1981). Health care in the context of civil rights. Washington, DC: National Academy Press.

    Google Scholar 

  • Institute of Medicine. (2001). Improving the quality of long-term care. Washington, DC: National Academies Press.

    Google Scholar 

  • Kaiser Family Foundation. (2002). Nursing home quality: State agency survey funding and performance. Issue Paper. The Kaiser Commission on Medicaid and the Uninsured.

    Google Scholar 

  • Kemper, P., Komisar, H. L., & Alecxih, L. (2005). Long-term care over an uncertain future: What can current retirees expect? Inquiry, 42(4), 335–350.

    Article  Google Scholar 

  • Konetzka, R. T., & Werner, R. M. (2009). Review: Disparities in long-term care. Medical Care Research and Review, 66(5), 491–521.

    Article  Google Scholar 

  • Koyanagi, C., Kaiser Commission on Medicaid and the Uninsured, & Henry J. Kaiser Family Foundation. (2007). Learning from history: Deinstitutionalization of people with mental illness as precursor to long-term care reform. Henry J. Kaiser Family Foundation.

    Google Scholar 

  • Linton v. Commissioner of Health and Environment, FED App. 0278P (6th Cir.), 1995.

    Google Scholar 

  • Mirotznik, J., & Kamp, L. L. (2000). Cognitive status and relocation stress. The Gerontologist, 40(5), 531–539.

    Article  Google Scholar 

  • Mor, V. (2004). A comprehensive clinical assessment tool to inform policy and practice: Applications of the minimum data set. Medical Care, 42(suppl. III), 50.

    Google Scholar 

  • Mor, V., Berg, K., Angelelli, J., Gifford, D., Morris, J., & Moore, T. (2003). The quality of quality measurement in US nursing homes. The Gerontologist, 43(suppl 2), 37.

    Article  Google Scholar 

  • Mor, V., Zinn, J., Angelelli, J., Teno, J. M., & Miller, S. C. (2004). Driven to tiers: Socioeconomic and racial disparities in the quality of nursing home care. Milbank Quarterly, 82(2), 227–256.

    Article  Google Scholar 

  • Mukamel, D. B., & Spector, W. D. (2003). Quality report cards and nursing home quality. The Gerontologist, 43(suppl 2), 58.

    Article  Google Scholar 

  • National Center for Health Statistics. (2010). Health, United States, 2009: With special feature on medical technology. Hyattsville, MD: National Center for Health Statistics.

    Google Scholar 

  • National Center for Health Statistics (US), & National Center for Biotechnology Information (US). (2007). Health, United States 2007 [electronic resource]: With chartbook on trends in the health of Americans. Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.

    Google Scholar 

  • Ottenbacher, K. J., Graham, J. E., Al Snih, S., Raji, M., Samper-Ternent, R., Ostir, G. V., & Markides, K. S. (2009). Mexican Americans and frailty: Findings from the Hispanic established populations epidemiologic studies of the elderly. American Journal of Public Health, 99(4), 673–679.

    Article  Google Scholar 

  • Seidman, B. (2002). A briefing chartbook on shortfalls in medicaid funding for nursing home care. Report Prepared for the American Health Care Association

    Google Scholar 

  • Smith, D. B. (1999). Health care divided: Race and healing a nation. Ann Arbor: University of Michigan Press.

    Google Scholar 

  • Smith, D. B., Feng, Z., Fennell, M. L., Zinn, J. S., & Mor, V. (2007). Separate and unequal: Racial segregation and disparities in quality across US nursing homes. Health Affairs, 26(5), 1448–1458.

    Article  Google Scholar 

  • Smith, D. B., Feng, Z., Fennell, M. L., Zinn, J., & Mor, V. (2008). Racial disparities in access to long-term care: The illusive pursuit of equity. Journal of Health Politics, Policy and Law, 33(5), 861–881.

    Article  Google Scholar 

  • Stevenson, D. G., & Grabowski, D. C. (2010). Sizing up the market for assisted living. Health Affairs, 29(1), 35–43.

    Article  Google Scholar 

  • Strahan, G. W. (1997). An overview of nursing homes and their current residents: Data from the 1995 national nursing home survey. US Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.

    Google Scholar 

  • Taylor v. White. 1990, E.D. Pennsylvania.

    Google Scholar 

  • U.S. Census Bureau. (2007). Census bureau releases new data on residents of adult correctional facilities, nursing homes, and other group quarters. Washington, DC: September 27.

    Google Scholar 

  • United States Commission on Civil Rights. (1971). The federal civil rights enforcement effort: One year later. Washington, DC: The Commission.

    Google Scholar 

  • Zinn, J., Mor, V., Feng, Z., & Intrator, O. (2009). Determinants of performance failure in the nursing home industry. Social Science & Medicine, 68(5), 933–940.

    Article  Google Scholar 

  • Zinn, J., Spector, W., Hsieh, L., & Mukamel, D. B. (2005). Do trends in the reporting of quality measures on the nursing home compare web site differ by nursing home characteristics? The Gerontologist, 45(6), 720–730.

    Article  Google Scholar 

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Authors and Affiliations

  1. Brown University, Providence, RI, USA

    Mary L. Fennell, Melissa Clark, Zhanlian Feng, Vince Mor & Denise A. Tyler

  2. Temple University and Drexel University, Philadelphia, PA, USA

    David Barton Smith

Authors
  1. Mary L. Fennell
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  2. Melissa Clark
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  3. Zhanlian Feng
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  4. Vince Mor
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  5. David Barton Smith
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  6. Denise A. Tyler
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Corresponding author

Correspondence to Mary L. Fennell .

Editor information

Editors and Affiliations

  1. Dept. Sociology, University of Texas, Austin, University Station 1, Austin, 78712, Texas, USA

    Jacqueline L. Angel

  2. , Center for Policy Research on Aging, University of California, Los Angeles, Public Affairs Building 5341, Los Angeles, 90095, California, USA

    Fernando Torres-Gil

  3. University of Texas Medical Branch at Ga, Rte. 1153 1.128 Ewin, Galveston, 77555, Texas, USA

    Kyriakos Markides

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Fennell, M.L., Clark, M., Feng, Z., Mor, V., Smith, D.B., Tyler, D.A. (2012). Separate and Unequal Access and Quality of Care in Nursing Homes: Transformation of the Long Term Care Industry and Implications of the Research Program for Aging Hispanics. In: Angel, J., Torres-Gil, F., Markides, K. (eds) Aging, Health, and Longevity in the Mexican-Origin Population. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-1867-2_16

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