Comparison of African American and Caucasian Individuals in Nursing Homes: Analysis on the 2004 NNHS

Background: Racial or ethnic minorities, especially African Americans were an increasing share of the nursing home population. Little is known about this population relative to Caucasian residents.

Objective: We compare the characteristics of residents by racial group and length of stay.

Data and Methods: Data from the 2004 National Nursing Home Survey are used. Descriptive methods are used to compare the study groups of interest.

Findings: Compared to their Caucasian counterparts, African Americans had a higher portion of younger residents (age 31 to 64) (25.32% vs. 11.67%). Among the short-stay residents (less than 30 days), African Americans were less often married than Caucasians (17.31% vs. 31.01%). African Americans were less likely to utilize private insurance as a source of payment (15.65% vs. 31.36%). They were more likely to use the Medicaid (27.89% vs. 12.19%), and the difference becomes more obvious among the longer-stay residents (more than 180 days, which is eligible for “Money Follows the Person Demonstration”) (57.54% vs. 36.41%). African Americans were less likely to own a private house prior to admission (26.10% vs. 31.24%), but more likely to be admitted from acute-care facilities (38.55% vs. 34.09%) and psychiatric hospitals (2.20% vs. 1.83%). African Americans were more likely to live with families prior to the admission (55.26% vs. 48.60%), and they were less likely to have functional limitations.

Implications: In light of the Olmstead decision and subsequent policy initiatives including “Money Follows the Person Demonstration”, these findings have implications for identifying and assisting nursing home transitions for minority individuals.