A State Level Profile of Working-Age and Older Adults Admitted to Nursing Homes

Background: Older working-age adults are an increasing share of the nursing home population. Methods: MDS assessment data for 2000 and 2008 are used to explore sociodemographic, residential, medical and psychiatric characteristics of newly admitted working-age adults (31-64) relative to their older counterparts (65+). Findings: The working-age population is substantially more male than its older counterpart. Black working-age adults are over-represented in nursing homes across 45 states and the District of Columbia, relative to their share of the state population. In contrast, Hispanic working-age adults are underrepresented across the states, as are Hispanic older adults. Chronic conditions, including diabetes, renal failure, COPD, asthma and circulatory/heart disorders appear to contribute to the increasing presence of older working-age adults, as does an increasing presence of psychiatric conditions at admission. Conclusions: The extent to which the over-representation of working-age Blacks in nursing homes relates to a greater prevalence of chronic disease and their complications, socioeconomic factors such as insurance coverage, or other factors (e.g., disparities) is important to examine. Research that explores whether working-age Black men are at greater risk for nursing home use is also important, given the greater share of males among the working-age nursing home population. With regard to the underrepresentation of Hispanics, research indicates that even when Hispanics and non-Hispanic Blacks are socioeconomically similar, many health indicators among Hispanics are more similar to non-Hispanic Whites. Continuing to examine this “epidemiologic paradox” is important, given Hispanics' growing share of the US population.